Employer-sponsored plans 

Medical plan options

With our plans, your clients will enjoy affordable, quality care whenever they need it. Plans vary by premiums, deductibles, copays and coinsurance. To help employer groups manage costs of providing benefits to their employees and dependents, see our Funding Options for information about how we can help with your clients. 

PPO plans

We offer a wide selection of preferred provider organization (PPO) plans to meet your client’s specific needs. Our PPO plans combine great benefits with access to PPO contracted physicians and hospitals to help members save money. Members can visit any provider they choose, but they’ll get the best benefits, a greater selection of doctors and broader geographic coverage when visiting a PPO-contracted provider. 

High-deductible health plans (HDHP) option

These plans are compatible with a health savings account (HSA). Having an HDHP allows members to use tax-free funds for eligible healthcare expenses. They can simply check to see if their financial institution has an HSA. Members with this plan option can choose a financial institution that offers HSA accounts to get the tax advantages. 

Pharmacy benefits

Quality pharmacy benefits through medication tiers

All Moda Health medical plans come with an option of pharmacy plans. These benefits connect members with our Preferred Drug Program, a way to save money on safe and effective prescription medications. Through the program, plans cover prescriptions by these medication tiers: value, select, preferred, non-preferred, preferred specialty and non-preferred specialty. Each tier has a copay or coinsurance amount set by the plan. Easily check to see what medications are covered for your clients. View our formulary by tier and coverage level.

Pharmacy Network

Members have access to comprehensive prescription drug benefits through the Navitus pharmacy network. The Navitus network includes more than 65,000 pharmacies nationwide. This means they can fill prescriptions almost anywhere, including local and national drug store chains. Find in-network pharmacies.

Additional services

Third-party administrative services via BenefitHelp Solutions

BenefitHelp Solutions, a Moda Health subsidiary, provides third-party administrative services, sorting through the ever-changing laws, regulations, intricate policies and guidelines of benefits management. They offer comprehensive support that includes:

• Administration of flexible spending accounts, commuter expense reimbursement accounts and health reimbursement arrangements
• Online access to account balances, claims status, payment details and claims submission
• AutoPay enhancement for direct claim submission
• Full-service COBRA administration
• Premium administration, including retiree and other group premiums

Based on your funding type and plan, you may have access to some of these services. To learn more about how BenefitHelp Solutions can help you, visit the BenefitHelp Solutions website, or call 888-387-5440.

Member perks

Empower your client's employees to be better in every way with member perks — a comprehensive collection of innovative services, programs, and tools. Learn more about member perks

Vision coverage through VSP

Regular eye exams help prevent common eye diseases and help your client’s employees keep their vision strong. Vision coverage for adults includes routine vision exam and eyewear through the VSP Choice plan and in-network coverage through VSP’s Choice provider network. All routine vision exams and eyewear claims are administered by VSP. See your summary of benefits for more details.