2-50 employees

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Health Plans

Simply BlueSM HRA PPO

These employer-paid health reimbursement arrangement plans help employees lower their costs while saving you money.

Plan highlights
  • Increases health care engagement for your employees 
  • Your company owns and keeps any unused funds. 
  • Prescription drug coverage is included. 
  • Preventive care is 100% covered.

NETWORK SIZE

an image

PREMIUM COST

$$$$

LEVEL OF CONSUMER ENGAGEMENT

Low

INDIVIDUAL DEDUCTIBLE

$1,500 - $5,000

HOW HRAs WORK

With a health reimbursement arrangement, or HRA, you provide the funds to your employee's account. These funds can pay for expenses like deductibles and coinsurance.

Here are some of the benefits:

  • These pay-as-you-go plans have no startup or administrative fees.
  • They offer tax advantages and seamless processing of medical claims.

Want more details about Simply Blue HRA PPO?

2024 Documents

Download 2024 plan certificate

 

Plan options for 2024

2024 Simply Blue HRA PPO Gold Option 1

This is a mid-level plan with a $1,500 deductible.

Monthly premium

Medium

Deductible

$1,500

Out-of-pocket maximum

$9,100

PCP visit copay

$30

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

$1,500

Out of network

$9,100

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

$3,000

Out of network

$6,000

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

20%

Out of network

40%

Individual 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

$4,000

Out of network

$8,000

Family 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

$8,000

Out of network

$16,000

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

$9,100

Out of network

$18,200

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

$18,200

Out of network

$36,400

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

$30

Out of network

40% after deductible

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

$20

Out of network

$20 plus 25% of approved cost

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

 $1,500 $9,100

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. 

 $3,000 $6,000

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.

 20% 40%

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.

 $4,000 $8,000

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.

 $8,000 $16,000

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.

 $9,100 $18,200

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.

 $18,200 $36,400

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.

 $30 40% after deductible

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.

 $20 $20 plus 25% of approved cost

2024 Simply Blue HRA PPO Gold Option 2

This is a mid-level plan with a $2,000 deductible.

Monthly premium

Medium

Deductible

$2,000

Out-of-pocket maximum

$9,100

PCP visit copay

$40

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

$2,000

Out of network

$4,000

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

$4,000

Out of network

$8,000

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

20%

Out of network

40%

Individual 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

N/A

Family 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

N/A

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

$9,100

Out of network

$18,200

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

$18,200

Out of network

$36,400

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

$40

Out of network

40% after deductible

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

$20

Out of network

$20 plus 25% of approved cost

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

 $2,000 $4,000

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. 

 $4,000 $8,000

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.

 20% 40%

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 N/A

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 N/A

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.

 $9,100 $18,200

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.

 $18,200 $36,400

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.

 $40 40% after deductible

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.

 $20 $20 plus 25% of approved cost

2024 Simply Blue HRA PPO Gold Option 3

This is a mid-level plan with a $4,000 deductible.

Monthly premium

Medium

Deductible

$4,000

Out-of-pocket maximum

$9,100

PCP visit copay

$30

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

$4,000

Out of network

$8,000

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

$8,000

Out of network

$16,000

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

20%

Out of network

40%

Individual 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

N/A

Family 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

N/A

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

$9,100

Out of network

$18,200

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

$18,200

Out of network

$36,400

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

$30

Out of network

40% after deductible

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

$20

Out of network

$20 plus 25% of approved cost

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

 $4,000 $8,000

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. 

 $8,000 $16,000

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.

 20% 40%

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 N/A

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 N/A

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.

 $9,100 $18,200

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.

 $18,200 $36,400

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.

 $30 40% after deductible

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.

 $20 $20 plus 25% of approved cost

2024 Simply Blue HRA PPO Platinum

This is a top-level plan with a $5,000 deductible.

Monthly premium

High

Deductible

$5,000

Out-of-pocket maximum

$6,350

PCP visit copay

$30

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

$5,000

Out of network

$10,000

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

$10,000

Out of network

$20,000

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

30%

Out of network

50%

Individual 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

N/A

Family 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

N/A

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

$6,350

Out of network

$12,700

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

$12,700

Out of network

$25,400

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

$30

Out of network

50% after deductible

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

$20

Out of network

$20, plus 25% of approved cost

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

 $5,000 $10,000

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. 

 $10,000 $20,000

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.

 30% 50%

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 N/A

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 N/A

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.

 $6,350 $12,700

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.

 $12,700 $25,400

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.

 $30 50% after deductible

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.

 $20 $20, plus 25% of approved cost
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Resources

Pharmacy benefit manager changes

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