Understanding Our Plans

We know employees get sick or hurt, and when they do, they need health care. They can’t always avoid the bad stuff life throws at them, but it’s nice to help them through it. That’s why we’re here–to give them insurance for real life.  We explain more about our plan options below.

HMO Plans

  • Only care provided at an in-network provider or hospital is covered, but at very affordable rates.
  • Out-of-network care is covered in emergencies or when referral preauthorizations are given.
  • Members choose primary care providers (PCP) to coordinate all their medical care.
  • For specialty care, PCPs give referrals to participating specialists.
  • Women can also choose Woman’s Principal Healthcare Providers (specializing in obstetrics, gynecology, or family practice) in addition to their PCPs.

PCPs understand the big picture of members' health and serve as a healthcare partner. Ask your insurance agent for more information on our extended network options for employer groups.

PPO Plans

  • PPO members can see any provider, but they’ll pay the least in-network. Members are not required to select a primary care provider (PCP) to coordinate care.
  • We do not require PPO members to get a referral for specialty care, although some providers may require it.

We have a strong network of top-notch doctors, hospitals, clinics, and pharmacies. Ask your insurance agent for more information on our extended network options for employer groups.

POS Plans

  • Coverage is determined at the point of service, depending on the provider chosen. When choosing one of our in-network providers, HMO-style benefits apply. When choosing an out-of-network provider, your costs may be higher, except in emergencies or when preauthorization is given.
  • Members select primary care providers (PCP) to coordinate all medical care.
  • For participating specialty care, PCPs give referrals to participating specialists. Specialty care received without a referral or from an out-of-network provider is covered at the out-of-network benefit level.
  • Women can also choose Woman’s Principal Healthcare Providers (specializing in obstetrics, gynecology, or family practice) in addition to their PCPs.

POS plans are a combination of HMO financial advantages with out-of-network benefits at an out-of-network coverage level. Members have the freedom to go out-of-network, but can save money when staying in-network. Our network is broad and features premier providers. PCPs understand the big picture of members' health and serve as a healthcare partner. Ask your insurance agent for more information on our extended network options for employers.

Learn More

Plans that say HSA can also be paired with a health savings account.

Learn more in our plan booklets.