Regional
Medical Plans
Program Highlights
- Seamless enrollment through our secure online portal
- Experienced benefits professionals to assist with strategy, contributions, onboarding and enrollment
- Composite (tiered) medical rates, regardless of group size (no age-banding)
- No participation minimums on ancillary plans
- Custom employee benefit guide tailored to your plan offering
California
HMO
Plan Name | Full HMO 0/100% CA | Full HMO 1,000/100% CA | Full HMO 2,000/100% CA | Full HMO $4000/100 CA | Full HMO 5,000/100% CA |
|---|---|---|---|---|---|
Plan Type | HMO | HMO | HMO | HMO | HMO |
Provider Network | Aetna Full HMO | Aetna Full HMO | Aetna Full HMO | Aetna Full HMO | Aetna Full HMO |
Deductible | In Network | In Network | In Network | In Network | In Network |
Individual | $0 | $1,000 | $2,000 | $4,000 | $5,000 |
Family | $0 | $2,000 | $4,000 | $8,000 | $10,000 |
Coinsurance | |||||
Your Percentage | 0% | 0% | 0% | 0% | 0% |
Out of Pocket Max | |||||
Individual | $6,000 | $7,000 | $7,000 | $7,000 | $7,000 |
Family | $12,000 | $14,000 | $14,000 | $14,000 | $14,000 |
Office Visits | |||||
Preventive | $0 | $0 | $0 | $0 | $0 |
Primary Care | $30 | $40 | $40 | $55 | $40 |
Specialist | $60 | $70 | $70 | $70 | $70 |
Lab & X-Ray | 0%, ded waived/$60 | 0%, ded waived/$70 | 0%, ded waived/$70 | 0%, ded waived/$70 | 0%, ded waived/$70 |
Urgent Care | $75 | $100 | $100 | $100 | $100 |
Hospital | |||||
Inpatient | $600/day x3 | Ded & $300/day x5 | Ded & $400/day x5 | Ded & $500/day x5 | Ded & $500/day x5 |
Outpatient Surgery | $350 | Ded & $250 | Ded & $300 | Ded & $350 | Ded & $300 |
Emergency Room | $350 | Ded & $350 | Ded & $350 | Ded & $350 | Ded & $350 |
Prescriptions | |||||
Rx Deductible | $150/$450 | $150/$450 | $150/$450 | $150/$450 | $150/$450 |
Generic | $15 | $15 | $15 | $15 | $15 |
Formulary | $35 | $35 | $35 | $35 | $35 |
Non-Formulary | $60 | $60 | $60 | $60 | $60 |
Specialty | 30% Max $250 | 30% Max $250 | 30% Max $250 | 30% Max $250 | 30% Max $250 |
California
HMO - Page 2
Plan Name | AVN HMO 0/100% CA | AVN HMO 1,000/100% CA | AVN HMO 2,000/100% CA | AVN HMO $4000/100 CA | AVN HMO 5,000/100% CA |
|---|---|---|---|---|---|
Plan Type | HMO | HMO | HMO | HMO | HMO |
Provider Network | Aetna Value Network HMO | Aetna Value Network HMO | Aetna Value Network HMO | Aetna Value Network HMO | Aetna Value Network HMO |
Deductible | In Network | In Network | In Network | In Network | In Network |
Individual | $0 | $1,000 | $2,000 | $4,000 | $5,000 |
Family | $0 | $2,000 | $4,000 | $8,000 | $10,000 |
Coinsurance | |||||
Your Percentage | 0% | 0% | 0% | 0% | 0% |
Out of Pocket Max | |||||
Individual | $6,000 | $7,000 | $7,000 | $7,000 | $7,000 |
Family | $12,000 | $14,000 | $14,000 | $14,000 | $14,000 |
Office Visits | |||||
Preventive | $0 | $0 | $0 | $0 | $0 |
Primary Care | $30 | $40 | $40 | $55 | $40 |
Specialist | $60 | $70 | $70 | $70 | $70 |
Lab & X-Ray | 0%, ded waived/$60 | 0%, ded waived/$70 | 0%, ded waived/$70 | 0%, ded waived/$70 | 0%, ded waived/$70 |
Urgent Care | $75 | $100 | $100 | $100 | $100 |
Hospital | |||||
Inpatient | $600/day x3 | Ded & $300/day x5 | Ded & $400/day x5 | Ded & $500/day x5 | Ded & $500/day x5 |
Outpatient Surgery | $350 | Ded & $250 | Ded & $300 | Ded & $350 | Ded & $300 |
Emergency Room | $350 | Ded & $350 | Ded & $350 | Ded & $350 | Ded & $350 |
Prescriptions | |||||
Rx Deductible | $150/$450 | $150/$450 | $150/$450 | $150/$450 | $150/$450 |
Generic | $15 | $15 | $15 | $15 | $15 |
Formulary | $35 | $35 | $35 | $35 | $35 |
Non-Formulary | $60 | $60 | $60 | $60 | $60 |
Specialty | 30% Max $250 | 30% Max $250 | 30% Max $250 | 30% Max $250 | 30% Max $250 |
California, Colorado, Mid-Atlantic (MD, VA, DC), Northwest (OR & Southwest WA), Washington (outside Vancouver, Longview)
HMO
Plan Name | DHMO $1000 | HDHP $3400 | DHMO $3000 | DHMO $5000 | HMO 30 |
|---|---|---|---|---|---|
Plan Type | DHMO | HMO HDHP | DHMO | DHMO | HMO |
Provider Network | Kaiser | Kaiser | Kaiser | Kaiser | Kaiser |
Deductible | In Network | In Network | In Network | In Network | In Network |
Individual | $1,000 | $3,400 | $3,000 | $5,000 | $0 |
Family | $2,000 | $6,800 | $6,000 | $10,000 | $0 |
Coinsurance | |||||
Your Percentage | 20% | 20% | 30% | 30% | 0% |
Out of Pocket Max | |||||
Individual | $3,500 | $5,000 | $6,000 | $7,500 | $3,000 |
Family | $7,000 | $10,000 | $12,000 | $15,000 | $6,000 |
Office Visits | |||||
Preventive | $0 | $0 | $0 | $0 | $0 |
Primary Care | $20 | Ded & 20% | $30 | $40 | $30 |
Specialist | $30 | Ded & 20% | $40 | $50 | $40 |
Lab & X-Ray | $20 | Ded & 20% | $30 | $40 | $30 |
Urgent Care | $10 | Ded & 20% | Ded & $10 | Ded & $15 | $10 |
Hospital | |||||
Inpatient | Ded & 20% | Ded & 20% | Ded & 30% | Ded & 30% | $500/day x3 |
Outpatient Surgery | Ded & 20% | Ded & 20% | Ded & 30% | Ded & 30% | $250 |
Emergency Room | Ded & $200 | Ded & 20% | Ded & $200 | Ded & 30% | $200 |
Prescriptions | |||||
Rx Deductible | None | w/ Med. | None | None | None |
Generic | $10 | $15 | $15 | $15 | $15 |
Formulary | $30 | $35 | $35 | $40 | $35 |
Non-Formulary | $30 | $35 | $35 | $40 | $35 |
Specialty | 20%, max $250 | 20%, max $250 | 30%, max $250 | 30%, max $250 | 20%, max $250 |
Hawaii HMO
Plan Name | HMO 0 HI |
|---|---|
Plan Type | HMO |
Provider Network | Kaiser |
Deductible | In Network |
Individual | $0 |
Family | $0 |
Coinsurance | |
Your Percentage | 0% |
Out of Pocket Max | |
Individual | $2,500 |
Family | $7,500 |
Office Visits | |
Preventive | $0 |
Primary Care | $15 |
Specialist | $15 |
Lab & X-Ray | $15 |
Urgent Care | $15 |
Hospital | |
Inpatient | 10% |
Outpatient Surgery | 10% |
Emergency Room | $100 |
Prescriptions | |
Rx Deductible | None |
Generic | $10 |
Formulary | $45 |
Non-Formulary | $45 |
Specialty | $200 |
Arizona
Plans: Banner Network Managed Choice Open Access/Managed Choice
Plan Name | JV Banner OA MC
500/100% | JV Banner OA MC 1,000/80% | JV Banner OA MC
2,500/80% | JV Banner OA MC 6,500/100% | JV Banner OA MC HDHP 5,500/80% |
|---|---|---|---|---|---|
Plan Type | JV | JV | JV | JV | HDHP JV |
Provider Network | Banner Managed Plus/Open Access Managed Plus | Banner Managed Plus/Open Access Managed Plus | Banner Managed Plus/Open Access Managed Plus | Banner Managed Plus/Open Access Managed Plus | Banner Managed Plus/Open Access Managed Plus |
Deductible | In Network | In Network | In Network | In Network | In Network |
Individual | $500 | $1,000 | $2,500 | $6,500 | $5,500 |
Family | $1,000 | $2,000 | $5,000 | $13,000 | $11,000 |
Coinsurance | |||||
Your Percentage | 0% | 20% | 20% | 0% | 20% |
Out of Pocket Max | |||||
Individual | $3,000 | $5,500 | $7,500 | $7,500 | $6,500 |
Family | $6,000 | $11,000 | $15,000 | $15,000 | $13,000 |
Office Visits | |||||
Preventive | $0 | $0 | $0 | $0 | $0 |
Primary Care | $15 | $25 | $30 | $25 | Ded & 20% |
Specialist | $50 | $50 | $60 | $65 | Ded & 20% |
Lab & X-Ray | $0/0% after ded | Ded & 20% | Ded & 20% | 0% after ded | Ded & 20% |
Urgent Care | $85 | $85 | $85 | Ded & 0% | Ded & 20% |
Hospital | |||||
Inpatient | Ded then $300 per day (Max 5 days) | Ded & 20% | Ded & 20% | Ded & 0% | Ded & 20% |
Outpatient Surgery | $250 Copay, ded, then 0% | Ded & 20% | Ded & 20% | Ded & 0% | Ded & 20% |
Emergency Room | $400 | $400 | $400 | Ded & 0% | Ded & 20% |
Prescriptions | |||||
Rx Deductible | None | None | None | None | Combined With Medical, waived for preventive |
Generic | $10 | $10 | $10 | $10 | $10 after ded |
Formulary | $45 | $45 | $45 | $45 | $45 after ded |
Non-Formulary | $80 | $80 | $80 | $80 | $70 after ded |
Specialty | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 |
Utah
Aetna Whole Health (UT) - Connected Utah
Plan Name | ACO UT OA MC
300/90% | ACO UT OA MC
1,000/80% | ACO UT OA MC
2,000/80% | ACO UT OA MC
3,000/70% | ACO UT OA MC HDHP
3,500/90% | ACO UT OA MC HDHP
5,000/80% |
|---|---|---|---|---|---|---|
Plan Type | POS | POS | POS | POS | POS | POS |
Provider Network | Aetna Whole Health (UT) - Connected Utah | Aetna Whole Health (UT) - Connected Utah | Aetna Whole Health (UT) - Connected Utah | Aetna Whole Health (UT) - Connected Utah | Aetna Whole Health (UT) - Connected Utah | Aetna Whole Health (UT) - Connected Utah |
Deductible | In Network | In Network | In Network | In Network | In Network | In Network |
Individual | $300/2x | $1,000 | $2,000 | $3,000 | $3,500 | $5,000 |
Family | $600 | $2,000 | $4,000 | $6,000 | $7,000 | $10,000 |
Coinsurance | ||||||
Your Percentage | 10% | 20% | 20% | 30% | 10% | 20% |
Out of Pocket Max | ||||||
Individual | $3,000 | $4,500 | $6,850 | $6,850 | $6,000 | $6,850 |
Family | $6,000 | $9,000 | $13,700 | $13,700 | $12,000 | $13,700 |
Office Visits | ||||||
Preventive | $0 | $0 | $0 | $0 | $0 | $0 |
Primary Care | $20 | $25 | $30 | $40 | Ded & 10% | Ded & 20% |
Specialist | $40 | $50 | $60 | $80 | Ded & 10% | Ded & 20% |
Lab & X-Ray | Ded & 10% | Ded & 20% | Ded & 20% | Ded & 30% | Ded & 10% | Ded & 20% |
Urgent Care | $85 | $85 | $85 | $85 | Ded & 10% | Ded & 20% |
Hospital | ||||||
Inpatient | Ded & 10% | Ded & 20% | Ded & 20% | Ded & 30% | Ded & 10% | Ded & 20% |
Outpatient Surgery | Ded & 10% | Ded & 20% | Ded & 20% | Ded & 30% | Ded & 10% | Ded & 20% |
Emergency Room | $350 | $350 | $350 | $350 | Ded & 10% | Ded & 20% |
Prescriptions | ||||||
Rx Deductible | None | None | None | None | Combined with Medical, Waived for Preventive | Combined with Medical, Waived for Preventive |
Generic | $10 | $10 | $10 | $10 | $10 | $10 |
Formulary | $45 | $45 | $45 | $45 | $45 | $45 |
Non-Formulary | $70 | $70 | $70 | $70 | $70 | $70 |
Specialty | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 |
Idaho
Regence BlueShield of Idaho – Preferred PPO
Plan Name | RC $500 | RC $1000 | RC $2000 | RC $3000 | RC $4000 |
|---|---|---|---|---|---|
Plan Type | Regence Classic | Regence Classic | Regence Classic | Regence Classic | Regence Classic |
Provider Network | Preferred | Preferred | Preferred | Preferred | Preferred |
Deductible | |||||
Individual | $500 | $1,000 | $2,000 | $3,000 | $4,000 |
Family | $1,500 | $3,000 | $6,000 | $9,000 | $12,000 |
Coinsurance | |||||
Your Percentage | 10% | 20% | 20% | 20% | 20% |
Out of Pocket Max | |||||
Individual | $3,000 | $3,500 | $4,500 | $5,500 | $6,500 |
Family | $6,000 | $7,000 | $9,000 | $11,000 | $13,000 |
Office Visits | |||||
Preventive | $0 | $0 | $0 | $0 | $0 |
Primary Care | $30 | $30 | $30 | $30 | $30 |
Specialist | $60 | $60 | $60 | $60 | $60 |
Urgent Care | $60 | $60 | $70 | $70 | $70 |
Lab & X-Ray | Ded & 20% | Ded & 20% | Ded & 20% | Ded & 20% | Ded & 20% |
Hospital | |||||
Inpatient | Ded & 10% | Ded & 20% | Ded & 20% | Ded & 20% | Ded & 20% |
Outpatient Surgery | Ded & 20% | Ded & 20% | Ded & 20% | Ded & 20% | Ded & 20% |
Emergency Room | $300 | $300 | $300 | $300 | $300 |
Prescriptions | |||||
Rx Deductible | None | None | None | None | None |
Generic | $10 | $10 | $10 | $10 | $10 |
Formulary | $35 | $35 | $35 | $35 | $35 |
Non-Formulary | $75 | $75 | $75 | $75 | $75 |
Specialty | 50% No Max | 50% No Max | 50% No Max | 50% No Max | 50% No Max |
Idaho
Regence BlueShield of Idaho – Preferred PPO (Continued)
Plan Name | RC $6000 | RHSA $1700 20% | RHSA $3400 20% | RHSA $5000 20% | RHSA $6350 20% |
|---|---|---|---|---|---|
Plan Type | Regence Classic | Regence HDHP | Regence HDHP | Regence HDHP | Regence HDHP |
Provider Network | Preferred | Preferred | Preferred | Preferred | Preferred |
Deductible | |||||
Individual | $6,000 | $1,700 | $3,400 | $5,000 | $6,350 |
Family | $12,000 | $3,300 | $6,600 | $10,000 | $12,700 |
Coinsurance | |||||
Your Percentage | 20% | 20% | 20% | 20% | 20% |
Out of Pocket Max | |||||
Individual | $7,500 | $5,000 | $6,000 | $6,000 | $7,500 |
Family | $15,000 | $10,000 | $12,000 | $12,000 | $15,000 |
Office Visits | |||||
Preventive | $0 | $0 | $0 | $0 | $0 |
Primary Care | $40 | Ded & 20% | Ded & $40 | Ded & 20% | Ded & 20% |
Specialist | $60 | Ded & 20% | Ded & $60 | Ded & 20% | Ded & 20% |
Urgent Care | $70 | Ded & 20% | Ded & $60 | Ded & 20% | Ded & 20% |
Lab & X-Ray | Ded & 20% | Ded & 20% | Ded & 20% | Ded & 20% | Ded & 20% |
Hospital | |||||
Inpatient | Ded & 20% | Ded & 20% | Ded & 20% | Ded & 20% | Ded & 20% |
Outpatient Surgery | Ded & 20% | Ded & 20% | Ded & 20% | Ded & 20% | Ded & 20% |
Emergency Room | $300 | $300 | Ded & 20% | $300 | $300 |
Prescriptions | |||||
Rx Deductible | None | Shared w/Medical | Shared w/Medical | Shared w/Medical | Shared w/Medical |
Generic | $10 | 20% | 20% | 20% | 20% |
Formulary | $35 | 20% | 20% | 20% | 20% |
Non-Formulary | $75 | 20% | 20% | 20% | 20% |
Specialty | 50% No Max | 20% | 20% | 20% | 20% |
Disclaimer: Carrier & Medical plan(s) availability subject to Employer location, minimum contributions, participation and employee location(s). Select plans and plan details effective as of 1/1/2026.