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

> Member Handbook

 

CERTIFICATE OF COVERAGE

> Certificate of Coverage – High Deductiable

> Certificate of Coverage – Grandfathered

Certificate of Coverage – Non-Grandfathered

 

MEDICAL RIDERS

> $20 Office Visit Rider

> $30 Office Visit Rider

> $20-$40 Office Visit Large Group

> $100 ER Large Group

> $150 ER Large Group

> $200 ER Large Group

> $250 ER Large Group

> Office Visit

 

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

THC4031 65 Rx 7305020

THC40326610406025

THC403367RX10508030

THC403468RX10406025

 

RETURN