Page 21 - 2023-small-group-brochure

Health plans to fit your needs and budget
Choose up to four health plans1 to fit your budget and ensure your employees and their families are covered, even if they live outside of our five-county service area2
Personal Choice® PPO
Personal Choice EPO
Keystone Direct POS
Keystone HMO
X
X
X
X
X
X
X
X
X3
X
X
X
X
X
X
Access to more than 60,000 in-network doctors
X Select a PCP X
Out-of-network benefits
No specialist referrals needed for the highest level of benefits
In-network benefits nationwide through BlueCard® PPO
Away from Home Care for members temporarily living outside the coverage area
Emergency and urgent care access worldwide
Refer to the health plan charts beginning on page 37 to view the 2023 benefit options
X X
1 If a group selects four plans, one must be an HMO/DPOS.
2 Employees must reside in either the Pennsylvania 5-county area or a contiguous county to be eligible to enroll in a Keystone HMO Proactive plan.
3 Members with a Direct POS plan need a referral from their PCP for certain services: Routine X-rays, spinal manipulations, physical/occupational therapy, and acupuncture.
For lab work, members should use the designated site selected by their PCP for the lowest out-of-pocket costs.
Updated benefit for ER visits
In all copay plans, emergency room cost-sharing will be waived for members if they are admitted to the hospital.
2023 Small Group Plans | Independence Blue Cross 20