PHCS Ultra 3000

PHCS PPO Network (reference-based pricing)

PHCS Ultra 3000 — Deductible: $3,000 / $6,000; Max Out of Pocket: $9,450 / $18,900; Office Copays: $30 / $60; Coinsurance: 30% after deductible, up to the plan's allowed amount; Rx: $15 / $65 / $100.

Monthly premiums

Member: $900.00/mo
Member & Children: $1,458.00/mo
Member & Spouse: $1,641.00/mo
Member & Family: $2,164.00/mo

Plan details

Deductible (Individual): $3,000
Deductible (Family): $6,000
Out-of-Pocket Max (Individual): $9,450
Out-of-Pocket Max (Family): $18,900
Coinsurance (In-Network): 30%
Primary Care Copay: $30
Specialist Copay: $60
Urgent Care Copay: $60

Plan documents

Summary of Benefits and CoverageSBC

TelemedicineYes — Included

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