中型企業與平衡融資計畫文件 2026 年 7 月

药店

文件下载/访问
Open Drug List
BlueSignature Prosano PPO, BluePreferred PPO, BluePreferred PPO HSA, Ascend HMO Plus, Ascend HSA HMO

雇主健康計畫產品指南

指導下載
平衡融資
中型企業

福利與保障概要（SBC）

《福利與保障概要》（SBC）簡要描述了您的計劃涵蓋哪些服務以及您需要為涵蓋的福利支付多少費用。

計劃DO
BlueSignature Prosano 1000 80
BlueSignature Prosano 2500 80
BlueSignature Prosano 5000 80
BlueSignature Prosano 7000 70

藥局

文件下載/訪問
AZ Blue HSA Prosano Saver 3400 100
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 4000 100
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 5000 100
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 6000 100
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 7000 100
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 3400 90
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 4000 90
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 5000 90
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 6000 90
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 3400 80
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 4000 80
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 5000 80
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 6000 80
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 3400 70
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 4000 70
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 5000 70
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO
AZ Blue HSA Prosano Saver 6000 70
BlueSignature Prosano PPO 、BluePreferred PPO 、BluePreferred PPO HSA、Ascend HMO Plus、Ascend HSA HMO

計劃DO
BluePreferred 250 100
BluePreferred 500 100
BluePreferred 1000 100
BluePreferred 1500 100
BluePreferred 2000 100
BluePreferred 2500 100
BluePreferred 3000 100
BluePreferred 4000 100
BluePreferred 5000 100
BluePreferred 6000 100
BluePreferred 8300 100
BluePreferred 250 90
BluePreferred 500 90
BluePreferred 1000 90
BluePreferred 1500 90
BluePreferred 2000 90
BluePreferred 2500 90
BluePreferred 3000 90
BluePreferred 4000 90
BluePreferred 5000 90
BluePreferred 6000 90
BluePreferred 500 80
BluePreferred 1000 80
BluePreferred 1500 80
BluePreferred 2000 80
BluePreferred 2500 80
BluePreferred 3000 80
BluePreferred 4000 80
BluePreferred 5000 80
BluePreferred 6000 80
BluePreferred 7000 80
BluePreferred 1000 70
BluePreferred 1500 70
BluePreferred 2000 70
BluePreferred 2500 70
BluePreferred 3000 70
BluePreferred 4000 70
BluePreferred 5000 70
BluePreferred 6000 70
BluePreferred 7000 70
BluePreferred 8000 70
BluePreferred 2000 50

計劃DO
BluePreferred HSA Plus 3400 100
BluePreferred HSA Plus 4000 100
BluePreferred HSA Plus 5000 100
BluePreferred HSA Plus 6000 100
BluePreferred HSA Plus 7000 100
BluePreferred HSA Plus 1700 90
BluePreferred HSA Plus 3400 90
BluePreferred HSA Plus 4000 90
BluePreferred HSA Plus 5000 90
BluePreferred HSA Plus 6000 90
BluePreferred HSA Plus 3400 80
BluePreferred HSA Plus 4000 80
BluePreferred HSA Plus 5000 80
BluePreferred HSA Plus 6000 80
BluePreferred HSA Plus 3400 70
BluePreferred HSA Plus 4000 70
BluePreferred HSA Plus 5000 70
BluePreferred HSA Plus 6000 70

計劃DO
Ascend HMO Plus 8300 100
Ascend HMO Plus 3000 80
Ascend HMO Plus 5000 80
Ascend HMO Plus 6000 80
Ascend HMO Plus 7000 80
Ascend HMO Plus 3000 70
Ascend HMO Plus 5000 70
Ascend HMO Plus 6000 70
Ascend HMO Plus 7000 70
Ascend HMO Plus 8000 70

福利書籍

文件下載
Group Prosano PPO基本福利手冊
藍十字藍盾優先PPO基本福利手冊
Group BluePreferred PPO Balanced Funding Rider
Group Ascend HMO Plus 基本福利手冊
Group Ascend HMO平衡資金附加條款

BlueSignature Prosano PPO 1000 80
BlueSignature Prosano PPO 2500 80
BlueSignature Prosano PPO 5000 80
BlueSignature Prosano PPO 7000 70

Group AZ Blue HSA Prosano Saver PPO 3400 100
Group AZ Blue HSA Prosano Saver PPO 4000 100
Group AZ Blue HSA Prosano Saver PPO 5000 100
Group AZ Blue HSA Prosano Saver PPO 6000 100
Group AZ Blue HSA Prosano Saver PPO 7000 100
Group AZ Blue HSA Prosano Saver PPO 3400 80
Group AZ Blue HSA Prosano Saver PPO 4000 80
Group AZ Blue HSA Prosano Saver PPO 5000 80
Group AZ Blue HSA Prosano Saver PPO 6000 80
Group AZ Blue HSA Prosano Saver PPO 3400 90
Group AZ Blue HSA Prosano Saver PPO 4000 90
Group AZ Blue HSA Prosano Saver PPO 5000 90
Group AZ Blue HSA Prosano Saver PPO 6000 90
Group AZ Blue HSA Prosano Saver PPO 3400 70
Group AZ Blue HSA Prosano Saver PPO 4000 70
Group AZ Blue HSA Prosano Saver PPO 5000 70
Group AZ Blue HSA Prosano Saver PPO 6000 70

Group Ascend HMO Plus 8300 100
Group Ascend HMO Plus 3000 80
Group Ascend HMO Plus 5000 80
Group Ascend HMO Plus 6000 80
Group Ascend HMO Plus 7000 80
Group Ascend HMO Plus 3000 70
Group Ascend HMO Plus 5000 70
Group Ascend HMO Plus 6000 70
Group Ascend HMO Plus 7000 70
Group Ascend HMO Plus 8000 70