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Product Grids

The product grids on this page are current as of July 28, 2010. Archive grids can be obtained by contacting our office at 412-835-9100.

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Aetna | HealthAssurance/HealthAmerica | Highmark | HHIC | UnitedHealthcare | UPMC Health Plan


Aetna

Indemnity Indemnity 1.3 PPO PPO 1.3 PPO 2.3 POS POS 1.3 20-40-70 POS 2.3 20-40-70 POS 3.3 20-40-70 POS 4.3 20-40-70 POS - No Referral POS NR 1.3 20-40-70 POS NR 2.3 20-40-70 POS NR 3.3 20-40-70 POS NR 4.3 20-40-70 POS - Cost Sharing POS CS 1.3 POS CS 2.3 POS CS 3.3 HSA/HRA POS NR HSA 3.3 POS NR HSA 4.3 POS NR HSA 5.3 POS NR HSA 6.3

PPO 3.3 POS 6.3 10-25-50 POS 7.3 20-40-70 POS 8.3 20-40-70 POS 9.3 15-30-50 POS NR 5.3 15-35-60 POS NR 6.3 10-25-50 POS NR 7.3 20-40-70 POS NR 9.3 15-30-50 POS CS 4.3 POS CS 5.3 PPO HSA 1.3 PPO HSA 2.3 HNO HRA 1.3

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HealthAssurance/HealthAmerica

In Area Plans (one pager) Choice PPO $1250 Choice PPO $2000 Choice PPO $4000 Shared Choice PPO $1250 Shared Choice PPO $2000 Shared Choice PPO $4000 PPO Saver 100/90/70 PPO Saver 100/90/60 Premier PPO $5$10 Premier PPO $10$10 Premier PPO $15$30 Premier PPO $20$40 Premier PPO $250 Premier PPO $500 Premier PPO $750 Premier PPO $1000 Premier PPO $1250 Premier PPO $1500 Premier PPO $2000 Premier PPO $2500 1X Premier PPO $3000 Premier PPO $4000 1X Premier PPO $5000 Premier PPO $7500 1X Premier PPO $10000 1X Out of Area Plans (one pager) OOA Choice PPO $1250 OOA Choice PPO $2000 OOA Choice PPO $4000 OOA PPO Saver 100/90/70 OOA Premier PPO $10$10 OOA Premier PPO $15$30 OOA Premier PPO $250 OOA Premier PPO $500 OOA Premier PPO $1000 OOA Premier PPO $1250 OOA Premier PPO $2500 1X OOA Classic PPO $15$30 OOA Classic PPO $250 OOA Classic PPO $500 Vision Plans EyeMed Vision Basic Rider Insert EyeMed Vision Mid Rider Insert EyeMed Vision High Rider Insert

Classic PPO $15$30 Classic PPO $250 Classic PPO $500 Classic PPO $1000 Value PPO $20$40 Value PPO $250 Value PPO $500 Value PPO $750 Value PPO $1000 Value PPO $1500 Value PPO $2000 FlexChoice QHDHP PPO $1250 FlexChoice QHDHP PPO $1250 II FlexChoice QHDHP PPO $2500 FlexChoice QHDHP PPO $2500 1X FlexChoice Value PPO $1250 FlexChoice Value PPO $2500 FlexChoice Value PPO $3750 Super Saver PPO Plan 1 Super Saver PPO Plan 2 Super Saver PPO Plan 3 Super Saver PPO Plan 4 Rx Drug Riders OOA Value PPO $250 OOA Value PPO $500 OOA FlexChoice QHDHP PPO $1250 OOA FlexChoice QHDHP PPO $2500 OOA FlexChoice QHDHP Value PPO $2500 OOA FlexChoice QHDHP PPO $1250 II OOA Super Saver PPO Plan 1 OOA Super Saver PPO Plan 2 OOA Super Saver PPO Plan 3 OOA Super Saver PPO Plan 4 EyeMed Vision Discount Flyer EyeMed Vision Exam Only Rider Insert

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Highmark

PPOBlue Plans PPOBlue High Option I PPOBlue High Option II PPOBlue Enhanced PPOBlue Split Copayment 100/80 PPOBlue Standard PPOBlue $500 Deductible PPOBlue 70/50 PPOBlue 80/60 Non-Qualified HDHP's PPOBlue $1000 High-Deductible Value PPOBlue $1250 High-Deductible Value PPOBlue $1500 High-Deductible Value Qualified HDHP's PPOBlue HDHP 100/80 $1250 Ded Value PPOBlue HDHP 100/80 $1500 Ded Value PPOBlue HDHP 100/80 $2000 Ded Value PPOBlue HDHP 100/80 $2600 Ded Vision Plans Fashion Advantage Option I Fashion Advantage Option V

PPOBlue 90/70 PPOBlue Split Copayment 90/70 PPOBlue Value Plus 250 PPOBlue Value Plus 500 PPOBlue $750 Deductible Value OOA PPO High Option II OOA PPO Standard OOA PPO Value Plus 500 PPOBlue $2500 High-Deductible Value OOA PPO $1250 High-Deductible Value PPOBlue HDHP 90/70 $2600 Ded PPOBlue HDHP 90/70 $3500 Ded PPOBlue HDHP 80/60 Value Option OOA PPO HDHP 100/80 $2600 Ded Fashion Advantage Gold Option I Fashion Advantage Gold Option V

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HHIC

Premium Plans PPOBlue $10 PPOBlue $20 Sharing Plans PPOBlue $250 PPOBlue $500 PPOBlue $750 PPOBlue $1000 Smart Plans PPOBlue $500 80/60 PPOBlue $750 90/70 Healthy Savings Plans PPOBlue $1500Q PPOBlue $2000Q PPOBlue $2600Q Take Charge Plans PPOBlue 80/60 PPOBlue 70/50 Download all HHIC files (ZIP)

PPOBlue $20-40 PPOBlue $1250 PPOBlue $1500 PPOBlue $2500 PPOBlue $1250 90/70 PPOBlue $2600Q 90/70 PPOBlue $3500Q 9070 PPOBlue $250 90/70 PPOBlue $250 80/60

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UnitedHealthcare

Choice Plus (one pager) P1R P2C P2A P2E P2B Choice (one pager) P1A P1J P1H P1L P1I Intelli-Series (one pager) 5PD 5PE 5PA 5PB 5PC

P2F M1M P1P 2AC P1Q P1M P6A P1D P6B P1G 6PD 6PE 6PA 6PB 6PC

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UPMC Health Plan

PPO Plans PPO 4 15-30-50 PPO 5 15-30-50 PPO 6 15-30-50 PPO 8 15-30-50 EPO Plans EPO 2 15-30-50 EPO 4 15-30-50 EPO 5 15-30-50 EPO 6 15-30-50 EPO 8 15-30-50 HRA HRA $1000 80% HRA $1000 90% HRA $1250 90% HRA $1250 100% HRA $1500 80% HSA HSA $1250 90% HSA $1250 100% HSA $2500 80% Vision Plans Exam Only Exam Plus

PPO 9 15-30-50 PPO 10 15-30-50 PPO 11 15-30-50 PPO 12 15-30-50 EPO 11 15-30-50 EPO 12 15-30-50 EPO 13 15-30-50 EPO 14 15-30-50 EPO 15 15-30-50 HRA $1500 90% HRA $2500 80% HRA $2500 100% HRA $3750 80% HSA $2500 100% HSA $3750 80%

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