PPO plans
The PPO plans are part of our Simply Shield portfolio for small businesses of 2 to 50 employees, designed to deliver clear and simple healthcare coverage options. You'll find a solution that's just right for your employees - from plans with rich benefits and low or no annual medical deductibles, to our leanest plans with affordable monthly rates in exchange for greater cost-sharing. Download the overview of our PPO plan family (PDF, 143KB).
Blue Shield's PPO plans offer valuable healthcare coverage combined with smart and flexible solutions to suit the needs of your small business. The PPO plan families are designed and organized so that your employees can easily distinguish among the different benefit amounts. The plan families offer a logical progression of prices and benefits, allowing you and your employees to easily pinpoint the right level of coverage.
PPO plans are available through our two medical plan packages, SimpleSelect and SimpleSync. In addition, plans are also available as a single plan offering.
PPO plan families:
Premier PPO Plans
The Premier PPO plans represent some of the richest benefits and feature low annual medical deductibles and copayment maximums.
PPO in-network providers (unless otherwise noted) | Calendar-year medical deductibles1 | Copayment maximum | Office visits2 | Inpatient hospitalization services (facility) |
---|---|---|---|---|
Premier PPO 5* | $250/$500 | $1,500/$2,500 | $5 | 5% |
Premier PPO 15* | $250/$500 | $2,000/$4,000 | $15 | 15% |
Premier PPO 20 | $500/$1,000 | $3,000/$6,000 | $20 | 20% |
Premier PPO 25* | $500/$1,000 | $3,000/$6,000 | $25 | 25% |
Premier PPO 35* | $750/$1,500 | $4,000/$8,000 | $35 | 35% |
Premier PPO 45* | $1,000/$2,000 | $5,000/$10,000 | $45 | 45% |
Enhanced PPO Plans
The Enhanced PPO plans offer a balance between the richest and most affordable PPO plans, and provide the flexibility of a PPO with affordable monthly premiums.
PPO in-network providers (unless otherwise noted) | Calendar-year medical deductibles1 | Copayment maximum | Office visits2 | Inpatient hospitalization services (facility) |
---|---|---|---|---|
Enhanced PPO 15* |
$500/$1,000 | $3,000/$6,000 | $15 | 25% |
Enhanced PPO 25* |
$1,000/$2,000 | $4,000/$8,000 | $25 | 35% |
Enhanced PPO 30* |
$1,500/$3,000 | $5,000/$10,000 | $30 | 40% |
Enhanced PPO 35* |
$1,500/$3,000 | $5,000/$10,000 | $35 | 45% |
Enhanced PPO 40* |
$2,000/$4,000 | $6,000/$12,000 | $40 | 50% |
Enhanced PPO 45* |
$2,000/$4,000 | $6,000/$12,000 | $45 | 50% |
Base* PPO Plans
Featuring an affordable PPO plan solution with physician office visits2 covered before the deductible is met, these plans also offer generally-lower premiums than Premier PPO and Enhanced PPO plans.
PPO in-network providers (unless otherwise noted) | Calendar-year medical deductibles1 | Copayment maximum | Office visits2 | Inpatient hospitalization services (facility) |
---|---|---|---|---|
Base PPO 30* | $3,000/$6,0003 | $6,000/$12,000 | $30 | 30% |
Base PPO 40* | $4,000/$8,0003 | $7,000/$14,000 | $40 | 40% |
Base PPO 50* | $5,000/$10,0003 | $8,000/$16,000 | $50 | 50% |
Value PPO Plans
Helping you keep your budget in check with some of our most affordable rates for small groups, Value PPO plans still feature some of our most popular benefits.
PPO in-network providers (unless otherwise noted) | Calendar-year medical deductibles1 | Copayment maximum | Office visits2,4 | Inpatient hospitalization services (facility) |
---|---|---|---|---|
Shield SpectrumSM PPO Plan 750 Value* |
$750/member | $4,000/member |
$15 initial 3 visits |
$500/admit +30% |
Shield SpectrumSM PPO Plan 1000 Value* |
$1,000/member | $4,000/member |
$20 initial 3 visits |
$500/admit +30% |
Shield SpectrumSM PPO Plan 1500 Value* |
$1,500/member | $4,500/member |
$30 initial 3 visits |
$1000/year +30% |
Shield SpectrumSM PPO Plan 2000 Value* |
$2,500/member | $5,500/member |
$45 initial 3 visits |
$1000/year +35% |
* Underwritten by Blue Shield of California Life & Health Insurance Company except Premier PPO 20 plan. Pending regulatory approval.
1 The deductible does not accrue to the calendar-year copayment maximum, except for the Base plans; the deductible for the Base plans do accrue to the calendar-year copayment maximum. Please refer to the Certificate of Insurance and the group policy for exact terms and conditions of coverage.
2 Some limitations apply; please refer to the Certificate of Insurance for further details.
3 Calendar year medical deductible accrues separately for in- and out-of-network.