The State Health Plan has created a PPO alternative for all state employees called Smart Choice. What is a PPO? A PPO is an arrangement where providers are under contract to provide medical services at lower than usual fees in return for prompt payment and a certain volume of patients. There is freedom of choice among in-network providers, including specialists. No referrals are required for specialist office visits. When in-network providers are used, out-of-pocket expenses are lower and no claims forms are required.
| Coverage Type | | Smart Choice Basic | | Smart Choice |
|---|---|---|
| Employee Only Coverage | 0 | 0 |
| Employee/Child(ren) Coverage | 164.08 | 218.20 |
| Employee/Spouse | 422.74 | 502.74 |
| Employee/Family Coverage | 450.26 | 533.00 |