All plans
HDHP / HSAHDHPHSA-Eligible

3500 HSA

$3,500 individual deductible · 30% in-network coinsurance

Schedule of benefits

What members pay on 3500 HSA.

Deductibles & Limits

Deductible — Individual (In/Out)
$3,500 / $7,000
Deductible — Family (In/Out)
$7,000 / $14,000
OOP Max — Individual (In/Out)
$7,000 / $14,000
OOP Max — Family (In/Out)
$14,000 / $28,000
Co-Insurance (Member Pays)
30% in / 50% out

Care & Visits

Preventive Care
$0 Copay
Telemedicine
$0 — Unlimited
PCP / Specialist Office Visit
Deductible + 30%
Urgent Care
Deductible + 30%
Emergency Room
Deductible + 30%
Labs & X-Rays (Quest/LabCorp)
Deductible + 30%
Advanced Imaging
Deductible + 30%

Hospital & Surgery

Inpatient Hospital
Deductible + 30%
Outpatient Surgery
Deductible + 30%

Pharmacy

Pharmacy Deductible
In-network deductible applies
All Drugs
Deductible + 30%

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 3500 HSA for your group.

Premiums quoted on request — brokers can pre-qualify a group in 60 seconds with the Savings Estimator.