What to Expect

New offerings with limited underwriting.

Minimum Value Plans (MVP) Satisfy ACA Parts A and B

Click on the plans below to see the summary of benefits for each. We’re confident you’ll find at least one plan that will meet your unique needs.

Swipe to the right to see the full table.

INN – In-Network | OON – Out-of-Network PHCS Physician Network
(Base funding rates effective 01/01/2023) Unlmited
MVP Basic
Limited Day Medical℠ Plan
Employee & Spouse
Employee & Child(ren)
ACA Preventive and Wellness Covered 100%
Covered 100%
Deductibles (INN|OON) $5,000/$10,000
Max Out-of-Pocket (IND/FAM) (excludes non-covered days/services)
$8.700 /$17,400
Physician Services
$0 Copay (Unlimited)
Primary Care Office Visits (INN|OON)
$25 Copay
8 Visits Max/Year
INN – PHCS Rate | OON – 85% UCR
Specialty Care Office Visits (INN|OON)
$50 Copay
8 Visits Max/Year
INN – PHCS Rate | OON – 85% UCR
Urgent Care (INN|OON)
$50 Copay
2 Visits Max/Year
INN – PHCS Rate | OON – 85% UCR
Out-Patient Services
Non-Hospital Based Lab/X-Ray Services (INN|OON)
$50 Copay
3 Visits Max/Year
INN – PHCS Rate | OON – 85% UCR
Out-Patient Surgery/Complex Imaging (RBP*)
$350 Copay per Visit
1/1 Visit Max/Year
Hospital Services
In-Patient Hospital (RBP*)
$350 Copay per Admission
5 Days Max/Year
Emergency Room (RBP*)
$350 Copay
1 Visit Max/Year
Pharmacy Benefits
Generic Rx Preventive
$0 Copay
Generic Rx: Tier 1 (Prev) | Tier 2 (non-Prev)
Tier 1 – $5 Copay | Tier 2 – Not Covered
Brand Rx: Tier 3 (Preferred) | Tier 4 (Non-Pref)
Not Covered
Specialty Rx
Not Covered

See if Your Practice Qualifies

Use the “Apply Now” link below to see if your practice qualifies. This brief 2-page form will help us better understand the needs of your practice. You will be notified within 48 hours whether or not your practice is approved.

Anderson Thornton Consultants will guide you

Complete Your Paperwork

Anderson Thornton Consultants will guide you through all the paperwork that is necessary for you to enroll in PECAAHP. Please note that you must maintain a PECAA Membership and be in good standing to qualify for the PECAAHP plan.

Frequently Asked Questions

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Employer FAQ

The HBA program is a unique, level-funded, self-insured program in which each employer is its own Plan Sponsor and Plan Administrator as defined within ERISA and is free to pursue the claims funding/reinsurance strategy of its own choosing.  While the HBA is not a traditional insurance carrier and does not participate in or facilitate any transaction of insurance, employer inquiries will be referred to appropriate, informed parties for appropriate action to protect employer interests.

Must have at least 2 W2 employees, employer must complete group questionnaire.

The largest network nationwide, the PHCS Network.

Fill out the employer health questionnaire above, you will hear back within 48 hours whether or not your group qualifies.

Invoices are sent electronically directly from HBA administrators between the 7th-12th of every month. Premiums are collected via ACH on the first business day of the following month.

Depending on the plans offered, the HBA program requires participation of 25-50% of eligible employees who are not covered as a dependent under another group health plan.

The employer must contribute at least 50% of the employer only cost.

HBA administrators will provide COBRA administration services for all groups.

They will be done electronically online.

No, in many cases it can integrate with the payroll system.

Yes, Vision, Dental, and Life benefits can be added to supplement medical coverage.

If your group doesn’t qualify we will work to find you a plan that will suit your needs.