Large Group Point of Service (POS) 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. You can also log in as a member to our member portal to view documents specific to your plan
> POS – 3VSL2T
> POS – 3VSM2T
> POS – 3VSH2T
> POS – 3VS20002T
> POS – 3VS30002T
> POS – 3VSHD2800
> POS – 3VSHD4000-20
MEMBER HANDBOOK
CERTIFICATE OF COVERAGE
> Certificate of Coverage – HDHP
> Certificate of Coverage – Non-Grandfathered
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
