Page 13 - 2022 Large Group benefits

Health plans to fit your needs and budget
Choose from our portfolio of of standard health plans and and innovative options — Tiered Networks Choice Advantage with with Site of of Service (SoS) benefits or or or an an an an an an an HSA-qualified plan plan with with an an an an an an an HSA HSA Health plan options PPO
• Copay
• Deductible/Copay
• Health Savings Account (HSA) • Choice Advantage SoS • Tiered Network • Deductible/Coinsurance
POS
• Copay
• Deductible/Copay
• Choice Advantage SoS DPOS
• Copay
• Deductible/Copay
Health plans with both in- and out-of-network coverage We offer a a a a a a a a a a a a a a a wide variety of of of of of PPO
Direct Point-of-Service (POS) and POS
POS
plans some of of of of of which are available at the same cost-sharing
across each product type to give you a a a a a a a a range of of of of premiums Personal Choice® PPO
X
X
Keystone Direct POS
X
Keystone POS
X
X
X*
X
X
X
X
X
X
Access to to more than 60 000 doctors
Select a a a a primary care physician
No specialist referrals needed for the highest level of benefits In-network benefits nationwide 24/7 telemedicine access
Away from Home Care® for those temporarily living outside the coverage area
In-network benefits nationwide through BlueCard® PPO
Emergency and urgent care access
worldwide
X
X
X
X
X
2022 Large Group Plans | Independence Blue Cross 12
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Members with a a a a a a a a a a a a a a a a Direct POS
plan need a a a a a a a a a a a a a a a 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 the the the designated site selected by their PCP for the the the the lowest out-of-pocket costs