Small Group POS Plans

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HMO plans that fit your lifestyle

An HMO gives your emoloyees 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:

Aspirus Health Plans Signature Network

SigNet Icon Hospital
SigNet Icon Doc
SigNet Icon Clinic

With a POS plan, it is recommended that each member choose a primary care practitioner (PCP) who will help coordinate overall medical care. Unlike an HMO, POS plans give you the option to see other providers without a referral at an additional cost. Some services will require review and prior authorization.

If you seek care from an out-of-network provider, the non-participating reimbursement value will apply to out-of-network providers and services. The amount the plan pays is the allowed amount for any covered service. But if an out-of-network provider charges more than the allowed amount, you may have to pay the difference.

Here’s an example: You go to an out-of-network hospital, which charges $1,500 for an overnight stay. If the allowed amount is $1,000, you may have to pay the $500 difference.

POS Silver

Individual deductible
In network - $7,500
Out of network - $15,000

Individual out-of-pocket maximum
In network - $8,500
Out of network - $25,000

Family deductible
In network - $15,000
Out of network - $30,000

Family out-of-pocket maximum
In network - $17,000
Out of network - $50,000

Coinsurance
In network - 30%
Out of network - 50%

Office visits
$0 – $35, $70 Specialty

POS Bronze

Individual deductible
In network - $6,000
Out of network - $12,000

Individual out-of-pocket maximum
In network - $6,950
Out of network - $22,000

Family deductible
In network - $12,000
Out of network - $24,000

Family out-of-pocket maximum
In network - $13,900
Out of network - $44,000

Coinsurance
In network - 30%
Out of network - 50%

Office visits
30% after deductible