2-50 employees

Update

Simply BlueSM HSA PPO

These high-deductible health plans can help meet your employees health care needs while saving them money.

Plan highlights
  • Employees may be more responsible with their health care since they own their HSA funds.
  • Prescription drug coverage is included.
  • Preventive care is 100% covered.

NETWORK SIZE

an image

PREMIUM COST

$

LEVEL OF CONSUMER ENGAGEMENT

Low

INDIVIDUAL DEDUCTIBLE

$1,650 - $7,500

HOW HSAs WORK

A health savings account, or HSA, is like a 401(k) for medical expenses. Employees own the account and use it to pay for qualified medical expenses. Both of you can make pretax payroll contributions to an HSA.
Here are some of the benefits:

  • Plans that pair with an HSA typically cost less.
  • When employees have more say in how they spend their health care dollars, they may use them more responsibly.

Want more details about Simply Blue HSA PPO?

2025 Documents

Download 2025 plan certificate

Plan options for 2025

2025 Simply Blue HSA PPO Platinum

This is a mid-level plan with a $1,650 deductible and 0% coinsurance.

Monthly premium

Medium

Deductible

$1,650

Out-of-pocket maximum

$1,650

PCP visit copay

$0 after deductible

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$1,650

$3,300

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$3,300

$6,600

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

0%

20%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$1,650

$3,300

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$3,300

$6,600

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$0 after deductible

20% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$0 after deductible

$20 plus 20% of approved cost

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$1,650 $3,300

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$3,300 $6,600

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

0% 20%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$1,650 $3,300

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$3,300 $6,600

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$0 after deductible 20% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$0 after deductible $20 plus 20% of approved cost

2025 Simply Blue HSA PPO Gold Option 1

This is a mid-level plan with a $1,650 deductible and 20% coinsurance.

Monthly premium

Medium

Deductible

$1,650

Out-of-pocket maximum

$4,500

PCP visit copay

20% after deductible

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$1,650

$3,300

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$3,300

$6,600

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

20%

40%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$4,500

$9,000

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$9.000

$18,000

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

20% after deductible

40% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$20 after deductible

$20 plus 20% of approved cost

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$1,650 $3,300

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$3,300 $6,600

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

20% 40%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$4,500 $9,000

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$9.000 $18,000

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

20% after deductible 40% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$20 after deductible $20 plus 20% of approved cost

2025 Simply Blue HSA PPO Gold Option 2

This is a mid-level plan with a $2,500 deductible and 0% coinsurance.

Monthly premium

Medium

Deductible

$2,500

Out-of-pocket maximum

$4,500

PCP visit copay

$0 after deductible

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$2,500

$5,000

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$5,000

$10,000

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

0%

20%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$4,500

$9,000

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$9,000

$18,000

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$0 after deductible

$20 plus 20% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$20 after deductible

$20 plus 20% approved cost

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$2,500 $5,000

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$5,000 $10,000

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

0% 20%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$4,500 $9,000

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$9,000 $18,000

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$0 after deductible $20 plus 20% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$20 after deductible $20 plus 20% approved cost

2025 Simply Blue HSA PPO Gold Option 3

This is a mid-level plan with a $3,300 deductible and 0% coinsurance.

Monthly premium

Medium

Deductible

$3,300

Out-of-pocket maximum

$3,300

PCP visit copay

$0 after deductible

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$3,300

$6,600

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$6,600

$13,200

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

0%

20%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$3,300

$6,600

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$6,600

$13,200

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$0 after deductible

20% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$0 after deductible

$15 plus 20% of approved cost

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$3,300 $6,600

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$6,600 $13,200

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

0% 20%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$3,300 $6,600

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$6,600 $13,200

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$0 after deductible 20% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$0 after deductible $15 plus 20% of approved cost

2025 Simply Blue HSA PPO Silver Option 1

This a a standard-level plan with a $3,300 deductible and 20% coinsurance.

Monthly premium

Medium

Deductible

$3,300

Out-of-pocket maximum

$7,500

PCP visit copay

20% after deductible

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$3,300

$6,600

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$6,600

$13,200

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

20%

40%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$7,500

$15,000

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$15,000

$30,000

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

20% after deductible

40% after deductible

$15 after deductible

$15 plus 20% of approved cost

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$3,300 $6,600

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$6,600 $13,200

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

20% 40%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$7,500 $15,000

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$15,000 $30,000

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

20% after deductible 40% after deductible

$15 after deductible $15 plus 20% of approved cost

2025 Simply Blue HSA PPO Silver Option 2

This a a standard-level plan with a $4,500 deductible.

Monthly premiums

Medium

Deductible

$4,500

Out-of-pocket maximum

$7,000

PCP visit copay

$0 after deductible

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$4,500

$9,000

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$9,000

$18,000

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

0%

20%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$7,000

$14,000

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$14,000

$28,000

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$0 after deductible

$20 plus 20% of approved cost after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$20

$20 plus 20% approved cost

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$4,500 $9,000

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$9,000 $18,000

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

0% 20%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$7,000 $14,000

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$14,000 $28,000

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$0 after deductible $20 plus 20% of approved cost after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$20 $20 plus 20% approved cost

2025 Simply Blue HSA PPO Bronze

This is a base-level plan with a $7,500 deductible and 0% coinsurance.

Monthly premium

Low

Deductible

$7,500

Out-of-pocket maximum

$7,500

PCP visit copay

$0 after deductible

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$7,500

$15,000

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$15,000

$30,000

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

0%

20%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$7,500

$17,000

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$15,000

$34,000

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$0 after deductible

20% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$0 after deductible

20% after deductible

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$7,500 $15,000

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$15,000 $30,000

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

0% 20%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$7,500 $17,000

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$15,000 $34,000

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$0 after deductible 20% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$0 after deductible 20% after deductible
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