Balance plans

Our Balance plans offer a harmonious mix of cost-saving features and coverage for the services your employees use the most.

Balance plans offer:

  • A variety of deductible options and out-of-pocket maximums so you can select the plan and price point that fits within your budget
  • Separate deductibles and out-of-pocket maximums, in and out of the network
  • Deductibles waived for doctor and specialist visits, urgent care, physical therapy and chiropractic manipulation and acupuncture
  • Deductibles waived in Gold and Silver plans for lab and X-ray, and all drug tiers except specialty
  • Fully covered Express Care Clinic and Express Care Virtual visits
  • Provider choice, in or out of the Providence Signature Network
  • Pediatric dental coverage
  • Adult vision coverage (exams and hardware)
  • Up to 10 combined chiropractic manipulation and acupuncture visits per year

Cost-sharing ranges for in-network benefits

PCP Copay*  $35 - $65 
Coinsurance 20% - 50%
OOP Maximum $5,500 - $7,900
Deductible $750 - $7,900
Rx Preferred Generic Copay* $15 - $35
Rx Non-Preferred Generic Copay* $20 - $60
Rx Preferred Brand Copay* Gold and Silver: $50 - $75*
Bronze: 50%**
Rx Non-Preferred Brand Gold and Silver: 50%*
Bronze: 50%**
Preferred Rx Specialty** 50% with a $200 per script cap
Non-Preferred Rx Specialty** 50%

*Deductible waived

**Deductible applies; on the Balance 7900 Bronze plan, the non-preferred brand name and non-preferred specialty benefit is covered in full after the deductible is paid.

Benefit highlights

View the plan details for all six Balance plan options.

Tell me more