Health Plans for Groups, Individuals and Families

In a popularity contest, the PPO is king. PPO plans offer members different levels of affordable deductibles and coinsurance, as long as they stay within our preferred network of providers or hospitals.

Treatment outside of our network is covered but at a reduced rate. Members may have a higher cost share.

This plan design allows members to:

• Choose from a larger network of providers and specialists
• Make an appointment with a specialist without a referral

An EPO offers the best of both worlds – lower premium than a PPO and more freedom than an HMO. EPO members can see providers within the SHL PPO network but cannot go outside the network for care. There are no out-of-network benefits, except for emergency services and urgent care, or medically necessary services not available through a plan provider.

Although PCP selection isn’t required, we encourage members to choose one. PCPs become the leader of the health care team and are available for routine care, yearly checkups, and other general health concerns.

Weigh the risks of a consumer-directed high deductible PPO plan, also known as a catastrophic health insurance plan. The appeal of this plan is lower premiums compared to other plans.

This a great option for healthy individuals who only wants coverage in case of an emergency, such as someone who has no pre-existing medical conditions, who rarely sees a doctor, and doesn’t take prescription drugs regularly.

In exchange for often times lower premiums, insurance doesn’t kick in until the member meets their deductible – often $3,000 or more. For many people, the low monthly premium is worth having a high deductible.

This plan is paired with a Health Savings Account (HSA), which can save money on a tax-deferred basis for health care costs. It also includes prescription coverage in the core, making it easier for members to reach their deductible.

All of our plans are on a calendar year schedule. Calendar year deductibles reset every January 1 and end December 31.