Schedule of benefits
What members pay on 1000 EPO.
Deductibles & Limits
- Deductible — Individual
- $1,000
- Deductible — Family
- $2,000
- OOP Max — Individual
- $8,500
- OOP Max — Family
- $17,000
Care & Visits
- Preventive Care
- $0 — No Deductible
- Telemedicine
- $0 — Unlimited
- PCP / Specialist Visit
- $50 (after deductible)
- Urgent Care
- $50 (after deductible)
- Emergency Room
- $1,000 (after deductible)
- Labs
- $25 (after deductible)
- X-Rays
- $50 (after deductible)
- Advanced Imaging
- $200 (after deductible)
Hospital & Surgery
- Inpatient Hospital
- $2,500/admission (after ded.)
- Outpatient Surgery
- $2,500/surgery (after ded.)
Pharmacy
- Preventive Rx / Generics
- $0 Copay
- Preferred Brand / Specialty
- PAP Available
FCHP & PHCS networks available
All plans underwritten by Benefit Re Insurance, Inc. (NAIC #17459). FCHP and PHCS national networks — over 800,000 providers. Plans effective July 1, 2026. Premiums quoted on request.
Quote 1000 EPO for your group.
Premiums quoted on request — brokers can pre-qualify a group in 60 seconds with the Savings Estimator.