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PPO plan options

Flexible. Easy to use. No referrals.

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For groups of 51-99 employees

Give employees affordable health insurance and freedom of choice. Members see physicians and select hospitals of their choice with flat-rate copayments for routine office visits. PPO members have access to the Virtual Care, for only a $5 copay,  and wellness programs, including Healthy Blue Rewards and more.

2021 plans

Deductibles $0 - $1500

Plan Deductible Coinsurance Out-of-pocket max PCP Specialist Emergency room
Simple PPO 0/0/251 $0 0% $8,550 $25 $50 $200
PPO 0/0/35 $0 0% $6,900 $35 $65 $300
PPO 500/0/25 $500 0% $6,900 $25 $50 $200
PPO 1000/0/25 $1,000 0% $8,550 $25 $50 $200
PPO 1500/10/25 $1,500 10% $1,500 coinsurance only 
$8,550 overall out-of-pocket max		 $25 $50 $200

Deductibles $2000 - $3000

Plan Deductible Coinsurance Out-of-pocket max PCP Specialist Emergency room
PPO 2000/0/30 $2,000 0% $8,550 $15/$302 $50 $200
PPO 2000/20/35 $2,000 20% $2,000 coinsurance only 
$8,550 overall out-of-pocket max		 $35 $70 $200
PPO 3000/0/30 $3,000 0% $8,550 $15/$302 $50 $200
PPO 3000/20/35 $3,000 20% $3,000 coinsurance only 
$8,550 overall out-of-pocket max		 $35 $70 $200

Deductibles $4000 - $8000

Plan Deductible Coinsurance Out-of-pocket max PCP Specialist Emergency room
PPO 4000/0/30 $4,000 0% $8,550 $15/$302 $50 $200
PPO 5000/0/30 $5,000 0% $8,550 $15/$302 $50 $200
PPO 6000/0/30 $6,000 0% $8,550 $15/$302 $50 $200
PPO 7000/0/30 $7,000 0% $8,550 $15/$302 $50 $200
PPO 8000/0/30 $8,000 0% $8,550 $15/$302 $50 $200

2020 plans

Deductibles $0 - $1500

Plan Deductible Coinsurance Out-of-pocket max PCP Specialist Emergency room
PPO 0/0/35 $0 0% $6,650 $35 $65 $300
PPO 500/0/25 $500 0% $6,650 $25 $50 $200
PPO 1000/0/25 $1,000 0% $7,900 $25 $50 $200
PPO 1500/10/25 $1,500 10% $7,900 $25 $50 $200

Deductibles $2000 - $3000

Plan Deductible Coinsurance Out-of-pocket max PCP Specialist Emergency room
PPO 2000/0/30 $2,000 0% $7,900 $15/$302 $50 $200
PPO 2000/0/15 $2,000 0% $7,900 $15 $30 $200
PPO 2000/20/35 $2,000 20% $7,900 $35 $70 $200
PPO 3000/0/30 $3,000 0% $7,900 $15/$302 $50 $200
PPO 3000/0/15 $3,000 0% $7,900 $15 $30 $200
PPO 3000/20/35 $3,000 20% $7,900 $35 $70 $200

Deductibles $4000 - $8000

Plan Deductible Coinsurance Out-of-pocket max PCP Specialist Emergency room
PPO 4000/0/30 $4,000 0% $7,900 $15/$302 $50 $200
PPO 4000/0/15 $4,000 0% $7,900 $15 $30 $200
PPO 5000/0/30 $5,000 0% $7,900 $15/$302 $50 $200
PPO 6000/0/30 $6,000 0% $7,900 $15/$302 $50 $200
PPO 7000/0/30 $7,000 0% $7,900 $15/$302 $50 $200
PPO 8000/0/30 $8,000 0% $8,150 $15/$302 $50 $200

1Simple PPO 0/0/25 is a new plan design for 2021. It features copays for nearly all services, in lieu of any deductible or coinsurance for in-network medical services, and free Virtual Care visits when using Capital BlueCross's Virtual Care platform.

2These plans have a tiered PCP office visit benefit, called "Office Visit Plus - Total Care". The copay is lower when visiting one of these designated PCPs.

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