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Open Access POS Plans

PW_E219653
 

Rx Option B Plans – Benefit Summaries (effective 7/1/2014)

OAP5 500 100 6.3K b 
OAP5 500 90 3.3K B 
OAP5 500 90 B 
OAP5 500 80 2.5K B 
OAP5 500 80 B 
OAP5 1K 100 6.3K B 
OAP5 1K 90 5.9K B 
OAP5 1K 90 B 
OAP5 1K 80 4.7K B 
OAP5 1K 80 B 
OAP5 1.5K 100 6.3K B 
OAP5 1.5K 90 B 
OAP5 1.5K 80 B 
OAP5 2K 100 6.3K B 
OAP5 2.5K 100 6.3K B 
OAP5 2.5K 100 B 
OAP5 2.5K 80 B 
OAP5 3.5K 100 6.3K B 
OAP5 3.5K 100 B 
OAP5 3.5K 80 B 
OAP5 3.5K 70 B 
OAP5 5K 100 6.3K B 
OAP5 5K 100 B 
OAP5 5K 80 B 
OAP5 5K 70 B 
OAP5 6.3K 100 B 
2OAP5 500 100 B 
2OAP5 500 90 B 
2OAP5 500 80 B 
2OAP5 1K 100 B 
2OAP5 1K 90 B 
2OAP5 1K 80 B 
2OAP5 1.5K 100 B 
2OAP5 1.5K 90 B 
2OAP5 1.5K 80 B 
2OAP5 2K 100 B 
OAP9 2.5K 80 B  
OAP9 3.5K 80 B  
OAP9 5K 80 B  
OAP9 6.3K 100 B  
 
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