2015 Keystone HMO Proactive Plans

Learn how tiered network plans offer your employees quality care at a lower cost.

2014 health plans

Health Plans
Blue Solutions for small business employers

Blue Solutions® plans for 50 or fewer employees are categorized by the level of coverage they offer — platinum, gold, silver, or bronze — to help make it easy to find the right health plan and benefits for your employees.

Platinum Plans

Platinum plans provide the highest level of coverage. If you offer a PPO, DPOS, or HMO platinum plan, there is no deductible, and most services are covered by a copay. These plans are best-suited for employees who prefer to pay a higher monthly premium, while saving on out-of-pocket expenses. We also offer platinum plans designed to pair with a health savings account (HSA) or health reimbursement account (HRA).

Gold Plans

Gold plans offer a high level of coverage with a lower premium, but more out-of-pocket costs. Most services are covered by a copay, and are not subject to a deductible or coinsurance. We offer PPO, DPOS, and HMO plans, including HMO Gold Proactive, an HMO with a tiered network, for greater cost savings. HSA-qualified and HRA-compatible plans are also available, but covered services are subject to coinsurance, not copay, and include an upfront deductible.

Silver Plans

Silver plans have lower monthly premiums, with higher out-of-pocket costs than platinum and and gold plans. Services are covered with an upfront deductible, and your employees pay either a copay or coinsurance depending on the type of service. We offer PPO, DPOS, HMO, and HSA/HRA silver plans. Choosing HMO Silver Proactive, an HMO plan with a tiered network, can help you and your employees save even more.

Bronze Plans

Bronze plans have the lowest monthly premiums of all, along with the highest out-of-pocket costs. They work well for employees who don’t typically need a lot of health services but want to be covered in case of unexpected illness or injury. We offer DPOS, HMO, and HSA bronze plans.

HSA and HRA Plans

Blue Solutions Health Savings Account (HSA) and Health Reimbursement Account (HRA) plans can help you lower health care costs and offer your employees top-quality coverage.

Pharmacy

Every health plan in the Blue Solutions product suite includes IBC Prescription Drug coverage.

Dental

All Blue Solutions health plans purchased directly from IBC include pediatric dental coverage1.

Vision

Every health plan in the Blue Solutions product suite includes pediatric vision coverage. To help your employees maximize their coverage, we provide enhanced IBC Adult Vision Benefits in most of our Blue Solutions Plans.

Essential Health Benefits

As part of the Affordable Care Act, all plans offer a core set of health care service categories, known as essential health benefits. Essential health benefits include these ten categories of services:

Essential Health Benefit

Example

Preventive, wellness, and disease management services

Yearly physical, flu shot, and gynecological exam

Emergency care

Treatment for broken bones, heart attacks, and more at a hospital emergency room

Ambulatory services

Minor surgeries, blood tests, and X-rays

Hospitalization

Treatment at a hospital for conditions that require overnight or multiple day stays

Maternity and newborn services

Care through the course of pregnancy, delivery of the baby, and checkups after birth

Pediatric services1, including dental and vision2

Dental exams and cleanings, eye exams, and glasses

Prescription drugs3

High blood pressure medicine, insulin, antibiotics

Laboratory services

Blood tests

Mental health and substance abuse services, including behavioral health treatment

Help for conditions like depression, alcohol abuse, and drug abuse

Rehabilitation and habilitation services

Physical therapy, speech therapy, and occupational therapy

1 Blue Solutions health plans purchased on the Small Business Health Options Program (SHOP) exclude pediatric dental coverage.

2 United Concordia Dental is an independent company that administers and underwrites the dental programs; IBC Vision Care is administered by Davis Vision, an independent company.

3 Pharmacy benefits are administered by FutureScripts, a Catamaran company, an independent company providing pharmacy benefit management services.