More flexibility and provider choice—giving you greater control over how and where you receive care.
This plan combines a Blue Cross Blue Shield high deductible health plan with Nonstop Health funding to help reduce your out-of-pocket costs. While the plan includes a $5,000 individual deductible, Nonstop Health provides up to $4,000 for individual coverage or $8,000 for family coverage in funding to help cover eligible medical expenses.
In most cases, this means your actual exposure is significantly lower—while still giving you the freedom to see providers without referrals and access care both in and out of network.
This plan may be a good fit if flexibility and provider choice are more important to you than lower paycheck costs.
Nonstop Health Funding
Helps cover eligible medical expenses—reducing your actual out-of-pocket exposure.
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| PPO Coverage Information | ||
|---|---|---|
| In Network | Out Of Network | |
| General Services | ||
| Annual Deductible/Individual | $5,000 | $5,000 |
| Annual Deductible/Family | $10,000 | $10,000 |
| Annual Out-of-Pocket Limit/Individual | $6,850 | $6,850 |
| Annual Out-of-Pocket Limit/Family | $13,700 | $13,700 |
| Office Services | ||
| Office Visit/Exam | $25 / visit | 20% coinsurance |
| Specialist Visit | $40 / visit | 20% coinsurance |
| Urgent Care | $40 / visit | 20% coinsurance |
| Preventative Services | 100% Covered | 20% coinsurance |
| Hospital Services | ||
| Inpatient Hospital | 100% Covered | 20% coinsurance |
| Outpatient Surgery | 100% Covered | 20% coinsurance |
| Emergency Room | $150 / visit | 20% coinsurance |
| Prescription Drugs | ||
| Retail (30-Days) Tier 1 | $10 | $20 |
| Retail (30-Days) Tier 2 | $25 | $50 |
| Retail (30-Days) Tier 3 | $45 | $90 |
| Mail Order (90-Day) | $20 / $50 / $135 | Not Covered |
Plan Resources
Review important plan materials and access additional support for this benefit.