Base Health Plans

The power to customize your benefits and save money! 

 ASO MECPreventive BasicPreventive Advanced
 :
Group Size
ASO MEC:
1+
Preventive Basic:
1+
Preventive Advanced:
1+
 :
Claims Method
ASO MEC:
Claims as Accrued
Preventive Basic:
Built In
Preventive Advanced:
Built In
 :
Preventive Care Services
ASO MEC:
100%
Preventive Basic:
100%
Preventive Advanced:
100%
 :
Minimum Essential Coverage
ASO MEC:
Yes
Preventive Basic:
Yes
Preventive Advanced:
Yes
 :
Minimum Value Plan
ASO MEC:
No
Preventive Basic:
No
Preventive Advanced:
No
 :
Primary Care Physician Office Visit
ASO MEC:
Not Covered
Preventive Basic:
Not Covered
Preventive Advanced:
$20 Copay (max 3 per year)
 :
Specialist Office Visit
ASO MEC:
Not Covered
Preventive Basic:
Not Covered
Preventive Advanced:
$50 Copay (max 3 per year)
 :
Urgent Care
ASO MEC:
Not Covered
Preventive Basic:
Not Covered
Preventive Advanced:
$50 Copay (max 3 per year)
 :
Diagnostic X-ray and Lab
ASO MEC:
Not Covered
Preventive Basic:
Not Covered
Preventive Advanced:
$50 Copay (max 5 per year)
 :
Cat-Scan or MRI
ASO MEC:
Not Covered
Preventive Basic:
Not Covered
Preventive Advanced:
$200 Copay (1 per year)
 :
Outpatient Testing
ASO MEC:
Not Covered
Preventive Basic:
Not Covered
Preventive Advanced:
$200 Copay (1 up to $1,000)
 :
Network
ASO MEC:
Any Provider and PHCS
Preventive Basic:
Any Provider and PHCS
Preventive Advanced:
Any Provider and PHCS
 :
Telemedicine
ASO MEC:
TelaDoc (no copay)
Preventive Basic:
TelaDoc (no copay)
Preventive Advanced:
TelaDoc (no copay)
 :
Blink Health Rx Discount Plan
ASO MEC:
Included
Preventive Basic:
Included
Preventive Advanced:
Included
 :
Optum Rx Benefits
ASO MEC:
Not Covered
Preventive Basic:
Not Covered
Preventive Advanced:
2018 Rx Formulary
 :
Tier 1 – Low Cost
ASO MEC:
N/A
Preventive Basic:
N/A
Preventive Advanced:
$1 Copay
 :
Tier 2 – Generics
ASO MEC:
N/A
Preventive Basic:
N/A
Preventive Advanced:
10% Co-Insurance
 :
Tier 3 – Preferred Brand
ASO MEC:
N/A
Preventive Basic:
N/A
Preventive Advanced:
20% Co-Insurance
 :
Tier 4 – Non-Preferred 1
ASO MEC:
N/A
Preventive Basic:
N/A
Preventive Advanced:
40% Co-Insurance
 :
Tier 5 – Specialty
ASO MEC:
N/A
Preventive Basic:
N/A
Preventive Advanced:
10% Co-Insurance
 :
Tier 6 – Non-Preferred 2
ASO MEC:
N/A
Preventive Basic:
N/A
Preventive Advanced:
20% Co-Insurance
 :
ASO MEC:
Learn more | See Rates
Preventive Basic:
Learn more | See Rates
Preventive Advanced:
Learn more | See Rates

Preventive health plans meet the requirements for Minimum Essential Coverage (MEC) as outlined by the Affordable Care Act (ACA).  Groups of fifty (50+) or more employees should also consider a plan that meets the requirements to be a Minimum Value Plan (MVP) to avoid potential penalties for large employers.  Groups of fifty (50+) or more enrolled employees may be eligible for additional discounts.  Ask your Planstin representative for more information.

Our Preventive health plans are often paired with added benefits.  These added benefits may include catastrophic coverage, accident, critical illness, hospital or other complimentary plans.  Your insurance broker can help you customize a plan that will help you keep costs low while getting the coverage that you want.  See your health insurance broker or Planstin representative for more information.

Preventive Health Plans

 


Preventive Advanced

The Preventive Advanced plan includes the preventive coverages that meet the Minimum Essential Coverage (MEC) requirements along with many coverages that are most commonly utilized at a copay or with coinsurance.  These benefits include unlimited use of TelaDoc without a copay, copay to visit a doctor, copay for urgent care, a full prescription plan and more.

The plan includes access through the PHCS network but will allow you to use any doctor or provider you like.  See the online provider directory with PHCS.

Monthly Rates

Preventive Advanced Monthly
Employee Only $150
Employee + Spouse $240
Employee + Children $240
Employee + Family $325

$150 group setup fee charged upon implementation.

 


Preventive Basic

The Preventive Basic plan is great for those who want to have the claims included in the plan but without the extras that the Preventive Advanced plan has.  This plan is designed to keep both the employer and employee compliant to avoid tax penalties by having Minimum Essential Coverage (MEC).

The plan includes access through the PHCS network but will allow you to use any doctor or provider you like.  See the online provider directory with PHCS.

Monthly Rates

Preventive Basic Monthly
Employee Only $80
Employee + Spouse $110
Employee + Children $110
Employee + Family $150

$150 group setup fee charged upon implementation.

 


ASO MEC

The ASO MEC plan is a great plan to keep costs low and stay compliant.  For business owners, the ASO MEC plan is a compliance tool to avoid tax penalties along with a "use now, pay later" claims administration.  The claims are paid by the business owner as the benefits are used.  This strategy is great for those employers who are looking to avoid a tax penalty and keep costs low for Minimum Essential Coverage (MEC).

The plan includes access through the PHCS network but will allow you to use any doctor or provider you like.  See the online provider directory with PHCS.

Monthly Rates

ASO MEC Monthly
Employee Only $30
Employee + Spouse $55
Employee + Children $55
Employee + Family $80

$150 group setup fee charged upon implementation.