BCN HMO Plan options breakdown
BCN HMO
Plan options
Platinum $500/0% Gold $500/20% Gold $1,000/20% Gold $1,500/20% Gold $2,000/30% Gold $2,500/20% Silver $3,500/30% Silver $4,500/10% Silver $4,000/30%
Annual deductible
(individual / family)
$500 / $1,000 $500 / $1,000 $1,000 / $2,000 $1,500 / $3,000 $2,000 / $4,000 $2,500 / $5,000 $3,500 / $7,000 $4,500 / $9,000 $4,000 / $8,000
Coinsurance Percentage 0% 20% 20% 20% 30% 20% 30% 10% 30%
Embedded
Coinsurance Maximum

(individual / family)
N/A $4,000 / $8,000 $2,500 / $5,000
$1,500 / $3,000
$1,000 / $2,000
$2,000 / $4,000 N/A / N/A
N/A / N/A N/A / N/A
Out-of-pocket maximum
(individual / family)
$1,500 / $3,000 $6,600 / $13,200 $6,600 / $13,200 $6,600 / $13,200 $6,600 / $13,200 $7,350 / $14,700 $7,900 / $15,800 $7,900 / $15,800 $7,900 / $15,800
PCP office visit copay
$20 $20 $20 $20 $20 $30 $40 $40 $40
Preferred generic pharmacy copay
$4 $10 $6 $4 $4 $4 $15 $15 $15
BCN HMO Coinsurance Level Plan options breakdown
BCN HMO Coinsurance Level
Plan options
Platinum 10% Platinum 20% Gold 30%
Annual deductible
(individual / family)
$0 $0 $0
Coinsurance Percentage 10% 20% 30%
Embedded
Coinsurance Maximum

(individual / family)
$1,000 / $2,000
$1,000 / $2,000
N/A / N/A
Out-of-pocket maximum
(individual / family)
$5,000 / $10,000 $6,600 / $13,200 $7,900 / $15,800
PCP office visit copay
$20 $25 $30
Preferred generic pharmacy copay 
$4 $4 $10
BCN HMO PCP Focus Network breakdown
BCN HMO
PCP Focus Network
Plan options*
Platinum $500/0% Gold $1,000/20% Gold $1,500/20% Gold $2,000/30% Gold $2,500/20% Silver $3,500/30% Silver $4,000/30%
Annual deductible
(individual / family)
$500 / $1,000 $1,000 / $2,000 $1,500 / $3,000 $2,000 / $4,000 $2,500 / $5,000 $3,500 / $7,000 $4,000 / $8,000
Coinsurance Percentage 0% 20% 20% 30% 20% 30% 30%
Embedded
Coinsurance Maximum

(individual / family)
N/A $2,500 / $5,000 $1,500 / $3,000
$1,000 / $2,000
$2,000 / $4,000 N/A / N/A
N/A / N/A
Out-of-pocket maximum
(individual / family)
$1,500 / $3,000 $6,600 / $13,200 $6,600 / $13,200 $6,600 / $13,200 $7,350 / $14,700 $7,900 / $15,800 $7,900 / $15,800
PCP office visit copay 
$20 $20 $20 $20 $30 $40 $40
Preferred generic pharmacy copay 
$4 $6 $4 $4 $4 $15 $15

*PCP Focus is a custom primary care physician network. Plans that offer the PCP Focus network are only available to businesses with at least one location in one of the following counties: Bay, Calhoun, Clinton, Eaton, Genesee, Ingham, Kalamazoo, Kent, Livingston, Macomb, Monroe, Muskegon, Oakland, Ottawa, Saginaw, Shiawassee, St. Clair, Van Buren, Washtenaw, Wayne. To learn more, see "What's the PCP Focus network?"

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