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Company

Plan Type

Plan ID

Plan Name

Deductibles

PCP Office Visit

Specialist Office Visit

ObGyn Wellness

Lifetime Max

Application

Aetna PPO - details 11148 MCOA 2500 2500.0000 / 5000 100% after $35 copay 100% after $50 copay No charge, deductible waived, no waiting period or calendar year max, Annual Pap/Mammogram N/A application
PPO - details 11154 MCOA 3500 3500.0000 / 7000 100% after $35 copay 100% after $50 copay No charge, deductible waived, no waiting period or calendar year max, Annual Pap/Mammogram N/A application
PPO - details 11149 MCOA 5000 5000.0000 / 10000 100% after $35 copay 100% after $50 copay No charge, deductible waived, no waiting period or calendar year max, Annual Pap/Mammogram N/A application
HSA - details 11150 MCOA High Deductible 3500 (HSA Compatible) 3500.0000 / 7000 10% after deductible 10% after deductible No charge, deductible waived, no waiting period or calendar year max, Annual Pap/Mammogram N/A application
HSA - details 11151 MCOA High Deductible 5500 (HSA Compatible) 5500.0000 / 11000 No charge after deductible No charge after deductible No charge, deductible waived, no waiting period or calendar year max, Annual Pap/Mammogram N/A application
PPO - details 11156 MCOA Savings Plus 3000 3000.0000 / 6000 $35 copay, deductible waived, for 1st 3 visits, then member pays 100% Designated Providers: 20% after deductible; Non-Designated Providers: 20% after $50 copay,deductible applies No charge, deductible waived, no waiting period or calendar year max, Annual Pap/Mammogram N/A application
PPO - details 11157 MCOA Savings Plus 5000 5000.0000 / 10000 $35 copay, deductible waived, for 1st 3 visits, then member pays 100% Designated Providers: 20% after deductible; Non-Designated Providers: 20% after $50 copay, deductible applies No charge, deductible waived, no waiting period or calendar year max, Annual Pap/Mammogram N/A application
PPO - details 11153 MCOA Value 5000 5000.0000 / 10000 $40 copay for first 3 visits, deductible waived. Member pays 100% for subsequent visits but Aetna discount applies. 20% after deductible No charge, deductible waived, no waiting period or calendar year max, Annual Pap/Mammogram N/A application
PPO - details 11155 MCOA Value 7500 7500.0000 / 15000 $40 copay for first 3 visits, deductible waived. Member pays 100% for subsequent visits but Aetna discount applies. 20% after deductible No charge, deductible waived, no waiting period or calendar year max, Annual Pap/Mammogram N/A application
HSA - details 11152 Preventive and Hospital Care 2750 (HSA Compatible) 2750.0000 / 5500 Not covered Not covered No charge, deductible waived, no waiting period or calendar year max, Annual Pap/Mammogram N/A application
BCBS OK PPO - details 30640 Blue Advantage Bronze PPO 006 6000.0000 / 13100 No Charge after deductible No Charge after deductible No Charge application
PPO - details 30644 Blue Advantage Bronze PPO 104 4500.0000 / 13100 30% coinsurance 30% coinsurance No Charge application
PPO - details 30645 Blue Advantage Bronze PPO 105 6800.0000 / 13700 20% coinsurance; no charge for first office visit 20% coinsurance No Charge application
PPO - details 30636 Blue Advantage Gold PPO 101 500.0000 / 1500 $20 copay $40 copay No Charge application
PPO - details 30638 Blue Advantage Silver PPO 102 2000.0000 / 6000 $40 copay $60 copay No Charge application
PPO - details 30639 Blue Advantage Silver PPO 103 4000.0000 / 12000 $15 copay $60 copay No Charge application
PPO - details 24493 Blue Choice Bronze PPO 005 5000.0000 / 12700 20% coinsurance after deductible 20% coinsurance after deductible No Charge application
PPO - details 24494 Blue Choice Bronze PPO 006 6000.0000 / 12700 0% coinsurance after deductible 0% coinsurance after deductible No Charge application
PPO - details 24478 Blue Choice Gold PPO 001 3250.0000 / 9750 $30 copay $50 copay No Charge application
PPO - details 24479 Blue Choice Gold PPO 002 1500.0000 / 4500 $10 copay $60 copay No Charge application
PPO - details 24480 Blue Choice Gold PPO 011 1000.0000 / 3000 $30 copay $50 copay No Charge application
PPO - details 24487 Blue Choice Silver PPO 003 6000.0000 / 12700 $30 copay $50 copay No Charge application
PPO - details 24488 Blue Choice Silver PPO 004 3000.0000 / 9000 $35 copay $55 copay No Charge application
PPO - details 24484 Blue Options Gold PPO 001 750.0000 / 2250 $25 copay $50 copay No Charge application
PPO - details 24485 Blue Options Gold PPO 002 1000.0000 / 3000 $20 copay $40 copay No Charge application
PPO - details 24486 Blue Options Gold PPO 003 1500.0000 / 4500 $20 copay $40 copay No Charge application
PPO - details 24491 Blue Options Silver PPO 004 3000.0000 / 9000 $40 copay $60 copay No Charge application
PPO - details 24492 Blue Options Silver PPO 005 5000.0000 / 12700 $35 copay $55 copay No Charge application
PPO - details 24495 Blue Preferred Bronze PPO 005 5000.0000 / 12700 20% coinsurance after deductible 20% coinsurance after deductible No Charge application
PPO - details 24496 Blue Preferred Bronze PPO 006 6000.0000 / 12700 0% coinsurance after deductible 0% coinsurance after deductible No Charge application
PPO - details 30643 Blue Preferred Bronze PPO 006 6000.0000 / 13100 No Charge after deductible No Charge after deductible No Charge application
PPO - details 30641 Blue Preferred Bronze PPO 102 6000.0000 / 13700 30% coinsurance 30% coinsurance No Charge application
PPO - details 30642 Blue Preferred Bronze PPO 103 6750.0000 / 13700 First two visits are $40 copay/visit; deductible and coinsurance apply for subsequent visits 30% coinsurance No Charge application
PPO - details 24481 Blue Preferred Gold PPO 001 3250.0000 / 9750 $30 copay $50 copay No Charge application
PPO - details 24482 Blue Preferred Gold PPO 002 1500.0000 / 10500 $10 copay $60 copay No Charge application
PPO - details 24483 Blue Preferred Gold PPO 007 1000.0000 / 3000 $30 copay $50 copay No Charge application
PPO - details 30646 Blue Preferred Security PPO 100 6850.0000 / 13700 First three visits are $50 copay/visit; deductible and coinsurance apply for subsequent visits No Charge after deductible No Charge application
PPO - details 24489 Blue Preferred Silver PPO 003 6000.0000 / 12700 $30 copay $50 copay No Charge application
PPO - details 24490 Blue Preferred Silver PPO 004 3000.0000 / 9000 $35 copay $55 copay No Charge application
PPO - details 30637 Blue Preferred Silver PPO 101 3250.0000 / 9750 20% coinsurance, no charge for the first 3 office visits, deductible and coinsurance apply for subsequent visits 20% coinsurance No Charge application
PPO - details 24497 Blue Security Choice PPO 010 6350.0000 / 12700 $40 copay No Charge No Charge application
Humana PPO - details 12395 Humana Basic 6350/ChoiceCare PPO + Children's Dental 6350.0000 / 12700 For the first 3 visits, $35 copay before deductible. Then no charge after deductible. No charge after deductible No charge application
PPO - details 29261 Humana Basic 6600/ChoiceCare PPO + Children's Dental 6600.0000 / 13200 $35 copay per visit for the first 3 visits No Charge after deductible No Charge Unlimited application
PPO - details 29263 Humana Bronze 4850/ChoiceCare PPO + Children's Dental 4850.0000 / 9700 $55 copay per visit; 3 visits per year, then 20% after deductible $80 copay per visit; 3 visits per year, then 20% after deductible No Charge Unlimited application
PPO - details 12397 Humana Bronze 4850/ChoiceCare PPO + Children's Dental 4850.0000 / 9700 For the first 3 visits, $55 Copay before deductible. Then 20% after deductible. This combined copay limit of 3 per member per year includes PCP or Specialist or Urgent Care. For the first 3 visits, $80 Copay before deductible. Then 20% after deductible. This combined copay limit of 3 per member per year includes PCP or Specialist or Urgent Care. No charge application
PPO - details 12396 Humana Bronze 6300/ChoiceCare PPO + Children's Dental 6300.0000 / 12600 No charge after deductible No charge after deductible No charge application
PPO - details 29262 Humana Bronze 6300/ChoiceCare PPO + Children's Dental 6300.0000 / 12600 No Charge after deductible No Charge after deductible No Charge Unlimited application
PPO - details 12399 Humana Silver 3650/ChoiceCare PPO + Children's Dental 3650.0000 / 7300 No charge after deductible No charge after deductible No charge application
PPO - details 29265 Humana Silver 3650/ChoiceCare PPO + Children's Dental 3650.0000 / 7300 No Charge after deductible No Charge after deductible No Charge Unlimited application
PPO - details 29264 Humana Silver 4250/ChoiceCare PPO + Children's Dental 4250.0000 / 8500 $35 copay per visit $60 copay per visit No Charge Unlimited application
PPO - details 12398 Humana Silver 4250/ChoiceCare PPO + Children's Dental 4250.0000 / 8500 $35 copay $60 copay No charge application
UnitedHealthcare Life Insurance Company PPO - details 12272 Bronze Copay Select 5500.0000 / 5500 $50 copay, deductible does not apply. 4 visit limit - Per covered person, per calendar year. Additional visits subject to deductible and coinsurance $100 copay, deductible does not apply No charge, 100% covered in network application
PPO - details 29952 Bronze Copay Select 1 5000.0000 / 10000 $50 copay for first 2 visits; additional visits subject to deductible and coinsurance $150 copay No Charge application
PPO - details 28893 Bronze Copay Select 1 5000.0000 / 10000 $50 Copay for first 4 visits then 20% Coinsurance after deductible $100 copay No Charge application
PPO - details 28894 Bronze Copay Select 2 5000.0000 / 10000 $50 copay $100 copay No Charge application
PPO - details 29953 Bronze Copay Select 2 6000.0000 / 12000 $50 copay $150 copay No Charge application
PPO - details 28895 Bronze HSA 100 6300.0000 / 12600 0% Coinsurance after deductible 0% Coinsurance after deductible No Charge application
PPO - details 12271 Bronze HSA 100 6350.0000 / 6350 No charge after deductible No charge after deductible No charge, 100% covered in network application
PPO - details 29951 Bronze HSA 100 6500.0000 / 13000 No charge, after deductible No charge, after deductible No Charge application
PPO - details 12273 Catastrophic Select Saver 6350.0000 / 6350 $0 copay, deductible does not apply. 3 visit limit - Per covered person, per calendar year. Additional visits subject to deductible No charge after deductible No charge, 100% covered in network application
PPO - details 12266 Gold Copay Select 1 1000.0000 / 1000 $25 copay, deductible does not apply $30 copay, deductible does not apply No charge, 100% covered in network application
PPO - details 28896 Gold Copay Select 1 1000.0000 / 2000 $25 copay $30 copay No Charge application
PPO - details 28897 Gold Copay Select 2 1500.0000 / 3000 $15 copay $30 copay No Charge application
PPO - details 12265 Gold Copay Select 2 1500.0000 / 1500 $15 copay, deductible does not apply $30 copay, deductible does not apply No charge, 100% covered in network application
PPO - details 28899 Select Saver 6600.0000 / N/A $35 Copay for first 3 visits then 0% Coinsurance after deductible 0% Coinsurance after deductible No Charge application
PPO - details 29950 Select Saver 6850.0000 / N/A $35 copay for first 3 visits; additional visits subject to deductible and coinsurance No charge, after deductible No Charge application
PPO - details 29955 Silver Copay Select 1 5000.0000 / 10000 $20 copay $40 copay No Charge application
PPO - details 29956 Silver Copay Select 2 2500.0000 / 5000 $35 copay for first 4 visits; additional visits subject to deductible and coinsurance $70 copay No Charge application
PPO - details 29957 Silver Copay Select 3 3500.0000 / 7000 $20 copay $40 copay No Charge application
PPO - details 29954 Silver HSA 100 4000.0000 / 8000 No charge, after deductible No charge, after deductible No Charge application