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

Our 4 unique 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 with our large and broad statewide network of doctors. EverydayHealth and CopayComplete are also available at a lower cost with our High Performance 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 and Scottsdale Healthcare. 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.

The below chart does not show all available plans or all differences between displayed plans. All plans have exclusions, limitations and cost share requirements.

EverydayHealth

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Set costs for the most common healthcare needs such as doctor visits and prescriptions when employees use in-network providers. Provider Networks Available: Statewide PPO, Alliance. Cost share amounts listed below refer to services provided by in-network providers. Services provided by out-of-network providers may not be covered, and are subject to a higher cost share amount. Blue Cross Blue Shield of Arizona is a Qualified Health Plan issuer in the Health Insurance Marketplace.

 

Deductibles Available

Coinsurance

OOP Max

Office Visits

Prescription Medications

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

$15/$40/$80

View Pharmacy Details

EverydayHealth 2000
Metal Level: Silver

View Individual Details
View Family Details

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

30% after deductible

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

Primary Care: $30
Specialist: $60

View Doctor Directory

$25/$50/$100

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

$15/$50/$100

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

$25/$80/$160

View Pharmacy Details

Essential

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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. Provider Networks Available: Statewide PPO. Cost share amounts listed below refer to services provided by in-network providers. Services provided by out-of-network providers may not be covered, and are subject to a higher cost share amount.

 

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: $25§

View Doctor Directory

$15/$40/$90

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: $30§

View Doctor Directory

$15/$40/$90

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: $25§
Specialist: $25§

View Doctor Directory

$10/$25/$50

View Pharmacy Details

Essential 6000
Metal Level: Bronze

View Individual Details
View Family Details

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

30% after deductible

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

Primary Care: $35§
Specialist: $35§

View Doctor Directory

$25/$60/$120

View Pharmacy Details

Portfolio

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. Provider Networks Available: Statewide PPO. Cost share amounts listed below refer to services provided by in-network providers. Services provided by out-of-network providers may not be covered, or may be subject to a higher cost share amount.

 

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 office visits: 10% after deductible

View Doctor Directory

10% after deductible

View Pharmacy Details

Portfolio 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 and Specialist office visits: 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 office visits: 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 office visits: No charge after deductible

View Doctor Directory

No charge after deductible

View Pharmacy Details

CopayComplete

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A plan with $0 in-network deductible that offers convenient and predictable costs for most healthcare services obtained from in-network providers. Provider Networks Available: Statewide PPO, Alliance. Cost share amounts listed below refer to services provided by in-network providers. Services provided by out-of-network providers may not be covered, and are subject to a higher cost share amount.

 

Deductibles Available

Coinsurance

OOP Max

Office Visits

Prescription Medications

CopayComplete 20
Metal Level: Gold

View Individual Details
View Family Details

Individual: $0
Family: $0

none

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

Primary Care: $20
Specialist: $50

View Doctor Directory

$15/$45/$90

View Pharmacy Details

CopayComplete 40
Metal Level: Silver

View Individual Details
View Family Details

Individual: $0
Family: $0

none

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

Primary Care: $40
Specialist: $80

View Doctor Directory

$25/$90/$200

View Pharmacy Details

Disclaimer and Footnotes

This page shows employees’ in-network cost share amounts for certain services and benefits. It’s what they pay for care from a provider who is part of the BCBSAZ network. Their cost share and deductible will be higher if they get care from an out-of-network provider. Also, when they go out-of-network, they usually have to pay the difference between what the provider charges and the allowed amount (called “the balance bill”). For example: if an out-of-network hospital charges $1,500 for a service and the allowed amount is $1,000, they may have to pay the $500 difference, plus their out-of-network cost share.

This is only a brief summary of the benefit plans, and is designed to help you compare features of different plans. All plans are subject to limitations, exclusions and other cost share requirements not shown here. 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 the terms of this summary differ from the terms of the benefit plan booklets, the terms of the booklets control and apply.

* 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

All of our plans are available with our extensive BCBSAZ statewide provider network. EverydayHealth and CopayComplete are also available at a lower cost with our High Performance 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 and Scottsdale Healthcare. If you choose the Alliance network, most Arizona in-network doctors and hospitals are located in Maricopa County. Doctors and hospitals in the Alliance network can deliver more integrated care because they are part of a smaller, more localized and more integrated network. This is how BCBSAZ lowers the cost of services, passing the savings on to you with lower premiums for plans paired with a High Performance Network.

We also offer these three plans, paired with our statewide PPO, through the Small Business Health Options Program (SHOP), a federally sponsored health insurance marketplace. Beginning in 2014, a Small Business Health Care Tax Credit is available to certain employers who purchase coverage through the SHOP.

§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.

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