Small Group
Health Maintenance Organization (HMO) Plans

Call Sales: 715.843.1392

HMO plans that fit your lifestyle

An HMO gives your employees access to doctors and hospitals within its network. A primary care practitioner (PCP) can help coordinate your overall medical care. No matter which HMO plan you choose you will receive:

  • 100% coverage for preventive services completed by an in-network provider
  • $0 copay on preventive drugs that target common medical conditions
  • Access to our 24/7/365 online clinic, MDLIVE
  • Access to our RN Comprehensive Care Coordination team
  • Free Nurseline 24/7/365
  • Access to Hear in America
  • Tobacco Cessation coverage

Aspirus Health Plan Signature Network

SigNet Icon Hospital
SigNet Icon Doc
SigNet Icon Clinic

With an HMO plan, there is no referral necessary to see an in-network specialist, but some services will require review and prior authorization. If you receive care from an out-of-network provider, the HMO will not pay for that care unless the condition was deemed an emergency or approved prior authorization is received from Aspirus Health Plan.

2025 Small Group HMO Plans at a glance

2025 Plan Details – Contracts, Plan Summaries and Summary of Benefits and Coverage (SBCs).

HMO Platinum (one option)

Individual deductible

$400

Individual out-of-pocket maximum

$2,270

Family deductible

$800

Family out-of-pocket maximum

$4,540

Coinsurance

20%

Office visits

$0-$35, $70 Specialty

HMO Gold (four options)

Individual deductible

$1,150 or $1,700 or $2,100 or $2,600

Individual out-of-pocket maximum

$6,800 or $7,600 or $7,900 or $4,600

Family deductible

$2,300 or $3,400 or $4,200 or $5,200

Family out-of-pocket maximum

$13,600 or $15,200 or $15,800 or $9,200

Coinsurance

20% or 10% or 20% or 20%

Office visits

$0 - $35, $70 Specialty

HMO Silver (four options)

Individual deductible

$3,700 or $4,500 or $5,000 or $7,000

Individual out-of-pocket maximum

$8,650 or $9,050 or $7,500 or $8,250

Family deductible

$7,400 or $9,000 or $10,000 or $14,000

Family out-of-pocket maximum

$17,300 or $18,100 or $15,000 or $16,500

Coinsurance

20% or 10% or 20% or 30%

Office visits

$0 - $45, $90 Specialty

HMO HSA Gold (two options)

Individual deductible

$2,850 or $3,150

Individual out-of-pocket maximum

$2,850 or $3,850

Family deductible

$5,700 or $6,300

Family out-of-pocket maximum

$5,700 or $6,300

Coinsurance

0%

Office visits

0% after deductible

HMO HSA Silver (four options)

Individual deductible

$2,400 or $3,250 or $4,300 or $5,200

Individual out-of-pocket maximum

$7,550 or $7,450 or $5,300 or $5,200

Family deductible

$4,800 or $6,500 or $8,600 or $10,400

Family out-of-pocket maximum

$15,100 or $14,900 or $10,600 or $10,400

Coinsurance

30% or 20% or 20% or 0%

Office visits

30% or 20% or 20% or 0% after deductible

HMO HSA Bronze (three options)

Individual deductible

$6,200 or $7,200 or $8,050

Individual out-of-pocket maximum

$7,200 or $8,050

Family deductible

$12,400 or $14,400 or $16,100

Family out-of-pocket maximum

$14,400 or $16,100

Coinsurance

30% or 0% or 0%

Office visits

30% or 0% after deductible