Discontinued Small Group Health Insurance Plans - Aetna, Anthem Blue Cross, Blue Shield, California Choice, Health Net, Kaiser, PacifiCare, Sharp, UHC and more

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Old/Discontinued Plans (CA):


DISCONTINUED AETNA PLANS
DISCONTINUED Aetna PPO Plans	Effective	Network	In-Network (Ded Sgl/Fam)	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
MC HRA HDHP $5000 80/50	4-08	PPO	5000 indiv / 10000 fam	2000 indiv / 4000 family	$0 copay / 20% co-insurance	$20 $40 AD $ded	20% 20% / $0 20% / $0
EPO Limited (Open Access)	4-08	PPO	1000 indiv	4500 indiv	$0 copay / 50% co-insurance	$20 $40 AD $ded	50% 50% / $0 50% / $0
MC 2500 100/50	12-07	PPO	2500 indiv / 7500 fam	0 / 0	$25 copay / 0% co-insurance	$15 $35 0 $ded	0% 0% / $0 0% / $0
MC $500 50/50	12-07	PPO	500 indiv / 2 mem max	5000 indiv / 2 member max	$35 copay / 0% co-insurance	$15 na 0 $ded	50% 50% / $0 50% / $150
DISCONTINUED Aetna HMO Plans	Effective	Network	In-Network (Ded Sgl/Fam)	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
HMO $30/$40	4-07	HMO	0 / 0	3000 indiv / 6000 family	$30 copay / na	$15 $35 0 $ded	0% 0% / $500 0% / $250
HMO $20/$40	4-07	HMO	0 / 0	2500 indiv / 5000 family	$20 copay / na	$15 $35 0 $ded	0% 0% / $500 0% / $250
HMO $10/$30	4-07	HMO	0 / 0	2000 indiv / 4000 family	$10 copay / na	$15 $35 0 $ded	0% 0% / $300 0% / $250
HMO $10/$20	4-07	HMO	0 / 0	1500 indiv / 3000 family	$10 copay / na	$10 $25 0 $ded	0% 0% / $0 0% / $0
Value Network* HMO $30/$40	4-07	HMO	0 / 0	3000 indiv / 6000 family	$30 copay / na	$15 $35 150 $ded	0% 0% / $1000 0% / $250
Value Network* HMO $10/$20	4-07	HMO	0 / 0	1500 indiv / 3000 family	$10 copay / na	$10 $25 0 $ded	0% 0% / $0 0% / $0
DISCONTINUED Aetna HMO Plans	Effective	Network	In-Network (Ded Sgl/Fam)	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)

Old/Discontinued Plans (CA):


DISCONTINUED BLUE CROSS PLANS
DISCONTINUED Blue Cross HMO Plans	Effective	Network	In-Network (Ded Sgl/Fam)	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
Select HMO**	2-08	HMO	500 / 1000	2250 / 4500	0 visits / $25 copay / 0% co-ins	$15 $25 150 $ded	0% 0% / $0 20% / $0
Saver HMO	2-08	HMO	1500 / 3000	2250 / 4500	0 visits / $20 copay / 0% co-ins	$10 $25 150 $ded	0% 0% / $0 0% / $0
Classic HMO	2-08	HMO	0 / 0	1750 / 3500	0 visits / $20 copay / 0% co-ins	$10 $25 150 $ded	0% 0% / $0 20% / $0
DISCONTINUED Blue Cross HMO Plans	Effective	Network	In-Network (Ded Sgl/Fam)	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)

Old/Discontinued Plans (CA):


DISCONTINUED PLANS
DISCONTINUED Blue Shield HMO Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
PPO(SM) Savings Plan 3400* Discontinued as of 2-08	2-08	PPO	3400 / 6800	4500 / 9000	$0 copay / 30% co-ins	$10 $30 or 30% 0 $ded
DISCONTINUED Blue Shield HMO Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)

Old/Discontinued Plans (CA):


DISCONTINUED CALIFORNIA CHOICE PLANS
DISCONTINUED California Choice Plans	Effective	Network	In-Network (Ded Sgl/Fam)	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
None Available

Old/Discontinued Plans (CA):


DISCONTINUED HEALTH NET PLANS
DISCONTINUED Health Net Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
Options HMO 25 Silver - Plan S5Y	1-09	HMO	0 / 0	3000 / 6000	$25 copay	$15 $30 150 $ded
Options HMO 35 Silver - Plan S5Z	5-08	HMO	0 / 0	4000 / 8000	$35 copay	$15 $30 200 $ded
DISCONTINUED Health Net Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)

Old/Discontinued Plans (CA):


DISCONTINUED KAISER PLANS
DISCONTINUED Kaiser Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
None Available

Old/Discontinued Plans (CA):


DISCONTINUED SHARP PLANS
DISCONTINUED Sharp Plans	Effective	Network	In-Network (Ded Sgl/Fam)	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
None Available

Old/Discontinued Plans (CA):


DISCONTINUED UHC PLANS
DISCONTINUED UHC Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
Choice Plus Balanced Value 20/3000/90% Plan D6L	3-09	PPO	3000 / 9000	6000 / 12000 5 Million per covered person	$20 copay	$10 $35 $250 ded	10% 10% / $500 10% / $250 AD
Choice Plus Balanced Value 30/2500/80% Plan D6N	3-09	PPO	2500 / 7500	4500 / 9000 5 Million per covered person	$30 copay	$10 $35 $250 ded	20% 20% / $500 20% / $250 AD
Choice Plus Definity HSA 2850/80% Plan D6I	3-09	PPO	2850 / 5600	3500 / 7000 5 Million per covered person	20% co-ins AD	$10 $30 AD	20% 20% / $0 20% / $0 AD
Choice Plus Definity HSA 2850/80% Plan D6J	3-09	PPO	2850 / 5600	3500 / 7000 5 Million per covered person	20% co-ins AD	$10 $30 AD	20% 20% / $0 20% / $0 AD
Choice Plus Definity HSA 3000/70% Plan C3X	3-09	PPO	3000 / 6000	5000 / 10000 5 Million per covered person	30% co-ins AD	$10 $30 AD	30% 30% / $0 30% / $0 AD
Choice Plus Definity HSA 3500/70% Plan C3Y	3-09	PPO	3500 / 7000	5000 / 10000 5 Million per covered person	30% co-ins AD	$10 $30 AD	30% 30% / $0 30% / $0 AD
Choice Plus Definity HRA 2000/90% Plan C3W	3-09	PPO	2000 / 4000	5000 / 10000 5 Million per covered person	10% co-ins AD	$10 $35 $250 ded on tiers II & III	10% 10% / $0 10% / $0 AD
DISCONTINUED UHC Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
Non Differential PPO 2000/80% Plan 6HE	7-08	PPO	2000 / 6000	4000 / 12000	20% co-ins
Choice Plus Balanced 100 30/3000/100% Plan 6CX	7-08	PPO	3000 / 9000	3000 / 9000	$30 copay
Choice Plus Balanced 25/1000/80% Plan 6CW	7-08	PPO	1000 / 3000	3500 / 7000	$25 copay
Choice Plus Balanced 25/2500/80% Plan 6CV	7-08	PPO	2500 / 7500	4500 / 9000	$25 copay
DISCONTINUED UHC Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
Choice Plus Balanced 35/2000/50% Plan 6CN	5-08	PPO	2000 / 6000	6000 / 12000	$35 copay
Choice Plus Balanced Value 25/1000/80% Plan 6CP	5-08	PPO	1000 / 3000	3500 / 7000	$25 copay
Choice Plus Balanced Value 25/2500/80% Plan 6CQ	5-08	PPO	2500 / 7500	4500 / 9000	$25 copay
Choice Plus Balanced Value 35/1000/50% Plan 6CT	5-08	PPO	1000 / 3000	5000 / 10000	$35 copay
Choice Plus Balanced Value 35/1000/70% Plan 6CR	5-08	PPO	1000 / 3000	5000 / 10000	$35 copay
Choice Plus Balanced Value 35/2000/50% Plan 6CU	5-08	PPO	2000 / 6000	6000 / 12000	$35 copay
Choice Plus Balanced Value 40/1500/70% Plan 6CS	5-08	PPO	1500 / 4500	5000 / 10000	$40 copay
DISCONTINUED UHC Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
Choice Plus Definity HSA 1500/80% Plan U1O	12-07	PPO	1500 / 3000	3000 / 6000	20% co-ins
Non Differential PPO 2000/80% Plan 7CB	12-07 rev 02	PPO	2000 / 6000	4000 / 12000	20% co-ins
Choice Plus Balanced 100 30/3000/100% Plan 6CO	12-07	PPO	3000 / 9000	3000 / 9000	$30 copay
Choice Plus Balanced 100 30/3000/100% Plan 7AQ	12-07	PPO	3000 / 9000	3000 / 9000	$30 copay
Choice Plus Balanced 100 Value 30/3000/100% Plan 6CO	12-07	PPO	3000 / 9000	4000 / 12000	$30 copay
Choice Plus Balanced 25/1000/80% Plan 7AB	12-07	PPO	1000 / 3000	3500 / 7000	$25 copay
Choice Plus Balanced 25/2500/80% Plan 2AQ	12-07	PPO	2500 / 7500	4500 / 9000	$25 copay
Choice Plus Balanced 35/1000/50% Plan 6CE	12-07	PPO	1000 / 3000	5000 / 10000	$35 copay
Choice Plus Balanced 35/1000/70% Plan 6CC	12-07	PPO	1000 / 3000	5000 / 10000	$35 copay
Choice Plus Balanced 40/1500/70% Plan 6CF	12-07	PPO	1500 / 4500	5000 / 10000	$40 copay
Choice Plus Consumer 1500/80% Plan 6CH	12-07	PPO	1500 / 3000	3000 / 6000	20% co-ins
Choice Plus Consumer 1500/100% Plan 7AL	12-07	PPO	1500 / 4500	1500 / 4500	0% co-ins
Choice Plus Consumer 2000/100% Plan 7AM	12-07	PPO	2000 / 6000	2000 / 6000	0% co-ins
Choice Plus Consumer 2500/80% Plan S1Y	12-07	PPO	2500 / 5000	5000 / 10000	20% co-ins
Choice Plus Consumer 3000/70% Plan 6CG	12-07	PPO	3000 / 6000	5000 / 10000	30% co-ins
Choice Plus Traditional 20/250/90% Plan 6CM	12-07	PPO	250 / 750	3000 / 6000	$20 copay
Choice Plus Traditional 30/500/70% Plan 6CB	12-07	PPO	500 / 1500	3000 / 6000	$30 copay
Choice Plus Traditional 35/500/80% Plan 6CD	12-07	PPO	500 / 1500	5000 / 10000	$35 copay
DISCONTINUED UHC Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
Choice Plus Plan QPA	5-07	PPO	1000 / 3000	3500 / 7000	$25 copay
Choice Plus Plan QPB	5-07	PPO	3000 / 9000	3000 / 9000	$30 copay
DISCONTINUED UHC Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
HSA Options PPO Plan LDD	4-06	PPO	2000 / 4000	2000 / 4000	0% co-ins
HSA Options PPO Plan LDE	4-06	PPO	2000 / 4000	4000 / 8000	20% co-ins
HSA Options PPO Plan LDF	4-06	PPO	2850 / 5600	2850 / 5600	0% co-ins
HSA Options PPO Plan LDG	4-06	PPO	2850 / 5600	5000 / 10000	20% co-ins
HSA Options PPO Plan LDH	4-06	PPO	2850 / 5600	5000 / 10000	20% co-ins
HSA Options PPO Plan LDI	4-06	PPO	3500 / 7000	3500 / 7000	0% co-ins
HSA Options PPO Plan LDJ	4-06	PPO	3500 / 7000	5000 / 10000	20% co-ins
HSA Options PPO Plan LDK	4-06	PPO	3500 / 7000	5000 / 10000	20% co-ins
DISCONTINUED UHC Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
HSA Options PPO Plan LDL	4-06	PPO	5000 / 10000	5000 / 10000	0% co-ins
HSA Options PPO Plan LDM	4-06	PPO	5000 / 10000	5000 / 10000	0% co-ins
HSA Options PPO Plan LDN	4-06	PPO	1500 / 3000	1500 / 3000	0% co-ins
HSA Options PPO Plan LDO	4-06	PPO	1500 / 3000	3000 / 6000	20% co-ins
HSA Options PPO Plan LYA	4-06	PPO	2500 / 5000	2500 / 5000	0% co-ins
HSA Options PPO Plan LYB	4-06	PPO	2500 / 5000	5000 / 10000	20% co-ins
HSA Options PPO Plan LYC	4-06	PPO	5000 / 10000	5000 / 10000	0% co-ins
DISCONTINUED UHC Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
Options PPO Plan LKA	4-06	PPO	1500 / 4500	1500 / 4500	$25 copay
Options PPO Plan LKB	4-06	PPO	2500 / 7500	2500 / 7500	$25 copay
Options PPO Plan LKC	4-06	PPO	3000 / 9000	3000 / 9000	$25 copay
Options PPO Plan LKD	4-06	PPO	4000 / 12000	4000 / 12000	$25 copay
Options PPO Plan LKE	4-06	PPO	5000 / 15000	5000 / 15000	$25 copay
Options PPO Plan LKF	4-06	PPO	1000 / 3000	1000 / 3000	$25 copay
Options PPO Plan LKG	4-06	PPO	500 / 1500	3000 / 6000	$25 copay
Options PPO Plan LKH	4-06	PPO	1000 / 3000	3500 / 7000	$25 copay
DISCONTINUED UHC Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
Options PPO Plan LKI	4-06	PPO	2000 / 6000	2000 / 6000	$25 copay
Options PPO Plan LKJ	4-06	PPO	500 / 1500	3000 / 6000	$25 copay
Options PPO Plan LKK	4-06	PPO	250 / 750	2500 / 5000	$25 copay
Options PPO Plan LKL	4-06	PPO	1500 / 4500	4500 / 9000	$25 copay
Options PPO Plan NAA	4-06	PPO	250 / 750	1500 / 3000	$20 copay
Options PPO Plan NAB	4-06	PPO	250 / 750	1500 / 3000	$20 copay
Options PPO Plan NAC	4-06	PPO	500 / 1500	2000 / 4000	$20 copay
Options PPO Plan NAD	4-06	PPO	500 / 1500	2000 / 4000	$20 copay
DISCONTINUED UHC Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
Options PPO Plan NAE	4-06	PPO	1000 / 3000	2500 / 5000	$20 copay
Options PPO Plan NAF	4-06	PPO	1000 / 3000	2500 / 5000	$20 copay
Options PPO Plan NAG	4-06	PPO	1500 / 4500	3500 / 7000	10% co-ins
Options PPO Plan NAH	4-06	PPO	1500 / 4500	3500 / 7000	$25 copay
Options PPO Plan NAI	4-06	PPO	1500 / 4500	3500 / 7000	20% co-ins
Options PPO Plan NAJ	4-06	PPO	1500 / 4500	3500 / 7000	$25 copay
Options PPO Plan NAK	4-06	PPO	2000 / 6000	4000 / 8000	10% co-ins
Options PPO Plan NAL	4-06	PPO	2000 / 6000	4000 / 8000	$25 copay
DISCONTINUED UHC Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
Options PPO Plan NAM	4-06	PPO	2000 / 6000	4000 / 8000	20% co-ins
Options PPO Plan NAN	4-06	PPO	2000 / 6000	4000 / 8000	$25 copay
Options PPO Plan NAO	4-06	PPO	2500 / 7500	4500 / 9000	10% co-ins
Options PPO Plan NAP	4-06	PPO	2500 / 7500	4500 / 9000	$25 copay
Options PPO Plan NAQ	4-06	PPO	2500 / 7500	4500 / 9000	20% co-ins
Options PPO Plan NAR	4-06	PPO	2500 / 7500	4500 / 9000	$25 copay
Options PPO Plan NAS	4-06	PPO	3000 / 9000	5000 / 10000	10% co-ins
Options PPO Plan NAT	4-06	PPO	3000 / 9000	5000 / 10000	$30 copay
DISCONTINUED UHC Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
Options PPO Plan NAU	4-06	PPO	3000 / 9000	5000 / 10000	20% co-ins
Options PPO Plan NAV	4-06	PPO	3000 / 9000	5000 / 10000	$30 copay
Options PPO Plan NAW	4-06	PPO	5000 / 15000	7500 / 15000	10% co-ins
Options PPO Plan NAX	4-06	PPO	5000 / 15000	7500 / 15000	$30 copay
Options PPO Plan NAY	4-06	PPO	5000 / 15000	7500 / 15000	20% co-ins
Options PPO Plan NAZ	4-06	PPO	5000 / 15000	7500 / 15000	$30 copay
Options PPO Plan NDA	4-06	PPO	1000 / 3000	1000 / 3000	$20 copay
Options PPO Plan NDB	4-06	PPO	1000 / 3000	1000 / 3000	0% co-ins
DISCONTINUED UHC Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
Options PPO Plan NDC	4-06	PPO	2000 / 6000	2000 / 6000	$25 copay
Options PPO Plan NDD	4-06	PPO	2000 / 6000	2000 / 6000	0% co-ins
Options PPO Plan RUA	4-06	PPO	1100 / 2200	1100 / 2200	0% co-ins
Options PPO Plan RUB	4-06	PPO	2000 / 4000	2000 / 4000	0% co-ins
Options PPO Plan RUC	4-06	PPO	2850 / 5600	2850 / 5600	0% co-ins
Options PPO Plan TEA	4-06	PPO	500 / 1500	2000 / 4000	$20 copay
Options PPO Plan TEB	4-06	PPO	1000 / 3000	2500 / 5000	$20 copay
Options PPO Plan TEC	4-06	PPO	1500 / 4500	3500 / 7000	$25 copay
Options PPO Plan TED	4-06	PPO	1000 / 3000	1000 / 3000	$20 copay
Options PPO Plan TEE	4-06	PPO	2000 / 6000	2000 / 6000	$25 copay
DISCONTINUED PacifiCare POS Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
SignaturePOS 15/80-60	7-09	POS	0 / 0	2500 / 7500 None	$15 copay	$10 $25 $0 ded	0% 0% / $250 per admit 0% / $250 per admit
DISCONTINUED PacifiCare PPO Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
SV 10-30/500d	3-09	HMO	0 / 0	2000 / 6000 None	$10 copay	$15 $35 150 $ded	0% 0% / $500 per day, 2 day max per admit 0% / $400 per admit
SV Advantage 10-30/500d	3-09	HMO	0 / 0	2000 / 6000 None	$10 copay	$15 $35 150 $ded	0% 0% / $500 per day, max 2 days per admit 0% / $400 per admit
SV 20-40/500d	3-09	HMO	0 / 0	3000 / 9000 None	$20 copay	$20 $35 150 $ded	0% 0% / $500 per day, 4 days max per admit 0% / $400 per admit
SV Advantage 20-40/500d	3-09	HMO	0 / 0	3000 / 9000 None	$20 copay	$20 $35 150 $ded	0% 0% / $500 per day, max 4 days per admit 0% / $400 per admit
SV 35-45/600d	3-09	HMO	0 / 0	5000 / 15000 None	$35 copay	$20 $35 150 $ded	0% 0% / $600 per day, 4 days max per admit 0% / $500 per admit
SV Advantage 35-45/600d	3-09	HMO	0 / 0	5000 / 15000 None	$35 copay	$20 $35 150 $ded	0% 0% / $600 per day, max 4 days per admit 0% / $500 per admit
SignatureElite 20/90-50/250	3-09	PPO	250 / 500	3250 / 6500 5 Million	$20 copay	$10 $35 $150 ded	10% 10% / $0 10% / $0 AD
SignatureElite 30/80-60/250	3-09	PPO	250 / 500	3250 / 6500 5 Million	$30 copay	$10 $35 $150 ded	20% 20% / $0 20% / $0 AD
SignatureElite 30/80-60/500	3-09	PPO	500 / 1000	5500 / 11000 5 Million	$30 copay	$10 $35 $150 ded	20% 20% / $0 20% / $0 AD
SignatureElite 40--50-50--1000	3-09	PPO	1000 / 2000	4000 / 8000 5 Million	$40 copay	$10 $35 $150 ded	50% 50% / $0 50% / $0 AD
SignatureElite 40--70-50--1000	3-09	PPO	1000 / 2000	6000 / 12000 5 Million	$40 copay	$10 $35 $150 ded	30% 30% / $0 30% / $0 AD
SignatureElite 40--70-50--250	3-09	PPO	250 / 500	3250 / 6500 5 Million	$40 copay	$10 $35 $150 ded	30% 30% / $0 30% / $0 AD
SignatureElite 70-50/2000	3-09	PPO	2000 / 4000	5000 / 10000 5 Million	30% co-ins AD	$10 $35 250 $ded	30% 30% / $0 30% / $0 AD
SignatureElite 70-50/3500	3-09	PPO	3500 / 7000	5500 / 11000 5 Million	30% co-ins AD	$10 $35 250 $ded	30% 30% / $0 30% / $0 AD
DISCONTINUED PacifiCare PPO Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
SignatureElite 30/70-50/250	7-07	PPO	250 / 500	3000 / 6000	0 visits / $20 copay / 0% co-ins	$10 $35 150 $ded
SignatureElite 35/80-60/500	7-07	PPO	500 / 1000	5000 / 10000	0 visits / $35 copay / 0% co-ins	$10 $35 0 $ded
SignatureElite 35/70-50/1000	7-07	PPO	1000 / 2000	5000 / 10000	0 visits / $35 copay / 0% co-ins	$10 $35 0 $ded
SignatureElite 35/50-50/1000	7-07	PPO	1000 / 2000	3000 / 6000	0 visits / $35 copay / 0% co-ins	$10 $35 0 $ded
DISCONTINUED HMO Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
15/90-50/250	3-07	PPO	250 / 500	3000 / 6000	0 visits / $15 copay / 0% co-ins	$10 $25 0 $ded
20/80-60/250	3-07	PPO	250 / 500	3000 / 6000	0 visits / $20 copay / 0% co-ins	$10 $25 0 $ded
DISCONTINUED HMO Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
SV Advantage 20/1500ded	7-06	HMO	1500 / 3000	4000 / 8000	0 visits / $20 copay / 0% co-ins	$20 $35 0 $ded
SV Advantage 35/600d	7-06	HMO	0 / 0	5000 / 15000	0 visits / $35 copay / 0% co-ins	$15 $35 0 $ded
DISCONTINUED HMO Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
SV Advantage 10-30/100	6-06	HMO	0 / 0	1500 / 4500	0 visits / $10 copay / 0% co-ins	$10 $25 0 $ded
SV Advantage 15-30/250a	6-06	HMO	0 / 0	1500 / 4500	0 visits / $15 copay / 0% co-ins	$10 $25 0 $ded
DISCONTINUED PacifCare HMO Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)
SV 15-30/250a	2-06	HMO	0 / 0	1500 / 4500	0 visits / $15 copay / 0% co-ins	$10 $25 0 $ded
SV Advantage 10/500d	2-06	HMO	0 / 0	2000 / 6000	0 visits / $10 copay / 0% co-ins	$15 $35 0 $ded
DISCONTINUED PacifiCare HMO Plans	Effective	Network	In-Network Ded Sgl/Fam	In-Network Out/pocket max Lifetime Max	In-Network Office visits (AD = after deductible)	Rx Drugs... Generic Brand Name Deductible (AD = after deductible)	Professional Services... CoInsurance InP CoIns/Copay OutP CoIns/Copay (AD = after deductible)

Old/Discontinued Plans (CA):