2009 Plan Summaries and Schedules of Benefits

UPMC Health Plan 

• PPO Option 1 Summary of Plan (.pdf)
  PPO Option 1 Schedule of Benefits (.pdf)
  Group Number: 005782-300 (Rx A)/005782-301 (Rx B)
• PPO Option 2 Summary of Plan (.pdf)
  PPO Option 2 Schedule of Benefits (.pdf)
  Group Number: 005782-302 (Rx A)/005782-303 (Rx B)
• PPO Option 3 Summary of Plan (.pdf)
  PPO Option 3 Schedule of Benefits (.pdf)
  Group Number: 005782-304 (Rx A)/005782-305 (Rx B)
• High Deductible PPO with HRA Summary of Plan (.pdf)
  High Deductible PPO with HRA Schedule of Benefits (.pdf)
  Group Number: 005782-306 (Rx A)/005782-307 (Rx B)
  

HealthAmerica

• PPO Option 1 Summary of Benefits (.pdf)
  PPO Option 1 Schedule of Payments (.pdf)
  Group Number: 2186300006 (Rx A)/2186300008 (Rx B)
• PPO Option 2 Summary of Benefits (.pdf)
  PPO Option 2 Schedule of Payments (.pdf)
  Group Number: 2186300010 (Rx A)/2186300012 (Rx B)
• PPO Option 3 Summary of Benefits (.pdf)
  PPO Option 3 Schedule of Payments (.pdf)
  Group Number: 2186300014 (Rx A)/2186300016 (Rx B)
• High Deductible PPO with HRA Summary of Benefits (.pdf)
  High Deductible PPO with HRA Schedule of Payments (.pdf)
  Group Number: 2186300003 (Rx A)/2186300004 (Rx B)
• HMO Summary of Benefits (.pdf)
  Group Number: 5301870004 (Rx A)/5301870006 (Rx B)

Highmark Blue Cross/Blue Shield

• PPO Option 1 (PPOBlue) Summary of Benefits (.pdf)
  Group Number: 13058-01 (Rx A)/13058-11 (Rx B)
• PPO Option 2 (PPOBlue) Summary of Benefits (.pdf)
  Group Number: 13058-02 (Rx A)/13058-22 (Rx B)
• PPO Option 3 (PPOBlue) Summary of Benefits (.pdf)
  Group Number: 13058-03 (Rx A)/13058-33 (Rx B)
• High Deductible PPO with HRA (BlueAccount) Summary of Benefits (.pdf)
  Group Number: 13059-00 (Rx A)/13059-01 (Rx B)
• Comprehensive Plan Summary of Benefits (.pdf)
  Group Number: 40566-01 (Rx A)/40566-12 (Rx B)
• HMO Plan (KeystoneBlue) Summary of Benefits (.pdf)
  Group Number: 58149-50 (Highmark HMO Rx)