Standard Plans HMO/PPO/HSA Benefits Spreadsheet
For ALL groups as of 4/1/08
Standard Plans
Commonwealth
Choice Plans
HMO
PPO
HMO
Value HMO 15 (05)
Buying
with
Rx; click here
Buying
without
Rx; click here
Best Buy HSA PPO 1500 (GJ)
Buying
with
Rx; click here
Tiered Co-payment HMO 20 (0C)
Buying
with
Rx; click here
Affordable HMO 20 (W5)
Buying
with
Rx; click here
Buying
without
Rx; click here
Best Buy HSA PPO 1500 (GM)
Buying
with
Rx; click here
Best Buy HMO 1000 (0D)
Buying
with
Rx; click here
Affordable HMO 25 (W6)
Buying
with
Rx; click here
Buying
without
Rx; click here
Best Buy HSA PPO 2000 (GK)
Buying
with
Rx; click here
Core Coverage HMO (0H)
Buying
with
Rx; click here
Tiered Copayment HMO 20
Buying
with
Rx; click here
Buying
without
Rx; click here
Best Buy HSA PPO 2000 (GN)
Buying
with
Rx; click here
Core Coverage HMO (0H) no Rx
Buying
without
Rx; click here
Tiered Copayment HMO 30
Buying
with
Rx; click here
Buying
without
Rx; click here
Best Buy HSA PPO 3000 (GL)
Buying
with
Rx; click here
Best Buy HMO 500 (19)
Buying
with
Rx; click here
Buying
without
Rx; click here
Best Buy HSA PPO 3000 (GO)
Buying
with
Rx; click here
Best Buy HMO 1000 (0D)
Buying
with
Rx; click here
Buying
without
Rx; click here
HSA
Best Buy HMO 2000 (71)
Buying
with
Rx; click here
Buying
without
Rx; click here
Best Buy HSA PPO Overview
Core Coverage HMO
Buying
with
Rx; click here
Buying
without
Rx; click here
Benefits
Core Coverage HMO 1750
Buying
with
Rx; click here
Maximum Deductions
Best Buy Overview
HSA Scenarios
Mellon HSA Guide