Plan Details

HMO Options:
HMO Co-plan 10
HMO Co-plan 10+
HMO Co-plan 10C
HMO Co-plan 15
HMO Co-plan 15 with Rider #232
HMO Co-plan 15+
HMO Co-plan 15C
HMO Co-plan 25
HMO Co-plan 25 with Rider #232
HMO Co-plan 25+
HMO Co-plan 25C

HMO Rx Options:
VT 50%
VT $5/$20/$40
VT $10/$30/$50
VT $15/$35/$50

High Deductible HMO Plans:
HMO VT 100% $1,500/$3,000
HMO VT 90% $1,500/$3,000
HMO VT 80% $1,500/$3,000
HMO VT 100% $2,000/$4,000
HMO VT 90% $2,000/$4,000
HMO VT 80% $2,000/$4,000
HMO VT 100% $2,500/$5,000
HMO VT 90% $2,500/$5,000
HMO VT 80% $2,500/$5,000

POS Benefit Summary Sheets:
MVP POS VT 70% $500,000
MVP POS VT 80% $500,000
MVP POS VT 70% $1,000,000
MVP POS VT 80% $1,000,000

POS High Deductible Plans:
MVP POS VT 90/70 $1,500/$3,000
MVP POS VT 80/60 $1,500/$3,000
MVP POS VT 90/70 $2,000/$4,000
MVP POS VT 80/60 $2,000/$4,000
MVP POS VT 90/70 $2,500/$5,000
MVP POS VT 80/60 $2,500/$5,000

PPO Co-plan Charts:
$200/$400 Deductible
MVP PPO 10 (W/90% In-Network Coinsurance)
MVP PPO 10 (W/80% In-Network Coinsurance)

$500/$1,000 Deductible
MVP PPO 10
MVP PPO 15

$1,000/$2,000 Deductible
MVP PPO 15
MVP PPO 25

$2,500/$5000 Deductible
MVP PPO 15
MVP PPO 25

$10,000/$20,000 Deductible
MVP PPO 25

PPO Rx Options:
VT $5/$20/$40
VT $10/$30/$50
VT 50%