2-50 employees
UpdateBCN HMO Fixed Cost offers simplicity for both you and your employees. It's a copay-only plan so there's no cost uncertainty for your employees.
NETWORK SIZE
PREMIUM COST
$$$
LEVEL OF CONSUMER ENGAGEMENT
Low
INDIVIDUAL DEDUCTIBLE
$0
A copay-only plan means your employees will only have to worry about just that — paying copays. They'll know what they need to pay before they go. No more figuring out percentages or deductibles.
This plan also includes these features:
Want more details about BCN HMO Fixed Cost?
2024 Documents
This is a top-level plan with a $0 deductible. The copays listed are not a complete list of services that require a copay.
Monthly premium
High
Deductible
$0
Out-of-pocket maximum
$4,000
PCP visit copay
$15
Individual annual deductible
Individual annual deductible
An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay.
In network
$0
Out of network
Not covered
Family annual deductible
Family annual deductible
A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay.
In network
$0
Out of network
Not covered
Coinsurance percentage
Coinsurance percentage
Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.
In network
0%
Out of network
Not covered
Embedded coinsurance maximum
Embedded coinsurance maximum
The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.
In network
N/A
Out of network
Not covered
Individual out-of-pocket maximum
Out-of-pocket maximum
This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.
In network
$4,000
Out of network
Not covered
Family out-of-pocket maximum
Out-of-pocket maximum
This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.
In network
$8,000
Out of network
Not covered
PCP visit copay
PCP office visit copay
This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.
In network
$15
Out of network
Not covered
Specialist care copay (when referred)
In network
$30
Out of network
Not covered
Retail health clinic copay
In network
$30
Out of network
Not covered
Urgent care copay
In network
$30
Out of network
Not covered
Emergency room copay
In network
$250
Out of network
Not covered
Ambulance copay (when medically necessary)
In network
$100
Out of network
Not covered
Preferred generic pharmacy copay
Preferred generic pharmacy copay
This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.
In network
$4
Out of network
Not covered
|
|
||
---|---|---|---|
Individual annual deductible An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. |
$0 | Not covered | |
Family annual deductible A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. |
$0 | Not covered | |
Coinsurance percentage Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible. |
0% | Not covered | |
Embedded coinsurance maximum The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum. |
N/A | Not covered | |
Out-of-pocket maximum This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services. |
$4,000 | Not covered | |
Out-of-pocket maximum This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services. |
$8,000 | Not covered | |
PCP office visit copay This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care. |
$15 | Not covered | |
|
$30 | Not covered | |
|
$30 | Not covered | |
|
$30 | Not covered | |
|
$250 | Not covered | |
|
$100 | Not covered | |
Preferred generic pharmacy copay This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs. |
$4 | Not covered |
This is a mid-level plan with a $0 deductible. The copays listed are not a complete list of services that require a copay.
Monthly premium
Medium
Deductible
$0
Out-of-pocket maximum
$8,500
PCP visit copay
$20
Individual annual deductible
Individual annual deductible
An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay.
In network
$0
Out of network
Not covered
Family annual deductible
Family annual deductible
A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay.
In network
$0
Out of network
Not covered
Coinsurance percentage
Coinsurance percentage
Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.
In network
0%
Out of network
Not covered
Embedded coinsurance maximum
Embedded coinsurance maximum
The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.
In network
N/A
Out of network
Not covered
Individual out-of-pocket maximum
Out-of-pocket maximum
This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.
In network
$8,500
Out of network
Not covered
Family out-of-pocket maximum
Out-of-pocket maximum
This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.
In network
$17,000
Out of network
Not covered
PCP visit copay
PCP office visit copay
This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.
In network
$20
Out of network
Not covered
Specialist care copay (when referred)
In network
$50
Out of network
Not covered
Retail health clinic copay
In network
$50
Out of network
Not covered
Urgent care copay
In network
$50
Out of network
Not covered
Emergency room copay
In network
$250
Out of network
Not covered
Ambulance copay (when medically necessary)
In network
$100
Out of network
Not covered
Preferred generic pharmacy copay
Preferred generic pharmacy copay
This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.
In network
$15
Out of network
Not covered
|
|
||
---|---|---|---|
Individual annual deductible An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. |
$0 | Not covered | |
Family annual deductible A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. |
$0 | Not covered | |
Coinsurance percentage Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible. |
0% | Not covered | |
Embedded coinsurance maximum The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum. |
N/A | Not covered | |
Out-of-pocket maximum This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services. |
$8,500 | Not covered | |
Out-of-pocket maximum This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services. |
$17,000 | Not covered | |
PCP office visit copay This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care. |
$20 | Not covered | |
|
$50 | Not covered | |
|
$50 | Not covered | |
|
$50 | Not covered | |
|
$250 | Not covered | |
|
$100 | Not covered | |
Preferred generic pharmacy copay This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs. |
$15 | Not covered |
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Our agents can help you set up your plan, enroll your employees and help you determine the easiest way to set up payments. Contact an agent to learn more.
How do I choose an HSA, FSA or HRA for my employees?
There are three types of accounts used to pay for medical expenses: a health savings account, or HSA, a health reimbursement arrangement, or HRA, and a flexible spending account, also known as an FSA.
These accounts are part of what's called consumer-directed health care. They offer:
We can help you decide which is best for your business and employees. Connect with us.
What is a PCP Focus network?
PCP Focus is a custom primary care physician HMO network offered by Blue Care Network. The doctors your employees will choose from this network have shown they can provide quality care and a high level of efficiency that lowers health care costs. We pass those savings on to you: your premiums are up to 8% lower when you choose a plan with the PCP Focus network.
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