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Plan Details — Effective July 1, 2026

Nine plans. One carrier. Every group covered.

All plans underwritten by Benefit Re Insurance, Inc. (NAIC #17459). FCHP and PHCS national networks — over 800,000 providers. Premiums quoted on request.

HSA Plans EPO Plans Visit Limit Plans Copay Plans Supplemental Benefits
HSA-Eligible · HDHP
Plan 1
8300 HSA
HDHP HSA-Eligible $25/mo HSA Contribution
⭐ Benefit Re contributes $25/month to member HSA accounts
Deductible & Out-of-Pocket
Deductible — Individual (In/Out)$8,300 / $16,600
Deductible — Family (In/Out)$16,600 / $33,200
OOP Max — Individual (In/Out)$8,300 / $16,600
OOP Max — Family (In/Out)$33,200 / $66,400
Co-Insurance (Member Pays)0% in / 50% out
Physician Services
Preventive Care$0 Copay
Telemedicine$0 — Unlimited
PCP / Specialist Office VisitDeductible + 0%
Hospital & Surgery
Inpatient HospitalDeductible + 0%
Outpatient SurgeryDeductible + 0%
Emergency & Urgent Care
Emergency RoomDeductible + 0%
Urgent CareDeductible + 0%
Labs, Imaging & Diagnostics
Labs & X-Rays (Quest/LabCorp)Deductible + 0%
Advanced ImagingDeductible + 0%
Pharmacy
Pharmacy DeductibleSubject to plan deductible
Generic Drugs$20 (after deductible)
Preferred Brand$65
Non-Preferred / Specialty$95 / $200
FCHP & PHCS networks available
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Plan 2
3500 HSA
HDHP HSA-Eligible
Deductible & Out-of-Pocket
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
Physician Services
Preventive Care$0 Copay
Telemedicine$0 — Unlimited
PCP / Specialist Office VisitDeductible + 30%
Hospital & Surgery
Inpatient HospitalDeductible + 30%
Outpatient SurgeryDeductible + 30%
Emergency & Urgent Care
Emergency RoomDeductible + 30%
Urgent CareDeductible + 30%
Labs, Imaging & Diagnostics
Labs & X-Rays (Quest/LabCorp)Deductible + 30%
Advanced ImagingDeductible + 30%
Pharmacy
Pharmacy DeductibleIn-network deductible applies
All DrugsDeductible + 30%
FCHP & PHCS networks available
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Exclusive Provider Organization
Plan 5
1750 HSA EPO
EPO HDHP HSA-Eligible
Deductible & Out-of-Pocket
Deductible — Individual$1,750
Deductible — Family$3,500
OOP Max — Individual$8,500
OOP Max — Family$17,000
Physician Services
Preventive Care$0 — No Deductible
Telemedicine$0 — Unlimited
PCP / Specialist Visit$50 (after deductible)
Hospital & Surgery
Inpatient Hospital$2,500/admission (after ded.)
Outpatient Surgery$2,500/surgery (after ded.)
Emergency & Urgent Care
Emergency Room$1,000 (after deductible)
Urgent Care$50 (after deductible)
Labs & Imaging
Labs$25 (after deductible)
X-Rays$50 (after deductible)
Advanced Imaging$200 (after deductible)
Pharmacy
Preventive Rx / Generics$0 Copay
Preferred Brand / SpecialtyPAP Available
FCHP & PHCS networks available
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Plan 6
1000 EPO
EPO
Deductible & Out-of-Pocket
Deductible — Individual$1,000
Deductible — Family$2,000
OOP Max — Individual$8,500
OOP Max — Family$17,000
Physician Services
Preventive Care$0 — No Deductible
Telemedicine$0 — Unlimited
PCP / Specialist Visit$50 (after deductible)
Hospital & Surgery
Inpatient Hospital$2,500/admission (after ded.)
Outpatient Surgery$2,500/surgery (after ded.)
Emergency & Urgent Care
Emergency Room$1,000 (after deductible)
Urgent Care$50 (after deductible)
Labs & Imaging
Labs$25 (after deductible)
X-Rays$50 (after deductible)
Advanced Imaging$200 (after deductible)
Pharmacy
Preventive Rx / Generics$0 Copay
Preferred Brand / SpecialtyPAP Available
FCHP & PHCS networks available
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Plan 9
2000 HSA EPO
EPO HDHP HSA-Eligible Dental Included
🦷 Includes embedded dental — preventive, basic & major
Deductible & Out-of-Pocket
Deductible — Individual$2,000
Deductible — Family$4,000
OOP Max — Individual$8,500
OOP Max — Family$17,000
Physician Services
Preventive Care$0 — No Deductible
Telemedicine$0 — Unlimited
PCP / Specialist Visit$50 (after deductible)
Hospital & Surgery
Inpatient Hospital$2,500/admission (after ded.)
Outpatient Surgery$2,500/surgery (after ded.)
Emergency & Urgent Care
Emergency Room$1,000 (after deductible)
Urgent Care$50 (after deductible)
Labs & Imaging
Labs$25 (after deductible)
X-Rays$50 (after deductible)
Advanced Imaging$200 (after deductible)
Pharmacy
Preventive Rx / Generics$0 Copay
Preferred Brand / SpecialtyLimited Formulary / PAP
Dental Coverage Included $50 annual deductible · Preventive: 100% · Basic: 80% · Major: 50%
FCHP network only
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Visit Limit Plans
Plan 7
1750 HSA VL
Visit Limit HDHP HSA-Eligible
Deductible & Out-of-Pocket
Deductible — Individual$1,750
Deductible — Family$3,500
OOP Max — Individual$8,500
OOP Max — Family$17,000
Physician Services
Telemedicine (OurLiveDoc)$0 Copay
PCP / Specialist (10 visits/yr combined)$50 (after deductible)
Urgent Care (10 visits/yr combined)$50 (after deductible)
Hospital & Surgery
Inpatient (2 ICU + 2 non-ICU/yr)$1,000/admission (after ded.)
Outpatient Surgery (3/yr)$250/surgery (after ded.)
Emergency Care
ER (2 accident + 2 sickness/yr)$250 (after deductible)
Labs & Imaging (3/yr each)
Labs$25 (after deductible)
X-Rays$50 (after deductible)
Advanced Imaging$200 (after deductible)
Pharmacy
Generics (Retail & Mail)$0 Copay
Preferred Brand / Non-PreferredPAP Available
Visit Limit Plan — What brokers should know Annual visit allowances apply: 10 combined PCP/specialist/urgent care visits, 4 hospital admissions, 3 surgeries, 3 labs/X-rays/imaging, 4 ER visits. Best fit for younger or healthier groups. Services beyond limits are not covered under this plan.
FCHP & PHCS networks available
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Plan 8
1000 VL
Visit Limit
Deductible & Out-of-Pocket
Deductible — Individual$1,000
Deductible — Family$2,000
OOP Max — Individual$8,500
OOP Max — Family$17,000
Physician Services
Telemedicine (OurLiveDoc)$0 Copay
PCP / Specialist (10 visits/yr combined)$50 (after deductible)
Urgent Care (10 visits/yr combined)$50 (after deductible)
Hospital & Surgery
Inpatient (2 ICU + 2 non-ICU/yr)$1,000/admission (after ded.)
Outpatient Surgery (3/yr)$250/surgery (after ded.)
Emergency Care
ER (2 accident + 2 sickness/yr)$250 (after deductible)
Labs & Imaging (3/yr each)
Labs$25 (after deductible)
X-Rays$50 (after deductible)
Advanced Imaging$200 (after deductible)
Pharmacy
Generics (Retail & Mail)$0 Copay
Preferred Brand / Non-PreferredPAP Available
Visit Limit Plan — What brokers should know Same annual visit allowances as 1750 HSA VL — lower deductible, not HSA-eligible. Best fit for groups that want lower deductibles without the HDHP structure.
FCHP & PHCS networks available
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Traditional Copay
Plan 3
4500 Copay
Copay Plan
Deductible & Out-of-Pocket
Deductible — Individual (In/Out)$4,500 / $9,000
Deductible — Family (In/Out)$9,000 / $18,000
OOP Max — Individual (In/Out)$9,000 / $18,000
OOP Max — Family (In/Out)$18,000 / $36,000
Co-Insurance (Member Pays)30% in / 50% out
Physician Services
Telemedicine$0 — Unlimited
PCP Office Visit$40 Copay
Specialist Office Visit$75 Copay
Hospital & Surgery
Inpatient HospitalDeductible + 30%
Outpatient SurgeryDeductible + 30%
Emergency & Urgent Care
Emergency RoomDeductible + 30%
Urgent Care$90 Copay
Labs & Imaging
Labs & X-Rays (Quest/LabCorp)$25 after deductible
Advanced Imaging$200 after deductible
Pharmacy
Pharmacy DeductibleNone
Generic$20
Preferred Brand$65
Non-Preferred / Specialty$95 / $200
FCHP & PHCS networks available
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Plan 4
3500 Copay
Copay Plan
Deductible & Out-of-Pocket
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)20% in / 50% out
Physician Services
Telemedicine$0 — Unlimited
PCP Office Visit$40 Copay
Specialist Office Visit$75 Copay
Hospital & Surgery
Inpatient HospitalDeductible + 20%
Outpatient SurgeryDeductible + 20%
Emergency & Urgent Care
Emergency RoomDeductible + 20%
Urgent Care$90 Copay
Labs & Imaging
Labs & X-Rays (Quest/LabCorp)$25 after deductible
Advanced Imaging$200 after deductible
Pharmacy
Pharmacy DeductibleNone
Generic$20
Preferred Brand$65
Non-Preferred / Specialty$95 / $200
FCHP & PHCS networks available
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Optional Add-On · HSA & Copay Plans

Supplemental Benefits Package

Adds meaningful cash benefits that pay directly to the member to offset deductibles and out-of-pocket costs at the moments that matter most. Available on HSA and Copay plans for $70/tier/month.

Hospital Confinement: $2,500 (sickness) / $3,500 (injury)  ·  Outpatient Surgery: $500 Tier 1 / $1,000 Tier 2  ·  ER: $100 (sickness) / $250 (injury)  ·  Advanced Imaging: $500 (sickness) / $700 (injury)  ·  Health Screen: $50/yr  ·  PCP/Specialist Visit: $25/visit (up to 3x/yr)

$70
per tier / per month
add-on to base plan

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