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