BCN HMO Plan options breakdown
BCN HMO
Plan options
Platinum $500 Gold $500/20% Gold $1,000 Gold $1,500 Gold $2,000 Gold $2,500 Silver $3,500 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% 20% 10% 30%
Embedded
Coinsurance Maximum

(individual / family)
N/A $3,000 / $6,000 $2,500 / $5,000
$1,500 / $3,000
$1,000 / $2,000
$2,000 / $4,000 $2,500 / $5,000
N/A / N/A $2,000 / $4,000
Out-of-pocket maximum
(individual / family)
$1,000 / $2,000 $6,600 / $13,200 $6,600 / $13,200 $6,600 / $13,200 $6,600 / $13,200 $7,350 / $14,700 $7,350 / $14,700 $7,350 / $14,700 $7,350 / $14,700
Office visit copays
$20 $20 $20 $20 $20 $30 $40 $30 $35
Pharmacy copays
$4 $10 $4 $4 $4 $4 $10 $10 $6
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 $6,850 / $13,700
Office visit copays
$20 $25 $30
Pharmacy copays
$4 $4 $6
BCN HMO PCP Focus Network breakdown
BCN HMO
PCP Focus Network
Plan options*
Platinum $500 Gold $1,000 Gold $1,500 Gold $2,000 Gold $2500 Silver $3,500 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% 20% 30%
Embedded
Coinsurance Maximum

(individual / family)
N/A $2,500 / $5,000 $1,500 / $3,000
$1,000 / $2,000
$2,000 / $4,000 $2,500 / $5,000
$2,000 / $4,000
Out-of-pocket maximum
(individual / family)
$1,000 / $2,000 $6,600 / $13,200 $6,600 / $13,200 $6,600 / $13,200 $7,350 / $14,700 $7,350 / $14,700 $7,3500 / $14,700
Office visit copays
$20 $20 $20 $20 $30 $40 $35
Pharmacy copays
$4 $4 $4 $4 $4 $10 $6

*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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