Major Medical/Rx Plans
Clario offers two medical plans through Highmark BCBS: a High Deductible Health Plan with a Health Savings Account and a PPO plan. Both plans utilize the national PPO network of physicians, hospitals, and other health care providers. With both plans, you have the freedom to seek services from providers who do not participate in the PPO network; however, you will typically have more out-of-pocket costs for covered services, and you will need to file claims for reimbursement
Elections you make during Open Enrollment will be effective January 1, 2025 and remain in effect until December 31, 2025 unless you experience a Qualified Life Event.
Plan 1: HDHP $2,000 (individual) / $4,000 (family)
The HDHP plan has an aggregate deductible with an embedded out-of-pocket maximum. This means that each member has their own deductible to meet, but all accumulate towards the overall out-of-pocket maximum
Plan 2: PPO $1,000 (individual) / $2,000 (family)
The PPO plan has an aggregate deductible and out-of-pocket maximum. Each member accumulates towards the entire deductible and out-of-pocket maximum collectively.
A comparison chart of the plans is shown below.
Medical Plan Benefits
**Your cost share for Diagnostic Testing is dependent on the place of service. Diagnostic Testing for Professional Provider's Offices are only covered at 100% after office visit copay, if billed in conjunction with an office visit code, on the same date of service. If you go to an independent lab (Labcorp, Quest, etc), then you will be charged deductible and 80% coinsurance.
Please contact Quantum Health for coordination and full details of your benefits coverage.
Prescription Drug Benefits ⊕
Medical Plan Documents
Consider a Participating Provider Organization (PPO) plan if:
- You want access to both in-and out-of-network providers
- You want a lower deductible and out-of-pocket maximums
- You are willing to pay more in premiums
Consider a High Deductible Health Plan (HDHP) if:
- You want to be able to see any provider, even a specialist, without a referral
- You want tax-free savings on your healthcare costs
- You want to build a savings account for future healthcare costs for you and your eligible family members
- You want an extra way to add to your retirement savings
Still unsure which plan to pick? Click the link below for help:
Highmark Programs
Telehealth
We’ve all been there - it’s the middle of the night and you have a sick child or maybe you are trying to get an appointment with your primary care provider, but the first appointment isn’t for two weeks. Good news… there’s an easier way!
Diabetes Management
Diabetes management provided by Onduo helps you take control of your diabetes once and for all. If eligible, be on the lookout for additional program communication with information on how to get started.
