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If you have any questions about any of
the plans,
please feel free to contact us
directly.
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Emblem - (EPO)
40/100/500/250
Click here for the detailed plan summary. |
| This plan
is only available to groups consisting of 2+
employees. This
policy is an EPO (Exclusive Provider Organization)
with no out-of-network coverage and no referrals
needed. This plan has a $40 primary and specialist
office visit copay with a $500 inpatient hospital
copay and $100 emergency room visit copay. The
prescription coverage is $0/$30/$50 with one time
$50 deductible per year and a $3,000 maximum. Full
time dependant coverage to age 23. |
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Quarterly |
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Sole Proprietor |
Small Group |
|
Employee |
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$1,175.37 |
|
Employee
+ Spouse |
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$2,045.61 |
|
Employee
+ Child(ren) |
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$2,243.43 |
| Family |
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$3,401.82 |
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Plan
Selection |
Plan
Selection |
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Instructions |
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Application |
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Emblem - EPO
20/50/0/0
Click here for the detailed plan
summary. |
| This plan is
only available to groups consisting of 2+ employees. This option
is an EPO (Exclusive Provider Organization) with no out-of-network coverage
and no referrals needed. This plan has
a $20 primary and specialist office visit copay with a $0
inpatient hospital copay and $50 emergency room visit copay.
The prescription coverage is $0/$30/$50 with no
deductible. Full time dependant coverage to age 23. |
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Quarterly |
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Sole Proprietor |
Small Group |
| Employee
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$1,671.00 |
| Employee
+ Spouse |
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$3,676.17 |
| Employee
+ Child(ren) |
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$3,185.19 |
| Family |
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$4,943.10 |
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Plan
Selection |
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Instructions |
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Application |
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Emblem -
PPO 30/0/10000/70%
Click here for the detailed plan
summary. |
| This plan is
only available to groups consisting of 2+ employees. This plan
option is a PPO (Preferred Provider Organization) with both in
and out-of-network coverage,
no referrals needed. This plan has a $30 primary and
specialist office visit copay with a $0 inpatient
hospital copay and $100 emergency room visit copay. The
prescription coverage is $0/$25/$40 with one time $100
deductible per year. Full time dependant coverage to age
23. |
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Quarterly |
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Sole Proprietor |
Small Group |
| Employee
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$2,115.90 |
| Employee
+ Spouse |
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$4,653.63 |
| Employee
+ Child(ren) |
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$4,030.29 |
| Family |
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$6,255.27 |
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Plan
Selection |
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Instructions |
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Application |
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Emblem -1500/1300
Click here for the detailed plan
summary. |
|
Details to come |
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Quarterly |
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Sole Proprietor |
Small Group |
| Employee
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$783.30 |
| Employee
+ Spouse |
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$1,723.32 |
| Employee
+ Child(ren) |
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$1,488.30 |
| Family |
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$2,310.75 |
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Plan
Selection |
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Instructions |
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Application |
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Emblem -2500/5000
Click here for the detailed plan
summary. |
|
Details to come |
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Quarterly |
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Sole Proprietor |
Small Group |
| Employee
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$650.76 |
| Employee
+ Spouse |
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$1,431.66 |
| Employee
+ Child(ren) |
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1,236.45 |
| Family |
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$1,919.73 |
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Plan
Selection |
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|
Instructions |
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|
Application |
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