Summary of 2012 Health Insurance Plans for Small Groups (2+employee/owners)

The following table is a summary of some of the more popular plans available to businesses with 2 or more employees/owners. They are listed by cost of the monthly premium for a single plan - smallest to greatest premium. Other plans are available but will fall within this range of premium and coverages (slight differences in coverage will cause slight differences in premium). If you think your business needs a plan you don't see here, call us for rates and coverage. Every plan on the market is available for you - we just can't list them all here.
This is meant to be a summary - actual coverages and contract terms will be found on documents provided by the insurance carrier

Click on the PLAN ID link in the table to take you to a detailed benefits summary for that plan.                Printable Version

Carrier
Plan ID/
Form ID
Plan Description
Monthly Premium
Annual Deductible
Annual-out of- Pocket Max
PCP Co-Pay
Specialist Co-Pay
Drug Coverage
Emergency Room
Urgent Care
Hospital Admission
Out Patient Procedure
Rewards
These columns show the cost sharing portion for the Subscriber - this is the amount the subscriber (employee) pays.
BCBS SBHDHP15 Simply Blue HDHP
SGL=$150.14
CPL=$366.32
OPF=$312.47
FAM=$398.11
$5500 SGL
$11000 FAM
$5500 SGL
$11000 Fam
No Copay
No CoPay

Covered at 100% after deductible
Covered at 100% after deductible
Covered at 100% after deductible
Covered at 100% after deductible
Covered at 100% after deductible
Blue 365
BCBS

HBHDHP8

 Healthy Blue HDHP

SGL=$236.99
CPL=$578.29
OPF=$492.55
FAM=$627.54
$1800 SGL
$3600 Fam
$3600 SGL
$7200 Fam
10% Co-Ins (In)
20% Co-Ins (Out) after Deductible **
10% Co-Ins (In)
20% Co-Ins (Out) after Deductible **
$5 Tier 1 ($0<19)
$35 Tier 2
$70 Tier 3
After deductible
10% Co-Ins (In or Out) after Deductible **
10% Co-Ins (In)
20% Co-Ins (Out) after Deductible **
10% Co-Ins (In)
20% Co-Ins (Out) after Deductible **
10% Co-Ins (In)
20% Co-Ins (Out) after Deductible **
$500 Per Adult
$1000 Total
MVP NEHDO6S Preferred High Deductible EPO

SGL=$243.86
DBL=$487.72
FAM=$634.04
$2500 SGL
$5000 Fam
$5000 SGL
$10000 Fam
20% Co-Ins after Deductible *
20% Co-Ins after Deductible *
20% Tier 1
20% Tier 2
40% Tier 3
After deductible
20% Co-Ins after Deductible *
20% Co-Ins after Deductible *
20% Co-Ins after Deductible *
20% Co-Ins after Deductible *
$300
Per Contract
BCBS SBHDHP11 Simply Blue HDHP
SGL=$246.95
CPL=$602.55
OPF=$513.99
FAM=$654.86
$1300 SGL
$2600 FAM
$3000 SGL
$6000 Fam
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **

$5 Tier 1 ($0<19)
$35 Tier 2
$70 Tier 3
After deductible
20% Co-Ins (In)
20% Co-Ins (Out) after Deductible **
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **
Blue 365
BCBS HBHDHP2 Healthy Blue HDHP
SGL=$255.32
CPL=$622.98
OPF=$530.66
FAM=$676.10
$1300 SGL
$2600 Fam
$3000 SGL
$6000 Fam
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **
$5 Tier 1 ($0<19)
$35 Tier 2
$70 Tier 3
After deductible
20% Co-Ins (In or Out) after Deductible **
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **
$500 Per Adult
$1000 Total
BCBS P170 (L2) Simply Blue CoPay $40 / $60
SGL=$309.67
CPL=$752.85
OPF=$652.15
FAM=$819.61
None (In)
40% (Out)
$9000 SGL
$27000 Fam
$40
$60

$10 Generic Only
$0 Generic <19 yo

$350
$75 (In)
40% subject to deductible (Out)
$750 per day
4 day max (In)
40% (out)
$350
None
MVP NEHDO7S Preferred High Deductible EPO
SGL=$341.69
DBL=$683.38
FAM=$888.40
$1500 SGL
$3000 Fam
$2500 SGL
$5000 Fam
Covered in full after Deductible
Covered in full after Deductible
$10 Tier 1
$30 Tier 2
$50 Tier 3
After deductible
Covered in full after Deductible
Covered in full after Deductible
Covered in full after Deductible
Covered in full after Deductible
$300
Per Contract
MVP EC0022S Preferred EPO $40
SGL=$344.91
DBL=$689.82
FAM=$896.77
$1000 SGL
$2500 Fam
$3000 SGL
$7500 Fam
$40
$40
$10 Generic Rx Only
$200
$40
20% Co-Ins after Deductible *
20% Co-Ins after Deductible *
$300
Per Contract
BCBS P180 (B6) Healthy Blue CoPay w/ deductible
SGL=$360.33
CPL=$879.24
OPF=$742.08
FAM=$945.48
$1000 SGL
$3000 Fam
$3000 SGL
$9000 Fam
$30
$0 <19yo
$50
$5 Tier 1 ($0<19)
$35 Tier 2
$70 Tier 3
After deductible
$250
$50
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **
$500 Per Adult
$1000 Total
MVP E0016S Preferred EPO $30
SGL=$371.24
DBL=$742.48
FAM=$965.22
$1000 SGL
$2500 Fam
$3000 SGL
$7500 Fam
$30
$30
$10 Generic Rx Only
$200
$30
20% Co-Ins after Deductible *
20% Co-Ins after Deductible *
$300
Per Contract
MVP EC0034S Preferred EPO $30 / $50
SGL=$405.99
DBL=$811.98
FAM=$1055.57
$1000 SGL
$2500 Fam
$3000 SGL
$7500 Fam
$30
$50
$10 Generic
50% Tier 2
50% Tier 3
$200
$30
20% Co-Ins after Deductible *
20% Co-Ins after Deductible *
$300
Per Contract
BCBS HBC28 Healthy Blue CoPay w/deductible
SGL=$431.47
CPL=$1052.79
OPF=$888.67
FAM=$1132.26
None (In)
None (In)
$25
$0 <19yo
$40
$5 Tier 1 ($0<19)
$35 Tier 2
$70 Tier 3
$250
$40
$500
$250
$500 Per Adult
$1000 Total
BCBS P180 (B1) Healthy Blue w/ deductible
SGL=$436.30
CPL=$1064.58
OPF=$897.12
FAM=$1142.98
$500 SGL
$1500 Fam
$1500 SGL
$4500 Fam
$15
$0 <19yo
$25
$5 Tier 1 ($0<19)
$25 Tier 2
$50 Tier 3
$250
$25
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **
20% Co-Ins (In)
40% Co-Ins (Out) after Deductible **
$500 Per Adult
$1000 Total
MVP E0050S Preferred EPO $25 / $40
SGL=$444.67
DBL=$889.34
FAM=$1156.15
None
None
$25
$40
$10 Generic Rx Only
$100
$25
$500
$150
$300
Per Contract

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BCBS SBC14 SIMPLY BLUE COPAY $25 / $40
SGL=$447.06
CPL=$1090.85 OPF=$920.66
FAM=$1172.98
None (In)
None (In)
$25
$0 <19yo
$40
$5 Tier 1 ($0<19)
$25 Tier 2
$50 Tier 3
$75
$40
$150
$75
Blue 365
BCBS HBC44 Healthy Blue CoPay w/deductible
SGL=$469.95
CPL=$1146.71 OPF=$967.51
FAM=$1232.71
None (In)
None (In)
$15
$0 <19yo
$25
$5 Tier 1 ($0<19)
$25 Tier 2
$50 Tier 3
$75
$25
$150
$75
$500 Per Adult
$1000 Total
BCBS BC30 Blue Choice 30
SGL=$490.46
CPL=$1128.02 OPF=$1234.58 FAM=$1298.95
None
None
$30
$50
$10 Tier 1
$30 Tier 2
$50 Tier 3
$150
$50
$750
$150
None
MVP E0046S Preferred EPO $30
SGL=$507.96
DBL=$1015.92
FAM=$1320.69
None
None
$30
$30
$10 Generic
50% Tier 2
50% Tier 3
$100
$30
$500
$150
$300
Per Contract
MVP T03S TriVantage EPO
SGL=$521.00
DBL=$1042.00
FAM=$1354.60
None
None
$5 to $25
See Detail
$40
$10 Tier 1
$30 Tier 2
$50 Tier 3
$1000 then 50%
$50 to $75
See Detail
$15 to $25
See Detail
>19=$300
0-19=$0
$100
Up to $600
Per Contract
BCBS BC25 Blue Choice 25
SGL=$529.70
CPL=$1218.17 OPF=$1332.67
FAM=$1402.34
None
None
$25
$40
$10 Tier 1
$25 Tier 2
$40 Tier 3
$100
$35
$500
$75 / $200 or 20%
None
Discontinued Medical (as of 12/31/2011) Plans Monthly Premium
BCBS EPO6

Blue EPO Balance

Compare Current Plan to Default Plan
***You will be enrolled in Simply Blue $25/$40 CoPay unless you pick another plan
BCBS BHC

Healthy Choices Fit & Healthy

Compare Current Plan to Default Plan
***You will be enrolled in Healthy Blue $15/$25 CoPay unless you pick another plan
BCBS BHC

Healthy Choices Healthy Family

Compare Current Plan to Default Plan
***You will be enrolled in Healthy Blue $15/$25 CoPay unless you pick another plan
BCBS VALUE

Blue Choice Value

Compare Current Plan to Default Plan
***You will be enrolled in Blue Choice $25 CoPay unless you pick another plan
BCBS SELECT

Blue Choice Select

Compare Current Plan to Default Plan
***You will be enrolled in Blue Choice $25 CoPay unless you pick another plan
Dental Plans Monthly Premium
BCBS 501-010 Dental Blue Options
Contributory w/ Ortho
SGL=$31.70
CPL=$77.72 OPF=$77.44
FAM=$97.10
BCBS 501-011 Dental Blue Options
Contributory w/o Ortho
SGL=$31.70
CPL=$77.72 OPF=$72.15
FAM=$90.58
BCBS 501-012 Dental Blue Options
Non-Contributory w/ Ortho
SGL=$33.28
CPL=$81.60 OPF=$81.29
FAM=$101.91
BCBS 501-013 Dental Blue Options
Non-Contributory w/o Ortho
SGL=$39.07
CPL=$95.79 OPF=$90.06
FAM=$113.07
   

CONTINUED ON PAGE 3

 
GUARDIAN BASIC Basic Coverage
SGL=$41.17 CPL=$86.86
OPF=$79.29
FAM=$126.56
GUARDIAN PREMIUM Premium Coverage
SGL=$57.65
CPL=$121.59 OPF=$110.97 FAM=$177.18

Codes and abbreviations:
"SGL"=Single; "DBL"=Double: 2 people (2 adults or 1 adult & 1 child); "CPL"=Couple (2 adults); "OPF"=One Parent Family; "FAM"=Family
"In" or (In)= In-Network; "Out" or (Out)=Out-of-Network
*20% Co-Ins after Deductible=MVP covers 80% of allowable charges after deductible
**10% Co-Ins (In) 20% Co-Ins (Out) after Deductible (Excellus)=No copay, covered at 90% in-network and 80% out-of-network; subject to the deductible
**20% Co-Ins (In) 40% Co-Ins (Out) after Deductible (Excellus)=No copay, covered at 80% in-network and 60% out-of-network; subject to the deductible
***Click to open plan comparisons

This summary is intended to be for reference only. In the event that there is a discrepency between this summary and the Carrier's Certificate of Coverage, schedules and riders, the Carrier's information will be controlling.
UPDATED: 11/22/2011