Large Group HMO Plans for Employers with 51 or more employees
Due to various plan riders selected by Large Employer groups, the Statement of Out-of- Pocket Expenses cannot be displayed on this website. Please contact Total Health Care’s Marketing Department at 1-800-826-2862 x7888 to request additional documents or log in as a member to our member portal, you will be able to view all materials specific to your plan
> HMO – 2B100
> HMO – 2B500
> HMO – 2B1000
> HMO – 2B3000
> HMO – 2B1000-20
> HMO – 2B1500-20
> HMO – 2B2000-20
> HMO – 2B3000-20
> HMO – 2B4000-30
> HMO – 2B5000-30
> HMO – 2BHD3000-20
> HMO – 2BHD4000-20
> HMO – 2BHD5000-20
> HMO – 2BHD1500
> HMO – 2BHD2800
> HMO – 2HU1000-20
> HMO – 2HU2000-20
> HMO – 2HU3500-20
> HMO – 2HU500
> HMO – 2HUHD1500
> HMO – 2HUHD2800
> HMO – 2HUHD3000 – 20
> HMO – 2HUHD5000 – 20
MEMBER HANDBOOK
CERTIFICATE OF COVERAGE
> Certificate of Coverage – High Deductiable
> Certificate of Coverage – Grandfathered
> Certificate of Coverage – Non-Grandfathered
> Certificate of Coverage – Hurley
MEDICAL RIDERS
> $20-$40 Office Visit Large Group
PHARMACY RIDERS
> THC4011B $0 RX Rider Grandfathered
> THC4012 $0-10 RX Rider Grandfathered
> THC4013 $5-15 RX Rider Grandfathered
> THC4030THC48 RX 20 coins after ded
