Skip to content

Close Welcome! We've made a few changes to our site. We've refreshed the design and added great content to help you make smarter health care choices.

Medical Plans for Groups 1-50* - PPO Plans/Statewide Network

Our plans are designed for Arizonans in every stage of life. Choose a plan that works best for you and your employees. Each plan is available as either a PPO plan or an EPO (Exclusive Provider Organization) plan. PPO plans are paired with our large and broad statewide network of doctors. EPO plans are available at a lower cost with our exclusive network, called “Alliance.” Within Arizona, Alliance Network providers are located primarily in Maricopa County and include hospitals and doctors that are part of Banner Health, Scottsdale Healthcare, and John C. Lincoln Health Network.

All of the plans include coverage for most in-network preventive care services and kids’ dental check-ups at no out-of-pocket cost to employees.

Brief summaries of our plans are shown below. These summaries show in-network benefits only. Members of EPO plans paired with our Alliance network generally have no out-of-network benefits except for emergencies and other limited circumstances. Members of PPO plans paired with our statewide network pay cost share amounts for out-of-network services that are higher than those for in-network services and usually include a balance bill. Some services may not be available out-of-network. To see more information about a plan, click on the “Details” button, or call us.

The chart below is meant to help you compare key features of different 2015 small group plans. It does not show all differences between displayed plans. All plans have exclusions, limitations and cost share requirements that are not displayed. Some applicable limitations are shown in the Disclaimers and Footnotes at the bottom of this page.

Download Product Guide

EverydayHealth Statewide PPO Get A Quote
Set costs for the most common healthcare needs such as doctor visits and prescriptions when employees use in-network providers.

EverydayHealth Statewide PPO

Deductibles Available

Coinsurance

OOP Max

Office Visits

Prescription Medications

EverydayHealth 500
Metal Level: Platinum

View Individual Details
View Family Details

Individual: $500
Family: $1,000

10% after deductible

Individual: $2,000
Family: $4,000

Primary Care: $15
Specialist: $30

View Doctor Directory

Tier 1: $5
Tier 2: $20
Tier 3: $30

View Pharmacy Details

EverydayHealth 1000**
Metal Level: Gold

View Individual Details
View Family Details

Individual: $1,000
Family: $2,000

20% after deductible

Individual: $4,500
Family: $9,000

Primary Care: $20
Specialist: $40

View Doctor Directory

Tier 1: $15
Tier 2: $40
Tier 3: $80

View Pharmacy Details

EverydayHealth 1500
Metal Level: Gold

View Individual Details
View Family Details

Individual: $1,500
Family: $3,000

20% after deductible

Individual: $3,000
Family: $6,000

Primary Care: $20
Specialist: $40

View Doctor Directory

Tier 1: $15
Tier 2: $40
Tier 3: $80

View Pharmacy Details

EverydayHealth 2000**
Metal Level: Silver

View Individual Details
View Family Details

Individual: $2,000
Family: $4,000

20% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $30
Specialist: $60

View Doctor Directory

Tier 1: $15
Tier 2: $50
Tier 3: $100

View Pharmacy Details

EverydayHealth 2500
Metal Level: Silver

View Individual Details
View Family Details

Individual: $2,500
Family: $5,000

20% after deductible

Individual: $4,500
Family: $9,000

Primary Care: $35
Specialist: $70

View Doctor Directory

Tier 1: $25
Tier 2: $50
Tier 3: $90

View Pharmacy Details

EverydayHealth 3000
Metal Level: Silver

View Individual Details
View Family Details

Individual: $3,000
Family: $6,000

20% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $30
Specialist: $60

View Doctor Directory

Tier 1: $15
Tier 2: $50
Tier 3: $100

View Pharmacy Details

EverydayHealth 3500
Metal Level: Silver

View Individual Details
View Family Details

Individual: $3,500
Family: $7,000

20% after deductible

Individual: $4,500
Family: $9,000

Primary Care: $35
Specialist: $70

View Doctor Directory

Tier 1: $25
Tier 2: $50
Tier 3: $90

View Pharmacy Details

EverydayHealth 4000
Metal Level: Silver

View Individual Details
View Family Details

Individual: $4,000
Family: $8,000

20% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $30
Specialist: $60

View Doctor Directory

Tier 1: $15
Tier 2: $50
Tier 3: $100

View Pharmacy Details

EverydayHealth 5000
Metal Level: Silver

View Individual Details
View Family Details

Individual: $5,000
Family: $10,000

20% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $30
Specialist: $60

View Doctor Directory

Tier 1: $25
Tier 2: $80
Tier 3: $160

View Pharmacy Details

EverydayHealth 6000**
Metal Level: Bronze

View Individual Details
View Family Details

Individual: $6,000
Family: $12,000

20% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $40
Specialist: $80

View Doctor Directory

Tier 1: $25
Tier 2: $80
Tier 3: $160

View Pharmacy Details

Essential Statewide PPO Get A Quote
The first three in-network doctor office visits and most in-network generic prescription medications are covered at low out of pocket costs for members. Each member has copay cost share for up to three in-network total PCP/Specialist office visits per calendar year. After three copays, coinsurance applies.

Essential Statewide PPO

Deductibles Available

Coinsurance

OOP Max

Office Visits

Prescription Medications

Essential 1500
Metal Level: Gold

View Individual Details
View Family Details

Individual: $1,500
Family: $3,000

20% after deductible

Individual: $3,000
Family: $6,000

Primary Care: $25
Specialist: $50

View Doctor Directory

Tier 1: $10
Tier 2: $25 after deductible
Tier 3: $90 after deductible

Deductible: $200

View Pharmacy Details

Essential 2000
Metal Level: Silver

View Individual Details
View Family Details

Individual: $2,000
Family: $4,000

20% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $30
Specialist: $70

View Doctor Directory

Tier 1: $15
Tier 2: $40 after deductible
Tier 3: $90 after deductible

Deductible: $200

View Pharmacy Details

Essential 3000
Metal Level: Silver

View Individual Details
View Family Details

Individual: $3,000
Family: $6,000

20% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $30
Specialist: $70

View Doctor Directory

Tier 1: $10
Tier 2: $30 after deductible
Tier 3: $90 after deductible

Deductible: $400

View Pharmacy Details

Essential 4000
Metal Level: Silver

View Individual Details
View Family Details

Individual: $4,000
Family: $8,000

20% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $30
Specialist: $70

View Doctor Directory

Tier 1: $10
Tier 2: $30 after deductible
Tier 3: $90 after deductible

Deductible: $400

View Pharmacy Details

Essential 5000
Metal Level: Silver

View Individual Details
View Family Details

Individual: $5,000
Family: $10,000

20% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $30
Specialist: $70

View Doctor Directory

Tier 1: $10
Tier 2: $30 after deductible
Tier 3: $90 after deductible

Deductible: $400

View Pharmacy Details

Essential 6000
Metal Level: Bronze

View Individual Details
View Family Details

Individual: $6,000
Family: $12,000

20% after deductible

Individual: $6,600
Family: $13,200

Primary Care: $35
Specialist: $70

View Doctor Directory

Tier 1: $25
Tier 2: $70 after deductible
Tier 3: $160 after deductible

Deductible: $600

View Pharmacy Details

Portfolio Statewide PPO Get A Quote
A low premium plan eligible for use with a Health Savings Account (HSA) from a qualified financial institution. This plan provides flexibility on how employees’ healthcare dollars are spent while offering the employee potential tax savings when the plan is paired with an HSA. Many in-network preventive services are covered at no out-of-pocket cost to employees.

Portfolio Statewide PPO

Deductibles Available

Coinsurance

OOP Max

Office Visits

Prescription Medications

Portfolio 1500
Metal Level: Gold

View Individual Details
View Family Details

Individual: $1,500
Family: $3,000

10% after deductible

Individual: $3,000
Family: $6,000

Primary Care and Specialist: 10% after deductible

View Doctor Directory

10% after deductible

View Pharmacy Details

Portfolio 2600
Metal Level: Silver

View Individual Details
View Family Details

Individual: $2,600
Family: $5,200

20% after deductible

Individual: $4,250
Family: $8,500

Primary Care and Specialist: 20% after deductible

View Doctor Directory

20% after deductible

View Pharmacy Details

Portfolio 3500
Metal Level: Silver

View Individual Details
View Family Details

Individual: $3,500
Family: $7,000

No charge after deductible

Individual: $3,500
Family: $7,000

Primary Care and Specialist: No charge after deductible

View Doctor Directory

No charge after deductible

View Pharmacy Details

Portfolio 5500
Metal Level: Bronze

View Individual Details
View Family Details

Individual: $5,500
Family: $11,000

No charge after deductible

Individual: $5,500
Family: $11,000

Primary Care and Specialist: No charge after deductible

View Doctor Directory

No charge after deductible

View Pharmacy Details

Portfolio 6300
Metal Level: Bronze

View Individual Details
View Family Details

Individual: $6,300
Family: $12,600

No charge after deductible

Individual: $6,300
Family: $12,600

Primary Care and Specialist: No charge after deductible

View Doctor Directory

No charge after deductible

View Pharmacy Details

CopayComplete Statewide PPO Get A Quote
A plan with a $0 in-network deductible that offers convenient and predictable costs for most healthcare services obtained from in-network providers.

CopayComplete Statewide PPO

Deductibles Available

Coinsurance

OOP Max

Office Visits

Prescription Medications

CopayComplete 15
Metal Level: Platinum

View Individual Details
View Family Details

Individual: $0
Family: $0

Copay for most covered services, see plan details.

Individual: $3,000
Family: $6,000

Primary Care: $15
Specialist: $30

View Doctor Directory

Tier 1: $5
Tier 2: $15
Tier 3: $40

View Pharmacy Details

CopayComplete 25
Metal Level: Gold

View Individual Details
View Family Details

Individual: $0
Family: $0

Copay for most covered services, see plan details.

Individual: $6,350
Family: $12,700

Primary Care: $25
Specialist: $50

View Doctor Directory

Tier 1: $10
Tier 2: $45
Tier 3: $90

View Pharmacy Details

CopayComplete 40
Metal Level: Silver

View Individual Details
View Family Details

Individual: $0
Family: $0

Copay for most covered services, see plan details.

Individual: $6,350
Family: $12,700

Primary Care: $40
Specialist: $80

View Doctor Directory

Tier 1: $25
Tier 2: $70
Tier 3: $160

View Pharmacy Details

Disclaimers and Footnotes

*These plans are offered to employers considered "small" for purposes of the Affordable Care Act (ACA) and/or Arizona law:

  • ACA -- the average number of total employees on business days during the previous calendar year is 50 or fewer
  • Arizona law -- on a typical business day, 50 or fewer employees are eligible for health benefit plan coverage

BCBSAZ offers both PPO and EPO plans to small groups. EPO plans are filed with the Arizona Department of Insurance as "Health Care Service Organization" plans (HMOs) and generally include out-of-network coverage only for emergencies and other limited circumstances. PPO plans include broader out-of-network benefits. Out of network cost share for PPO plans is higher, and members usually pay a balance bill, which is the difference between the BCBSAZ allowed amount and the provider’s billed charges. For example, if an out-of-network hospital charges $1,500 for a service, and the allowed amount is $1,000, the member must pay the $500 difference plus out-of-network cost share.

More detailed information about benefits, cost share, exclusions and limitations is in the benefit plan booklets and plan Summary of Benefits and Coverage (SBC), and is available prior to enrollment, on request. If you would like a copy of a plan Summary of Benefits and Coverage (SBC) please call us at 1-(877) 475-8440. If the terms of this webpage summary or the terms of the SBC differ from the terms of the benefit book, the benefit book controls.

**We also offer EverydayHealth 1000, 2000, and 6000, paired with our statewide PPO, through the Small Business Health Options Program (SHOP), a federally sponsored health insurance marketplace. A Small Business Health Care Tax Credit is available to certain qualified employers who purchase coverage through the SHOP. Blue Cross Blue Shield of Arizona is a Qualified Health Plan issuer in the Health Insurance Marketplace.

Read More Show Less