PriorityHRA HMO plans 

Our small business PriorityHRASM plans offer greater flexibility and funding options for employers. Choose the deductible and work with us to determine the employee contribution amount.

Once the employee contribution is used on the deductible, the employer contribution is then applied to the remaining deductible. If copayments occur before the deductible, the employee is responsible for those costs.

Smart idea:

If your small group is financially flexible, PriorityHRA is a smart choice.

Plan highlights

  • $0 virtual care and telehealth services โ€“ Covered in full before deductible
  • Diabetic coverage โ€“ certain diabetic supplies purchased through a participating DME provider are covered at 100% before deductible and preferred insulins are covered at the Tier 1b prescription drug tier
  • Chiropractic care โ€“ Covers up to 30 acute and/or maintenance care visits per contract year
  • Cash rewards โ€“ Our Cost Estimator tool lets members shop for high-quality care at lower-cost facilities. Best of all, when members receive care at a fair-price facility, weโ€™ll send them a Visaยฎ reward card
  • Hearing exams and discounts on high-quality hearing aids โ€“ Offered by our partner, TruHearing
  • Adult vision coverage, powered by EyeMed โ€“ $15 annual eye exam and in-network discounts on frames, standard plastic lenses, lens options, select contact lenses, laser vision correction, and non-prescription sunglasses
  • Optional dental coverage โ€“ Two Delta Dental PPO/Premier plans to choose from, both include annual exams and cleanings. Learn more
  • No referral needed โ€“ Our plans don't require a referral to see a specialist

Plan notes

We want you to know exactly what you're looking at, so here are explanations of the notes used in the plan pricing information.

  • (E) "Embedded" means the plan contains an individual limit (stop) within the family total. The embedded stop occurs when an individual's deductible or out-of-pocket limit has been satisfied, but the family deductible or out of pocket limit hasn't.
  • (A) "Aggregate" means the total deductible or out-of-pocket limit does not contain an individual limit. An individual is covered when the family deductible or out-of-pocket limit has been met.
  • Deductibles and out-of-pocket limits are listed as individual/family amounts.
  • PriorityHRA HMO 1500 (500)

    Deductible: $1500/$3000 E
    Coinsurance: 80%
    Out-of-pocket-limit: $4500/$9000 E
    Primary/specialist/urgent care: $10/$35/$75

  • PriorityHRA HMO 2000 (1000)

    Deductible: $2000/$4000 E
    Coinsurance: 70%
    Out-of-pocket-limit: $8150/$16300 E
    Primary/specialist/urgent care: $30/$60/$85
  • PriorityHRA HMO 4000 (600)

    Deductible: $4000/$8000 E
    Coinsurance: 70%
    Out-of-pocket-limit: $8150/$16300 E
    Primary/specialist/urgent care: $30/$60/$85

  • PriorityHRA HMO 5000 (600)

    Deductible: $5000/$10000 E
    Coinsurance: 80%
    Out-of-pocket-limit: $7900/$15800 E
    Primary/specialist/urgent care: $20/$60/$85

  • PriorityHRA HMO 5000 (2600)

    Deductible: $5000/$10000 E
    Coinsurance: 70%
    Out-of-pocket-limit: $8150/$16300 E
    Primary/specialist/urgent care: $30/$60/$85
  • PriorityHRA HMO 6750 (6100)

    Deductible: $6750/$13500 E
    Coinsurance: 70%
    Out-of-pocket-limit: $8300/$16600 E
    Primary/specialist/urgent care: $45/Coins/$85
  • PriorityHRA HMO 6750 (5750)

    Deductible: $6750/$13500 E
    Coinsurance: 70%
    Out-of-pocket-limit: $8150/$16300 E
    Primary/specialist/urgent care: $45/Coins/$85

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