PPO-Regence Blue Shield Preferred Provider Health Plans

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Preferred (PPO) Plans

Preferred Plans are typically listed two ways. For example:

80/80/50 for a plan without a copay OR
100/90/60/15 for a plan with a copay

The first number refers to the coverage (i.e., 80%) for professional services provided by a Preferred Plan provider, including office visits.

The second number refers to coverage (i.e., 80%) for Preferred Plan hospital facilities.

The third number refers to the coverage for most services (i.e., 50%) for participating (Non-Preferred Plan) providers.

The fourth number refers to the copay (i.e., $15) for office visits.

Summaries of Benefits

You can post the following summaries on your company's Intranet site. However, we encourage you to link directly to our site since these documents are subject to change. If you need help doing this, please send an email to wa_info@regence.com.

MEDICAL PLANS

2008	2007
Regence HSA Healthplan (groups with 2+ employees) Preferred Plan 80/80/50 Preferred Plan 100/90/60/15 Preferred Plan 100/90/60/15 with Deductible Waiver Preferred Plan 100/90/60/20 Preferred Plan 100/90/60/20 with Deductible Waiver Preferred Plan 100/90/60/25 Preferred Plan 100/90/60/25 with Deductible Waiver	Small Groups (1-50)
	Preferred Plan 80/80/50 Preferred Plan 100/90/60/15 Preferred Plan 100/90/60/15 with Deductible Waiver Preferred Plan 100/90/60/20 Preferred Plan 100/90/60/20 with Deductible Waiver Preferred Plan 100/90/60/25 Preferred Plan 100/90/60/25 with Deductible Waiver HSA-Qualified Preferred Plan 80/80/60
	Large Groups (51+)
	Preferred Plan 80/80/50 Preferred Plan 100/90/60/15 Preferred Plan 100/90/60/15 with Deductible Waiver Preferred Plan 100/90/60/20 Preferred Plan 100/90/60/20 with Deductible Waiver Preferred Plan 100/90/60/25 Preferred Plan 100/90/60/25 with Deductible Waiver HSA-Qualified Preferred Plan 80/80/60
Benefit Options for Traditional, Selections & Preferred Plans (except FourFront, HSA-Qualified Preferred Plan 80/80/60 and Regence HSA Healthplan) Benefit Options for Preferred Plan FourFront Benefit Options for Regence HSA Healthplan Exclusions and Limitations	Benefit Options for Traditional, Preferred & Selections Plans (except Preferred FourFront and HSA-Qualified) Benefit Options for HSA-Qualified Preferred Plan Exclusions and Limitations to Coverage

VISION PLANS

Preferred Plans Vision Care Option Summaries of Benefits
2008	2007
Vision Care Option #7 Vision Care Option #11 (Except HSA-Qualified Preferred Plan 80/80/60)	Vision Care Option #7 Vision Care Option #11 (Except HSA-Qualified Preferred Plan 80/80/60)

The benefit information contained in the documents above is effective on the date stated on the bottom of each document. For renewing groups, benefit changes are effective upon the group's renewal unless otherwise stated.

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