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2017 Standard PPO

        • The Standard Preferred Provider Organization (PPO) is a traditional health plan offering lower premiums and higher out-of-pocket costs.
          This plan does not require the LivingWell Promise.
        • This plan reimburses most covered expenses at 70%.
        • Under this plan, you pay 30% of the total in-network prescription cost within a minimum and maximum range. Regardless of the pharmacy tier, the amount you pay is capped at a maximum amount.
        • Emergency room co-pays are $150, plus the deductible and co-insurance.
        • Medical and prescription out-of-pocket maximums accumulate separately.




2017 Standard PPO SBC

2017 Standard PPO SPD

2017 RX SPD Standard PPO

Benefits Grid


90-day retail pharmacies

ACA Preventive Drug List

Preferred Drug List-As of April 2017

Specialty Drug List-As of April 2017

See how your costs compare  in the Standard PPO and the Standard CDHP options. The chart below is for illustrative purposes only.