Home

About Us

Members

Employers

Brokers

Providers

Contact Us

Medical Plans
Vision Plans
Pharmacy Plans
MMA 2003

Members A Physician/ Hospital A Pharmacy A Vision Care Center Request A Newsletter Member Welcome Document
Employers A Medical Plan A Pharmacy Plan A Vision Plan

Search

Concert Health Plan
2605 W 22nd St. Suite 25
Oak Brook, Illinois 60523
Phone: (630) 990-1090
Customer Service: (866) 818-3106

Medical Plans

Below are examples of our available medical plans. They are for example purposes only.

Preferred Provider Organization	Annual Deductible		Co-Insurance		Maximum Out of Pocket
Preferred Provider Organization	In-Network	Out-of-Network	In-Network	Out-of-Network	In-Network	Out-of-Network
HA40 (view pdf)	$1,100	$2,000	90% after deductible	70% of Maximum Allowable Fee	$3,000	$6,000
HB40 (view pdf)	$1,100	$2,000	80% after deductible	60% of Maximum Allowable Fee	$4,000	$8,000
HC40 (view pdf)	$2,000	$4,000	90% after deductible	70% of Maximum Allowable Fee	$3,000	$6,000
HD40 (view pdf)	$2,000	$4,000	80% after deductible	60% of Maximum Allowable Fee	$3,000	$6,000
HE40 (view pdf)	$2,500	$5,000	90% after deductible	70% of Maximum Allowable Fee	$2,500	$10,000
HF40 (view pdf)	$2,500	$5,000	80% after deductible	60% of Maximum Allowable Fee	$2,500	$10,000
HG40 (view pdf)	$1,100	$2,000	100% after deductible	70% of Maximum Allowable Fee	$0	$4,000
HG45 (view pdf)	$1,500	$3,000	100% after deductible	70% of Maximum Allowable Fee	$0	$4,000
HH40 (view pdf)	$2,500	$5,000	100% after deductible	70% of Maximum Allowable Fee	$0	$5,000
HH45 (view pdf)	$2,000	$4,000	100% after deductible	70% of Maximum Allowable Fee	$0	$5,000
HI40 (view pdf)	$5,000	$10,000	100% after deductible	70% of Maximum Allowable Fee	$0	$5,000
HR41 (view pdf)	$2,500	$5,000	100% after deductible	70% of Maximum Allowable Fee	$0	$5,000
HR42 (view pdf)	$5,000	$10,000	100% after deductible	70% of Maximum Allowable Fee	$0	$5,000
HR43 (view pdf)	$10,000	$20,000	100% after deductible	70% of Maximum Allowable Fee	$0	$5,000
SO40 (view pdf)	$0	$1,500	100%	50% of Maximum Allowable Fee	$0	$4,500

Preferred Provider Organization	Annual Deductible		Co-Insurance		Maximum Out of Pocket
Preferred Provider Organization	In-Network	Out-of-Network	In-Network	Out-of-Network	In-Network	Out-of-Network
PA40 (view pdf)	$0	$1,000	90%	70% of Maximum Allowable Fee	$1,000	$3,000
PB40 (view pdf)	$250	$500	90%	70% of Maximum Allowable Fee	$1,000	$3,000
PB45 (view pdf)	$250	$500	90%	70% of Maximum Allowable Fee	$1,500	$3,000
PC40 (view pdf)	$250	$500	80%	60% of Maximum Allowable Fee	$2,000	$6,000
PD40 (view pdf)	$500	$1,000	90%	70% of Maximum Allowable Fee	$1,000	$3,000
PD45 (view pdf)	$500	$1,000	90%	70% of Maximum Allowable Fee	$1,500	$3,000
PE40 (view pdf)	$500	$1,000	80%	60% of Maximum Allowable Fee	$2,000	$6,000
PF40 (view pdf)	$750	$1,500	90%	70% of Maximum Allowable Fee	$1,500	$4,500
PG40 (view pdf)	$1,000	$2,000	90%	70% of Maximum Allowable Fee	$1,500	$4,500
PH40 (view pdf)	$1,000	$2,000	80%	60% of Maximum Allowable Fee	$2,500	$7,500
PI40 (view pdf)	$1,250	$2,500	90%	70% of Maximum Allowable Fee	$2,000	$6,000
PJ40 (view pdf)	$1,500	$3,000	90%	70% of Maximum Allowable Fee	$2,000	$6,000
PK40 (view pdf)	$2,000	$4,000	90%	70% of Maximum Allowable Fee	$2,000	$6,000
PL40 (view pdf)	$2,500	$5,000	90%	70% of Maximum Allowable Fee	$2,000	$6,000
PM40 (view pdf)	$2,500	$5,000	80%	60% of Maximum Allowable Fee	$2,500	$7,500
PN40 (view pdf)	$5,000	$10,000	90%	70% of Maximum Allowable Fee	$2,500	$7,500