2025 年小型企業ACA計畫文件

計劃年度：

處方集

文件下載/訪問
Formulary EverydayHealth 和BlueSignature Prosano
處方集

Employer Health Plan Product Guide

DocumentsDownload
Small Business 2025

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。

PlansDownload
BlueSignature Prosano PPO Gold 1000
BlueSignature Prosano PPO Gold 2250
BlueSignature Prosano PPO Silver 5000
BlueSignature Prosano PPO Silver 6500

PlansDownload
EverydayHealth HMO Gold 1500
EverydayHealth HMO Silver 3000
EverydayHealth HMO Silver 4000
EverydayHealth HMO Silver 5000
EverydayHealth HMO Silver 6000
EverydayHealth HMO Bronze 7000
EverydayHealth HMO Bronze 8950

PlansDownload
Portfolio HSA PPO Gold 1700
Portfolio HSA PPO Silver 3300
Portfolio HSA PPO Silver 3750
Portfolio HSA PPO Silver 4250
Portfolio HSA PPO Bronze 5900
Portfolio HSA PPO Bronze 7500

PlansDownload
Portfolio HSA HMO Silver 3750
Portfolio HSA HMO Silver 4250
Portfolio HSA HMO Bronze 7500

福利書籍

文件下載
集團BlueSignature Prosano PPO基礎福利簿 場外交易
團體PPO基礎福利簿 場外交易
團體HMO基本福利 場外交易

BlueSignature Prosano PPO Gold 1000
BlueSignature Prosano PPO Gold 2250
BlueSignature Prosano PPO銀 5000
BlueSignature Prosano PPO銀 6500

EverydayHealth PPO白金 500
EverydayHealth PPO白金 750
EverydayHealth PPO白金 1000
EverydayHealth PPO Gold 1000
EverydayHealth PPO Gold 1500
EverydayHealth PPO Gold 2000
EverydayHealth PPO Gold 2500
EverydayHealth PPO Gold 3000
EverydayHealth PPO Gold 3500
EverydayHealth PPO銀 2500
EverydayHealth PPO銀 3000
EverydayHealth PPO銀 3250 / 60
EverydayHealth PPO銀 3500
EverydayHealth PPO銀 4000
EverydayHealth PPO銀 5000
EverydayHealth PPO銀 5800 / 100
EverydayHealth PPO銀 6000
EverydayHealth PPO銀 6500
EverydayHealth PPO青銅 7000
EverydayHealth PPO青銅 8950

EverydayHealth HMO黃金 1500
EverydayHealth HMO銀牌 3000
EverydayHealth HMO銀牌 4000
EverydayHealth HMO銀牌 5000
EverydayHealth HMO銀牌 6000
EverydayHealth HMO青銅 7000
EverydayHealth PPO青銅 8950

Portfolio HSA PPO Gold 1700
Portfolio HSA PPO銀 3300
Portfolio HSA PPO銀 3750
Portfolio HSA PPO銀 4250
Portfolio HSA PPO青銅 5900
Portfolio HSA PPO青銅 7500