2023 benefit updates

For renewing members

If you had 2022 coverage you can view your online renewal in your secure member portal.

Renewing medical coverage

On exchange plans purchased through Pennie.com

Gold Simple PPO 0/0/25

Below are the benefit changes for 2023

  • Diagnostic lab tests when performed at a Facility/Hospital owned lab - $75 copayment.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $10 copayment - Preferred Generic
    • $38 copayment - Non-Preferred Generic
    • $113 copayment - Preferred Brand
    • $175 copayment - Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Gold PPO 1800/10/20

Below are the benefit changes for 2023

  • In-network annual deductible - $1,800 single/$3,600 family
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $188 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Gold PPO 2650/10/20

Below are the benefit changes for 2023

  • In-network annual deductible - $2,650 single/$5,300 family.
  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $20 copayment, deductible waived.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $188 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Gold PPO Choice 2000/0/30

Below are the benefit changes for 2023

  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $188 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Gold PPO Choice 3000/0/25

Below are the benefit changes for 2023

  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $25 copayment, deductible waived for Choice 1 providers.
  • Outpatient office visits and consultations when provided by all other professional providers (specialist visits) $50 copayment, deductible waived for Choice 1 providers.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $188 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Gold Capital or Valley Advantage EPO 1800/10/20

Below are the benefit changes for 2023

  • In-network annual deductible - $1,800 single/$3,600 family.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $188 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Gold Capital or Valley Advantage EPO 2650/10/20

Below are the benefit changes for 2023

  • In-network annual deductible - $2,650 single/$5,300 family.
  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $20 copayment, deductible waived.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $188 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver PPO 6000/20/30

Below are the benefit changes for 2023

  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $30 copayment, deductible waived.
  • Outpatient office visits and consultations when provided by all other professional providers (specialist visits) - $60 copayment, deductible waived.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $125 copayment after deductible for Preferred Brand
    • $250 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver PPO 5800/15/15 CSR73

Below are the benefit changes for 2023

  • In-network annual deductible - $5,800 single/$11,600 family.
  • In-network annual maximum out-of-pocket limit - $7,250 single/$14,500 family.
  • Emergency room facility services - $250 copayment after deductible.
  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $15 copayment, deductible waived.
  • Outpatient office visits and consultations when provided by all other professional providers (specialist visits) - $30 copayment, deductible waived.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $13 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $138 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver PPO 1500/5/5 CSR87

Below are the benefit changes for 2023

  • In-network annual maximum out-of-pocket limit - $2,850 single/$5,700 family.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $8 copayment, deductible waived for Preferred Generic
    • $38 copayment after deductible for Preferred Brand
    • $100 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver PPO 400/0/3 CSR94

Below are the benefit changes for 2023

  • In-network annual deductible - $400 single/$800 family.
  • In-network annual maximum out-of-pocket limit - $1,000 single/$2,000 family.
  • 90 day supply of medication at a participating retail pharmacy or home delivery,
    • $5 copayment, deductible waived for Preferred Generic
    • $25 copayment after deductible for Preferred Brand
    • $63 copayment after deductible for Non-Preferred Brand.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver PPO Choice 4500/20/35

Below are the benefit changes for 2023

  • In-network annual deductible - $4,500 single/$9,000 family for Choice 1 providers, $9,100 single/$18,200 family for Choice 2 providers.
  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $125 copayment after deductible for Preferred Brand
    • $250 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver PPO Choice 4500/15/25 CSR73

Below are the benefit changes for 2023

  • In-network annual deductible - $4,500 single/$9,000 family for Choice 1 providers, $7,250 single/$14,500 family for Choice 2 providers.
  • In-network annual maximum out-of-pocket limit -$7,250 single/$14,500 family.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $13 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $138 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver PPO Choice 1500/0/15 CSR87

Below are the benefit changes for 2023

  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $8 copayment, deductible waived for Preferred Generic
    • $38 copayment after deductible for Preferred Brand
    • $100 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver PPO Choice 475/0/5 CSR94

Below are the benefit changes for 2023

  • In-network annual deductible - $475 single/$950 family for Choice 1 providers.
  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $20 copayment, deductible waived for Choice 2 providers.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $5 copayment, deductible waived for Preferred Generic
    • $25 copayment after deductible for Preferred Brand
    • $63 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver Capital or Valley Advantage EPO 6000/20/30

Below are the benefit changes for 2023

  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $30 copayment, deductible waived.
  • Outpatient office visits and consultations when provided by all other professional providers (specialist visits) - $60 copayment, deductible waived.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $125 copayment after deductible for Preferred Brand
    • $250 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver Capital or Valley Advantage EPO 6000/20/12 CSR73

Below are the benefit changes for 2023

  • In-network annual deductible - $6,000 single/$12,000 family.
  • In-network annual maximum out-of-pocket limit -$7,250 single/$14,500 family.
  • In-network coinsurance - 20%.
  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $12 copayment, deductible waived.
  • Outpatient office visits and consultations when provided by all other professional providers (specialist visits) - $25 copayment, deductible waived.
  • Emergency room facility services - $300 copayment after deductible.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $13 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $138 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver Capital or Valley Advantage EPO 1500/5/10 CSR87

Below are the benefit changes for 2023

  • In-network annual maximum out-of-pocket limit -$2,600 single/$5,200 family.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $8 copayment, deductible waived for Preferred Generic
    • $38 copayment after deductible for Preferred Brand
    • $100 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver Capital or Valley Advantage EPO 425/0/3 CSR94

Below are the benefit changes for 2023

  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $5 copayment, deductible waived for Preferred Generic
    • $25 copayment after deductible for Preferred Brand
    • $63 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Bronze PPO 7450/0/50

Below are the benefit changes for 2023

  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • Emergency room facility services - $400 copayment after deductible.
  • Urgent care services - $100 copayment, deductible waived.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Bronze QHDHP PPO 6300/0/50

Below are the benefit changes for 2023

  • Emergency room facility services - $400 copayment after deductible.
  • Urgent care services - $100 copayment after deductible.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Bronze PPO Choice 7100/0/50

Below are the benefit changes for 2023

  • In-network annual deductible - $9,100 single/$18,200 family for Choice 2 providers.
  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • Emergency room facility services - $400 copayment after deductible.
  • Urgent care services - $100 copayment.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Bronze QHDHP PPO Choice 6300/0/50

Below are the benefit changes for 2023

  • Emergency room facility services - $400 copayment after deductible.
  • Urgent care services - $100 copayment, after deductible.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Bronze Capital or Valley Advantage EPO 7450/0/50

Below are the benefit changes for 2023

  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • Emergency room facility services - $400 copayment after deductible.
  • Urgent care services - $100 copayment

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Catastrophic PPO 9100/0/0

Below are the benefit changes for 2023

  • In-network annual deductible - $9,100 single/$18,200 family.
  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Zero/Limited Plans

Below are the benefit changes for 2023

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Off exchange plans purchased directly through Capital Blue Cross

Gold Simple PPO 0/0/25

Below are the benefit changes for 2023

  • Diagnostic lab tests when performed at a Facility/Hospital owned lab - $75 copayment.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $10 copayment - Preferred Generic
    • $38 copayment - Non-Preferred Generic
    • $113 copayment - Preferred Brand
    • $175 copayment - Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Gold PPO 1800/10/20

Below are the benefit changes for 2023

  • In-network annual deductible - $1,800 single/$3,600 family
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $188 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Gold PPO 2650/10/20

Below are the benefit changes for 2023

  • In-network annual deductible - $2,650 single/$5,300 family.
  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $20 copayment, deductible waived.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $188 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Gold PPO Choice 2000/0/30

Below are the benefit changes for 2023

  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $188 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Gold PPO Choice 3000/0/25

Below are the benefit changes for 2023

  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $25 copayment, deductible waived for Choice 1 providers.
  • Outpatient office visits and consultations when provided by all other professional providers (specialist visits) $50 copayment, deductible waived for Choice 1 providers.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $188 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Gold Capital or Valley Advantage EPO 1800/10/20

Below are the benefit changes for 2023

  • In-Network annual deductible - $1,800 single/$3,600 family.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $188 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Gold Capital or Valley Advantage EPO 2650/10/20

Below are the benefit changes for 2023

  • In-network annual deductible - $2,650 single/$5,300 family.
  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $20 copayment, deductible waived.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $188 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver PPO 5950/20/30

Below are the benefit changes for 2023

  • In-network annual maximum out of pocket limit -$9,100 single/$18,200 family.
  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $30 copayment deductible waived.
  • Outpatient office visits and consultations when provided by all other professional providers (specialist visits) - $60 copayment, deductible waived.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $125 copayment after deductible for Preferred Brand
    • $250 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver PPO 6000/20/30

Below are the benefit changes for 2023

  • In-Network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $30 copayment, deductible waived.
  • Outpatient office visits and consultations when provided by all other professional providers (specialist visits) - $60 copayment, deductible waived.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $125 copayment after deductible for Preferred Brand
    • $250 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver QHDHP PPO 2500/10/40

Below are the benefit changes for 2023

  • In-network annual deductible - $2,500 single/$5,000 family.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $63 copayment after deductible for Preferred Brand
    • $188 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver PPO Choice 4450/20/35

Below are the benefit changes for 2023

  • In-network annual deductible - $4,450 single/$8,900 family for Choice 1 providers, $9,100 single/$18,200 family for Choice 2 providers.
  • In-network annual maximum out of pocket limit -$9,100 single/$18,200 family.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $125 copayment after deductible for Preferred Brand
    • $250 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver PPO Choice 4500/20/35

Below are the benefit changes for 2023

  • In-network annual deductible - $4,500 single/$9,000 family for Choice 1 providers, $9,100 single/$18,200 family for Choice 2 providers.
  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $125 copayment after deductible for Preferred Brand
    • $250 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver QHDHP PPO Choice 2700/10/35

Below are the benefit changes for 2023

  • In-network annual deductible - $2,700 single/$5,400 family for Choice 1 providers/$5,400 single/$10,800 family for Choice 2 providers.
  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $125 copayment after deductible for Preferred Brand
    • $250 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver Capital or Valley Advantage EPO 5950/20/30

Below are the benefit changes for 2023

  • In-network annual maximum out of pocket limit -$9,100 single/$18,200 family.
  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $30 copayment deductible waived.
  • Outpatient office visits and consultations when provided by all other professional providers (specialist visits) - $60 copayment, deductible waived.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $125 copayment after deductible for Preferred Brand
    • $250 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Silver Capital or Valley Advantage EPO 6000/20/30

Below are the benefit changes for 2023

  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • Outpatient office visits and consultations when provided by a Family Practitioner, General Practitioner, or Pediatrician (PCP visits) - $30 copayment, deductible waived.
  • Outpatient office visits and consultations when provided by all other professional providers (specialist visits) - $60 copayment, deductible waived.
  • 90 day supply of medication at a participating retail pharmacy or home delivery.
    • $25 copayment, deductible waived for Preferred Generic
    • $125 copayment after deductible for Preferred Brand
    • $250 copayment after deductible for Non-Preferred Brand

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Bronze PPO 7450/0/50

Below are the benefit changes for 2023

  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • Emergency room facility services - $400 copayment after deductible.
  • Urgent care services - $100 copayment, deductible waived.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Bronze HMO 7450/0/50

Below are the benefit changes for 2023

  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • Emergency room facility services - $400 copayment after deductible.
  • Urgent care services - $100 copayment, deductible waived.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Bronze QHDHP PPO 6300/0/50

Below are the benefit changes for 2023

  • Emergency room facility services - $400 copayment after deductible.
  • Urgent care services - $100 copayment, deductible waived.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Bronze PPO Choice 7100/0/50

Below are the benefit changes for 2023

  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family for Choice 2 providers.
  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • Emergency room facility services - $400 copayment after deductible.
  • Urgent care services - $100 copayment.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Bronze QHDHP PPO Choice 6300/0/50

Below are the benefit changes for 2023

  • Emergency room facility services - $400 copayment after deductible.
  • Urgent care services - $100 copayment, after deductible.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Bronze Capital or Valley Advantage EPO 7450/0/50

Below are the benefit changes for 2023

  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.
  • Emergency room facility services - $400 copayment after deductible.
  • Urgent care services - $100 copayment.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Catastrophic PPO 9100/0/0

Below are the benefit changes for 2023

  • In-network annual deductible -$9,100 single/$18,200 family.
  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Catastrophic HMO 9100/0/0

Below are the benefit changes for 2023

  • In-network annual deductible -$9,100 single/$18,200 family.
  • In-network annual maximum out-of-pocket limit -$9,100 single/$18,200 family.

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2023.

Pharmacy changes

Visit the prescription drug benefits page to view plan formularies and other important information for 2023.

Enrollment

Open enrollment timeline

Open enrollment is from November 1st, 2022 - January 15th, 2023.

Applications for coverage effective January 1st, 2023 must be submitted between November 1st - December 15th, 2022.

Applications for coverage effective February 1st, 2023 must be submitted between December 16th, 2022 - January 15th, 2023.

Any applications submitted outside of the above timeline will fall into the Special Enrollment Period and must have a qualifying event to enroll.

Ready to enroll or make a change

You can apply for medical with Rx included, dental or vision plans if you live in our service area.

Visit our individual and family plans to get started.

Enrollment details

Off Pennie Current members

If you’re a current member, you should receive a renewal packet with information about the changes to your plan and new premium rate in November. You do not need to take action if you want to keep your current plan.

On Pennie members

Visit Pennie to review your application for any changes, including any changes to your financial help. If Pennie sends us information to renew you, you will receive a renewal packet with information about the changes to your plan and new premium rate in mid- November.

New member

If you are a new member, you’ll receive a declaration page after you enroll. The page provides the effective date of coverage, covered members and expected premium amounts.

ID cards

You will receive a new ID card in mid-December. Please keep and be ready to use beginning January 1st.

Billing

Invoices for January enrollment will be generated on December 12, 2022.

Payment options

  • Credit card/eCheck

    Make payments by logging into your secure member account or by calling 833.496.7321. Select a single payment or setup recurring payment options.

  • Check it Out

    You will receive a notice when Check It Out is processed. Payment will be deducted from the selected account on the first day of each month.

  • Paper bill

    Invoices are mailed to the address on the enrollment application.

  • Bill payer

    Payments can be made through a financial institution’s bill payer program.

You can now view your invoices and payment history here.

Visit the Welcome page for more information about your plan.