BlueSimplicitySM Health Plans
2019 ACA Plan Comparison Guide for Small Groups | South Dakota
Health insurance can be simple for your employees with BlueSimplicity. With no deductible or coinsurance, up-front costs and simple language help them understand the value of their health and drug coverage. That means fewer surprises for them and fewer questions for you.
BlueSimplicity plan options
Regardless of the network you choose, all the products in the table are available. Amounts in the table reflect in-network services only. For PPO plans, additional cost shares will apply to out-of-network services.
With BlueSimplicity, services are grouped into six levels, making it easy for your employees to know their cost share even before receiving services.
- Level 1 services are free and include preventive services.
- Level 6 services require higher member copays and cover more serious health needs, such as air ambulance and hospitalizations.
|Plan Details||BlueSimplicitySM Bronze||BlueSimplicitySM Silver||BlueSimplicitySM Gold|
|Annual Benefit — Out-of-pocket maximum (opm) In-network1|
|Single out-of-pocket maximum||$7,900||$7,900||$4,000|
|Family2 out-of-pocket maximum||$15,800||$15,800||$8,000|
Preventive care3, Blue365® membership, BeWell 24/7SM
Primary care provider (PCP) office visit4, facility lab/X-ray, virtual visit5
Non-PCP office visit, outpatient PT/OT/ST, home health care, durable medical equipment
Emergency room, ground ambulance, diagnostic imaging/studies6 and radiation therapy
Outpatient practitioner and facility
Hospitalization, air ambulance and skilled nursing facility
|Prescription drugs - BlueSimplicitySM Rx|
|Level 1 (Preventive)||Free||Free||Free|