Benefits Overview
OHM Advisors offers two medical plan options, administered by Blue Cross Blue Shield of Michigan (BCBSM).
- Both options are PPO Plans (Preferred Provider Organization), and both options provide comprehensive coverage.
- A PPO provider gives you the flexibility to choose any provider you wish for care, but you will get the most benefits when you receive care from providers that participate in the BCBSM PPO Network.
- You are not required to designate a Primary Care Physician and do not need referrals for specialist care on these plans. To locate participating providers, visit www.bcbsm.com.
OHM Advisors Medical Plan Comparison
In-Network Benefits | HDHP PPO PLAN with HSA | STANDARD PPO PLAN |
---|---|---|
Preventive Care Services | Covered 100% (no deductible or cost share) | Covered 100% (no deductible or cost share) |
Deductible | $2,000 for a single contract $4,000 for a family contract (2 or more members) For the HDHP plan, the full family deductible must be met under a 2-person family contract before benefits are paid for any person. | $1,000 for a single contract $2,000 for a family contract (2 or more members) |
Fixed Dollar Copays | Applies to prescriptions after the deductible is satisfied | $20 for primary care office visits / $40 for specialist care office visits. |
$60 Urgent Care / $150 for Emergency Room visits | $60 Urgent Care / $150 for Emergency Room visits | |
Coinsurance (applies after deductible has been met) | Member pays 20% / Plan pays 80% for most services | Member pays 20% / Plan pays 80% for most services |
Member pays 50% / Plan pays 50% for private duty nursing | Member pays 50% / Plan pays 50% for private duty nursing | |
Annual coinsurance maximum | Single Contract: N/A Family Contract (2 or more members): N/A | $2,500 for a single contract $5,000 for a family contract (2 or more members) |
Total Out of Pocket Maximum | $3,000 for a single contract $6,000 for a family contract (2 or more members) | $6,350 for a single contract $12,700 for a family contract (2 or more members) |
- refer to the medical benefit summaries from BCBSM for more details.
Benefit Summaries