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Fully-Insured
Self-Funded
HealthyAdvantage Benefit Summaries - Valid Through 1/31/2023

HealthyAdvantage

HealthyAdvantage MEC Only
HealthyAdvantage PPO 250/100
HealthyAdvantage PPO 500/80
HealthyAdvantage PPO 1000/70
HealthyAdvantage PPO 1500/70
HealthyAdvantage PPO 2000/100
HealthyAdvantage PPO 2500/80
HealthyAdvantage PPO 3000/70
HealthyAdvantage PPO 3000/80
HA PPO 3000/100 (HealthySolutions)
HealthyAdvantage PPO 3500/80
HealthyAdvantage PPO 4000/80
HealthyAdvantage PPO 5000/100
HealthyAdvantage PPO 7000/100
HealthyAdvantage QHDHP 1500/100
HealthyAdvantage QHDHP 2800/80
HealthyAdvantage QHDHP 2800/100
HealthyAdvantage QHDHP 3500/100
HealthyAdvantage QHDHP 4000/70
HealthyAdvantage QHDHP 5000/100

HealthyAdvantage RBP

HealthyAdvantage RBP MEC Only
HealthyAdvantage RBP 250/100
HealthyAdvantage RBP 500/80
HealthyAdvantage RBP 1000/70
HealthyAdvantage RBP 1500/70
HealthyAdvantage RBP 2000/100
HealthyAdvantage RBP 2500/80
HealthyAdvantage RBP 3000/70
HealthyAdvantage RBP 3000/80
HA RBP 3000/100 (HealthySolutions)
HealthyAdvantage RBP 3500/80
HealthyAdvantage RBP 4000/80
HealthyAdvantage RBP 5000/100
HealthyAdvantage RBP 7000/100
HA RBP QHDHP 1500/100
HA RBP QHDHP 2800/80
HA RBP QHDHP 2800/100
HA RBP QHDHP 3500/100
HA RBP QHDHP 4000/70
HA RBP QHDHP 5000/100
HealthyAdvantage Benefit Summaries - Effective From 2/1/2023

HealthyAdvantage

HealthyAdvantage MEC Only
HealthyAdvantage PPO 250/100
HealthyAdvantage PPO 500/80
HealthyAdvantage PPO 1000/70
HealthyAdvantage PPO 1500/70
HealthyAdvantage PPO 2000/100
HealthyAdvantage PPO 2500/80
HealthyAdvantage PPO 3000/70
HealthyAdvantage PPO 3000/80
HA PPO 3000/100 (HealthySolutions)
HealthyAdvantage PPO 3500/80
HealthyAdvantage PPO 4000/80
HealthyAdvantage PPO 5000/100
HealthyAdvantage PPO 7000/ 70
HealthyAdvantage QHDHP 1500/100
HealthyAdvantage QHDHP 2800/80
HealthyAdvantage QHDHP 2800/100
HealthyAdvantage QHDHP 3500/100
HealthyAdvantage QHDHP 4000/70
HealthyAdvantage QHDHP 5000/100
HealthyAdvantage QHDHP 1600/100

HealthyAdvantage RBP

HealthyAdvantage RBP MEC Only
HealthyAdvantage RBP 250/100
HealthyAdvantage RBP 500/80
HealthyAdvantage RBP 1000/70
HealthyAdvantage RBP 1500/70
HealthyAdvantage RBP 2000/100
HealthyAdvantage RBP 2500/80
HealthyAdvantage RBP 3000/70
HealthyAdvantage RBP 3000/80
HA RBP 3000/100 (HealthySolutions)
HealthyAdvantage RBP 3500/80
HealthyAdvantage RBP 4000/80
HealthyAdvantage RBP 5000/100
HealthyAdvantage RBP 7000/70
HA RBP QHDHP 1500/100
HA RBP QHDHP 2800/80
HA RBP QHDHP 2800/100
HA RBP QHDHP 3500/100
HA RBP QHDHP 4000/70
HA RBP QHDHP 5000/100
HealthyAdvantage RBP QHDHP 1600/100
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