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For groups with up to 50 FTE. Full, tiered and select network plan options to suit employers’ needs. See our additional Small Group product resources.
| Plan Name | Year | Overview | Documents | Administration Forms |
|---|---|---|---|---|
| HMO HSA Flex | 2019 | Previously named Best Buy HSA HMO Flex. A High-deductible (QHDHP) HMO plan. Access to our full network of New England providers and hospitals. PCP selection and referrals required. Flex benefit provides member savings on general labs and day surgery. Option to fund an HSA. | Group Enrollment Form | |
| HMO Flex | 2019 | Previously named Affordable or Best Buy HMO Flex. A HMO plan available with or without a deductible. Includes access to our full network of New England providers and hospitals. PCP selection and referrals required. Flex benefit provides member savings on general labs and day surgery. | Group Enrollment Form | |
| Focus NetworkSM HMO | 2018 | Deductible, limited-network HMO plans featuring our high-performance network of providers. Lower premiums compared to full-network plans. PCP selection and referrals required. | How it WorksEmployer BrochureEmployee Brochure | Pre-RenewalChecklistGroup Enrollment Form |
| Core HMO Flex | 20182019 | Full New England network HMO with copays for set numbers of medical/behavioral office visits. Other visits/services subject to deductible, then coinsurance. PCP/referrals required. Flex benefit provides member savings on general labs and day surgery. | Facilities BrochureFlex Flyer | Pre-RenewalChecklistGroup Enrollment Form |
| Best Buy HSA HMO Flex | 2018 | High-deductible (QHDHP) HMO plan. Access to our full network of New England providers and hospitals. PCP selection and referrals required. Flex benefit provides member savings on general labs and day surgery. Option to fund an HSA. | Facilities BrochureFlex Flyer | Pre-RenewalChecklistGroup Enrollment Form |
| Best Buy HMO Flex | 2018 | Deductible HMO plan with access to our full network of New England providers and hospitals. PCP selection and referrals required. Flex benefit provides member savings on general labs and day surgery. | Facilities BrochureFlex Flyer | Pre-RenewalChecklistGroup Enrollment Form |
| Affordable HMO Flex | 2018 | No-deductible HMO plan with access to our full network of New England providers and hospitals. PCP selection and referrals required. Flex benefit provides member savings on general labs and day surgery. | Facilities BrochureFlex Flyer | Pre-RenewalChecklistGroup Enrollment Form |
Benefits, coverage and member cost-sharing details for our plans.
Schedules of Benefits and SBCs: Massachusetts
Individual 2018
| HMO - ON EXCHANGE with Dental | SOB | SBC |
|---|---|---|
| Standard Platinum MD0000004598 | Show Standard Platinum SOB | Show Standard Platinum SBC |
| Standard Gold MD0000004599 | Show Standard Gold SOB | Show Standard Gold SBC |
| Standard Silver MD0000004600 | Show Standard Silver SOB | Show Standard Silver SBC |
| Standard Bronze MD0000004601 | Show Standard Bronze SOB | Show Standard Bronze SBC |
| HMO - ON EXCHANGE with Dental - AI/AN - Limited | SOB | SBC |
|---|---|---|
| Standard Platinum MD0000004598 | Show Standard Platinum SOB | Show Standard Platinum SBC |
| Standard Gold MD0000004599 | Show Standard Gold SOB | Show Standard Gold SBC |
| Standard Silver MD0000004600 | Show Standard Silver SOB | Show Standard Silver SBC |
| Standard Bronze MD0000004601 | Show Standard Bronze SOB | Show Standard Bronze SBC |
| HMO - ON EXCHANGE with Dental - AI/AN - $0 | SOB | SBC |
|---|---|---|
| HMO MD0000004605 | Show HMO SOB | Show HMO SBC |
| HMO MD0000004605 | Show HMO SOB | Show HMO SBC |
| HMO MD0000004605 | Show HMO SOB | Show HMO SBC |
| HMO MD0000004605 | Show HMO SOB | Show HMO SBC |
Individual 2019
| HMO - ON EXCHANGE with Dental | SOB | SBC |
|---|---|---|
| Standard Platinum MD0000004922 | Show Standard Platinum SOB | Show Standard Platinum SBC |
| Standard High Gold MD0000004924 | Show Standard High Gold SOB | Show Standard High Gold SBC |
| Standard Low Gold MD0000004925 | Show Standard Low Gold SOB | Show Standard Low Gold SBC |
| Standard Silver MD0000004926 | Show Standard Silver SOB | Show Standard Silver SBC |
| Stanard High Bronze MD0000004928 | Show Stanard High Bronze SOB | Show Stanard High Bronze SBC |
| Standard Platinum MD0000004922 | Show Standard Platinum SOB | Show Standard Platinum SBC |
| Standard High Gold MD0000004924 | Show Standard High Gold SOB | Show Standard High Gold SBC |
| Standard Low Gold MD0000004925 | Show Standard Low Gold SOB | Show Standard Low Gold SBC |
| Standard Silver MD0000004926 | Show Standard Silver SOB | Show Standard Silver SBC |
| Stanard High Bronze MD0000004928 | Show Stanard High Bronze SOB | Show Stanard High Bronze SBC |
| HMO - ON EXCHANGE with Dental - AI/AN - Limited | SOB | SBC |
|---|---|---|
| Standard Platinum MD0000004922 | Show Standard Platinum SOB | Show Standard Platinum SBC |
| Standard High Gold MD0000004924 | Show Standard High Gold SOB | Show Standard High Gold SBC |
| Standard Low Gold MD0000004925 | Show Standard Low Gold SOB | Show Standard Low Gold SBC |
| Standard Silver MD0000004926 | Show Standard Silver SOB | Show Standard Silver SBC |
| Stanard High Bronze MD0000004928 | Show Stanard High Bronze SOB | Show Stanard High Bronze SBC |
| Standard Platinum MD0000004922 | Show Standard Platinum SOB | Show Standard Platinum SBC |
| Standard High Gold MD0000004924 | Show Standard High Gold SOB | Show Standard High Gold SBC |
| Standard Low Gold MD0000004925 | Show Standard Low Gold SOB | Show Standard Low Gold SBC |
| Standard Silver MD0000004926 | Show Standard Silver SOB | Show Standard Silver SBC |
| Stanard High Bronze MD0000004928 | Show Stanard High Bronze SOB | Show Stanard High Bronze SBC |
| HMO - ON EXCHANGE with Dental - AI/AN - $0 | SOB | SBC |
|---|---|---|
| HMO MD0000004923 | Show HMO SOB | Show HMO SBC |
| HMO MD0000004923 | Show HMO SOB | Show HMO SBC |
| HMO MD0000004923 | Show HMO SOB | Show HMO SBC |
| HMO MD0000004923 | Show HMO SOB | Show HMO SBC |
| HMO MD0000004923 | Show HMO SOB | Show HMO SBC |
| HMO MD0000004923 | Show HMO SOB | Show HMO SBC |
| HMO MD0000004923 | Show HMO SOB | Show HMO SBC |
| HMO MD0000004923 | Show HMO SOB | Show HMO SBC |
| HMO MD0000004923 | Show HMO SOB | Show HMO SBC |
Small Group 2018
| HMO - ON EXCHANGE with Dental | SOB | SBC |
|---|---|---|
| Standard Platinum MD0000004598 | Show Standard Platinum SOB | Show Standard Platinum SBC |
| Standard Gold MD0000004599 | Show Standard Gold SOB | Show Standard Gold SBC |
| Standard Silver MD0000004600 | Show Standard Silver SOB | Show Standard Silver SBC |
| Standard Bronze MD0000004601 | Show Standard Bronze SOB | Show Standard Bronze SBC |
| HMO - OFF EXCHANGE without Dental | SOB | SBC |
|---|---|---|
| Affordable HMO 25 - FLEX MD0000004607 | Show Affordable HMO 25 - FLEX SOB | Show Affordable HMO 25 - FLEX SBC |
| Best Buy HMO 1000 - FLEX MD0000004608 | Show Best Buy HMO 1000 - FLEX SOB | Show Best Buy HMO 1000 - FLEX SBC |
| Best Buy HMO 1000 with Coinsurance - FLEX MD0000004609 | Show Best Buy HMO 1000 with Coinsurance - FLEX SOB | Show Best Buy HMO 1000 with Coinsurance - FLEX SBC |
| Best Buy HMO 2000 - FLEX MD0000004610 | Show Best Buy HMO 2000 - FLEX SOB | Show Best Buy HMO 2000 - FLEX SBC |
| Best Buy HMO 2000 with Coinsurance - FLEX MD0000004611 | Show Best Buy HMO 2000 with Coinsurance - FLEX SOB | Show Best Buy HMO 2000 with Coinsurance - FLEX SBC |
| Best Buy HSA HMO 2000 - FLEX MD0000004612 | Show Best Buy HSA HMO 2000 - FLEX SOB | Show Best Buy HSA HMO 2000 - FLEX SBC |
| Best Buy HSA HMO 2000 with Coinsurance - FLEX MD0000004613 | Show Best Buy HSA HMO 2000 with Coinsurance - FLEX SOB | Show Best Buy HSA HMO 2000 with Coinsurance - FLEX SBC |