Small Business HMO Providers cont.

Access + HMO Plans:
Blue Shield's Health Maintenance Organization (HMO) plans offer low, fixed copayments for a wide range of benefits, such as preventive care, inpatient and outpatient hospital services and emergency care.

Features-

• Visit any participating specialist in the same medical group or independent practice association (IPA) as your personal physician without a referral for a $30 copayment.
• Receive a copayment refund if you are not satisfied with the service of a covered office visit with an HMO network physician
• Access urgent and emergency care worldwide through the BlueCard Program

Benefit Chart-

Access + HMO Plans
Benefits	Plan 5	Plan 10 Premier	Plan 10 Standard	Plan 15
Calendar Year Medical Deductible	None	None	None	None
Physician Office Visits	$5/visit Access Specialist: $30/visit	$10/visit Access Specialist: $30/visit	$10/visit Access Specialist: $30/visit	$15/visit Access Specialist: $30/visit
Calendar-Year Brand-Name Drug Deductible	None	None	None	$250/person
Retail Drug Copayments	$5 Generic $15 Brand-name	$10 Generic $15 Brand-name	$10 Generic $20 Brand-name	$15 Generic $25 Brand-name

BLUE CROSS

HMO Plan Features-

• Two plans including the affordable Saver HMO
• Self-referral to participating OB/GYN specialists
• DirectAccess and SpeedyReferral programs that make the specialist referral process quicker and easier

Plan Comparison-

	HMO 100%	Saver HMO
Annual Deductible	None	$1,500 per member
Annual Out-of-Pocket Maximum	$1,750 per member $3,500 per family	$2,250 per member $4,500 per family
Office Visits	$10 copay	$10 copay
Prescription Drugs	$10 copay generic (for each 30-day supply) not subject to deductible, $20 copay brand (for each 30-day supply) after annual $150 brand name prescription drug deductible per member	$10 copay generic (for each 30-day supply) not subject to deductibles, $25 copay brand (for each 30-day supply)after annual $150 brand name prescription drug deductible per member

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