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PPO Plans


Rx Option A Plans – Benefit Summaries (effective 1/1/2015)

PPO5 500/0 6.6K A 
PPO5 500/10 4.4K A 
PPO5 500/10 2K A 
PPO5 500/20 4.4K A 
PPO5 500/20 2K A 
PPO5 1K/0 6.6K A 
PPO5 1K/10 6.6K A 
PPO5 1K/10 4K A 
PPO5 1K/20 6.6K A 
PPO5 1K/20 4K A 
PPO5 1.5K/0 6.6K A 
PPO5 1.5K/10 6.6K A 
PPO5 1.5K/20 6.6K A 
PPO5 2K/0 6.6K A 
PPO5 2.5K/0 6.6K A 
PPO5 2.5K/0 A 
PPO5 2.5K/20 A 
PPO5 3.5K/0 6.6K A 
PPO5 3.5K/0 A 
PPO5 3.5K/20 A 
PPO5 3.5K/30 A 
PPO5 5K/0 6.6K A 
PPO5 5K/0 A 
PPO5 5K/20 A 
PPO5 5K/30 A 
PPO5 6.35K/0 A 
PPO5 500/0 A 
PPO5 500/10 A 
PPO5 500/20 A 
PPO5 1K/0 A 
PPO5 1K/10 A 
PPO5 1K/20 A 
PPO5 1.5K/0 A 
PPO5 1.5K/10 A 
PPO5 1.5K/20 A 
PPO5 2K/0 A 
PPO9 2.5K/20 A 
PPO9 3.5K/20 A 
PPO9 5K/20 A 
PPO9 6.35K/0 A 
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