SeeChange Small Business Group Health Insurance PPO HMO HSA HRA Plans - California

Rate Guide:  10-2014 (ACA)    
Provider Networks (SeeChange uses the Cigna Network for all of their PPO provider)
Effective
Network
In-Network
Ded Sgl/Fam

In-Network
Out/pocket max

In-Network
Office visits

(AD = after deductible)
Rx Drugs
(AD = after deductible)
Professional Services
(AD = after deductible)
SeeChange (ACA) BRONZE Plans
Bronze Reward HSA (BS)      SBC



IRS HSA Contribution Limits
1-2014
HSA
4500 / 9000
Aggregate
6350 / 12700
50% co-ins
$10 Gen
$25 Brand
AD
50% coins
50% InP
50% OutP
AD
Bronze Reward 50 (BS)      SBC

1-2014
PPO
5500 / 11000
Embedded
6350 / 12700
50% co-ins
$10 Gen
$50 Brand
AD
50% coins
50% InP
50% OutP
AD
Bronze Reward 80 (BS)      SBC

1-2014
PPO
5500 / 11000
Embedded
6350 / 12700
20% co-ins
$10 Gen
$25 Brand
AD
20% coins
20% InP
20% OutP
AD
Bronze Reward 100 (BS)      SBC

1-2014
PPO
6200 / 12400
Embedded
6200 / 12400
0% co-ins
0% Gen
0% Brand
AD
0% coins
0% InP
0% OutP
AD
Bronze Reward 70 Copay (BS)      SBC

1-2014
PPO
5000 / 10000
Embedded
6350 / 12700
$60 copay
(Ded applies after first
3 Non-Preventive Visits)
$25 Gen
$50 Brand
AD
30% coins
30% InP
30% OutP
AD
SeeChange (ACA)
SILVER
Plans
Effective
Network
In-Network
Ded Sgl/Fam

In-Network
Out/pocket max

In-Network
Office visits

(AD = after deductible)
Rx Drugs
(AD = after deductible)
Professional Services
(AD = after deductible)
Silver Reward HSA (BS)      SBC

1-2014
HSA
2000 / 4000
Aggregate
6350 / 12700
20% co-ins
$10 Gen
$25 Brand
AD
20% coins
20% InP
20% OutP
AD
Silver Reward 70 Copay (BS)      SBC

1-2014
PPO
1750 / 3500
Embedded
6350 / 12700
$45 copay
(Ded waived)
$10 Gen
$50 Brand
($250 (Single) Brand Name Ded
$500 (Family) Brand Name Ded - Embedded)
30% coins
30% InP
30% OutP
AD
Silver Reward 80 Copay (BS)      SBC

1-2014
PPO
1500 / 3000
Embedded
6350 / 12700
$45 copay
(Ded waived)
$25 Gen
$50 Brand
($500 (Single) Brand Name Ded
$1000 (Family) Brand Name Ded - Embedded)
20% coins
20% InP
20% OutP
AD
SeeChange (ACA)
GOLD
Plans
Effective
Network
In-Network
Ded Sgl/Fam

In-Network
Out/pocket max

In-Network
Office visits

(AD = after deductible)
Rx Drugs
(AD = after deductible)
Professional Services
(AD = after deductible)
Gold Reward 80 Copay (BS)      SBC

1-2014
PPO
0 / 0
6350 / 12700
$30 copay
$20 Gen
$50 Brand
20% coins
20% InP
20% OutP
SeeChange (ACA)
PLATINUM
Plans
Effective
Network
In-Network
Ded Sgl/Fam

In-Network
Out/pocket max

In-Network
Office visits

(AD = after deductible)
Rx Drugs
(AD = after deductible)
Professional Services
(AD = after deductible)
Platinum Reward 90 Copay (BS)      SBC

1-2014
PPO
0 / 0
4000 / 8000
$20 copay
$5 Gen
$15 Brand
10% coins
10% InP
10% OutP
VIEW DISCONTINUED SEECHANGE HEALTH INSURANCE PLANS - CLICK HERE
Health Insurance Carriers for
Small Group Medical (CA):

Aetna  |  Anthem Blue Cross  |  Blue Shield  |  California Choice  |  Health Net  |  Kaiser  |  Kaiser Choice Solution  |  SeeChange  |  Sharp  |  SuperAgent  |  UHC  |  Western Health Advantage
Dental Carriers (CA):
Aetna  |  Anthem Blue Cross  |  Blue Shield  |  New Dental Choice  |  Premier Access  |  UHC
Disability Carriers (CA):
American Fidelity  |  The Hartford  |  The Standard  |  Unum
HSA Administration (CA):
First Horizon  |  Health Equity  |  HSA Bank  |  Sterling HSA
Life Carriers (CA):
Aetna  |  American Fidelity  |  Anthem Blue Cross  |  Blue Shield  |  The Hartford  |  The Standard  |  UHC  |  Unum
Specialty Products (CA):
Ceridian  |  coPower  |  Satori  |  TASC
Vision Carriers (CA):
Aetna  |  Anthem Blue Cross  |  Blue Shield  |  UHC  |  VSP
Voluntary Benefits (CA):
Aflac  |  Allstate  |  American Fidelity  |  Colonial
Wellness At Work (CA):
My Wellchoice+