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Emblem
- (EPO) -
Click
here for the detailed plan summary.
Option #:3 |
| This plan is an EPO (Exclusive Provider
Organization) with no out of network coverage & no referrals
needed. It has a $40 primary & specialist office visit co-pay.
The inpatient hospital is a $500 co-pay for an emergency room
visit is a $100 co-pay. The prescription coverage is 0/30/50 with
a $50 annual deductable and a $3000 maximum. |
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Monthly |
Monthly |
Quarterly |
| Small Group |
Sole
Proprietor |
Sole
Proprietor |
| Individual |
$479.89 |
N/A |
N/A |
| Individual
+ Spouse |
$1,151.77 |
N/A |
N/A |
| Individual + Child(ren) |
$891.59
|
N/A |
N/A |
| Family
|
$1,444.69 |
N/A |
N/A |
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Plan
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