Small group plans coverage

Prescription drug coverage effective on or after Jan. 1, 2021

2021 Product  Medical Plan  Formulary
Balance Balance 750 Gold
Balance 1500 Gold
Balance 2500 Silver
Balance 3500 Silver
Balance 4500 Silver
Balance 6000 Silver
Balance 7000 Bronze
Balance 8550 Bronze
2021 Providence Formulary P

Choice Choice 750 Gold
Choice 1500 Gold
Choice 2800 Silver
Choice 3500 Silver
Choice 4500 Silver
Choice 6000 Silver
Choice 7000 Bronze
Choice 8550 Bronze
Connect Connect 750 Gold
Connect 1500 Gold
Connect 2800 Silver
Connect 3500 Silver
Connect 4500 Silver
Connect 6000 Silver
Connect 7000 Bronze
Connect 8550 Bronze
Standard Standard Gold
Standard Silver
Standard Bronze
Total Enhanced Total Enhanced 250 Platinum
Total Enhanced 500 Platinum
Total Enhanced 1000 Gold
Total Enhanced 1500 Gold
Total Enhanced 2500 Gold
Total Enhanced 3500 Gold
Total Enhanced 4500 Gold
Total Enhanced 5500 Gold
Total Enhanced 7200 Silver
HSA HSA 1500 Gold
HSA 2500 Silver
HSA 3500 Silver
HSA 4500 Bronze
HSA 5500 Bronze
HSA 6750 Bronze
2021 Providence Formulary P-HSA