In-Network
BSW Premier
BSWH Employee Plan Tier 2
Out-of-Network (Allowed Amount)
Individual
Small Group
Self-Funded
- 2025-09-01_AbbVie_PPO_Self_Funded_OON
- 2025-09-01_AbbVie_PPO_Self_Funded_OON
- 2025-09-01_Covenant_HMO_Self_Funded_OON
- 2025-09-01_Hendrick_HMO_Self_Funded_OON
- 2025-09-01_PYCO_PPO_Self_Funded_OON
- 2025-09-01_BSWH_Employee_-_HMO_SF_OON
- 2025-09-01_BSWH_Employee_-_PPO_SF_OON
- 2025-09-01_BSWH_Employee_Plan_OON
- 2025-09-01_Steady_Fund_-_PPO_SF_OON
Cigna Transparency in Coverage
UnitedHealthcare Transparency in Coverage
Pharmacy Information
CapitalRx Commercial
- 2025-09-25_BSW-Health-Plan_ACA_HMO_SG_prescription_drugs
- 2025-09-25_BSW-Health-Plan_ACA_PPO_SG_prescription_drugs
- 2025-09-25_BSW-Health-Plan_BSW_LG_prescription_drugs
- 2025-09-25_BSW-Health-Plan_BSW_LG_TR_prescription_drugs
- 2025-09-25_BSW-Health-Plan_BSW_TR_prescription_drugs
Archive
- 2025-08-25_BSW-Health-Plan_ACA_HMO_SG_prescription_drugs
- 2025-08-25_BSW-Health-Plan_ACA_PPO_SG_prescription_drugs
- 2025-08-25_BSW-Health-Plan_BSW_LG_prescription_drugs
- 2025-08-25_BSW-Health-Plan_BSW_LG_TR_prescription_drugs
- 2025-08-25_BSW-Health-Plan_BSW_TR_prescription_drugs
- 2025-07-26_BSW-Health-Plan_ACA_HMO_SG_prescription_drugs
- 2025-07-26_BSW-Health-Plan_ACA_PPO_SG_prescription_drugs
- 2025-07-26_BSW-Health-Plan_BSW_LG_prescription_drugs
- 2025-07-26_BSW-Health-Plan_BSW_LG_TR_prescription_drugs
- 2025-07-26_BSW-Health-Plan_BSW_TR_prescription_drugs
- 2025-06-25_BSW-Health-Plan_ACA_HMO_SG_prescription_drugs
- 2025-06-25_BSW-Health-Plan_ACA_PPO_SG_prescription_drugs
- 2025-06-25_BSW-Health-Plan_BSW_LG_prescription_drugs
- 2025-06-25_BSW-Health-Plan_BSW_LG_TR_prescription_drugs
- 2025-06-25_BSW-Health-Plan_BSW_TR_prescription_drugs
- 2025-05-30_BSW-Health-Plan_ACA_HMO_SG_prescription_drugs
- 2025-05-30_BSW-Health-Plan_ACA_PPO_SG_prescription_drugs
- 2025-05-30_BSW-Health-Plan_BSW_LG_prescription_drugs
- 2025-05-30_BSW-Health-Plan_BSW_LG_TR_prescription_drugs
- 2025-05-30_BSW-Health-Plan_BSW_TR_prescription_drugs
CapitalRx Exchange
OptumRx Commercial
- 2025-06-01_BSW-Health-Plan_BSW-LG-TR1_prescription-drugs
- 2025-06-01_BSW-Health-Plan_BSW-LG3_prescription-drugs
- 2025-06-01_BSW-Health-Plan_BSW-GF-TR2_prescription-drugs
Archive
- 2025-05-01_BSW-Health-Plan_BSW-LG-TR1_prescription-drugs
- 2025-05-01_BSW-Health-Plan_BSW-LG3_prescription-drugs
- 2025-05-01_BSW-Health-Plan_BSW-GF-TR2_prescription-drugs
- 2025-04-01_BSW-Health-Plan_BSW-LG-TR1_prescription-drugs
- 2025-04-01_BSW-Health-Plan_BSW-LG3_prescription-drugs
- 2025-04-01_BSW-Health-Plan_BSW-GF-TR2_prescription-drugs
- 2025-03-01_BSW-Health-Plan_BSW-LG-TR1_prescription-drugs
- 2025-03-01_BSW-Health-Plan_BSW-LG3_prescription-drugs
- 2025-03-01_BSW-Health-Plan_BSW-GF-TR2_prescription-drugs
OptumRx Exchange
- 2025-06-01_BSW-Health-Plan_ACA-HMO-EPO40788_prescription-drugs
- 2025-06-01_BSW-Health-Plan_ACA-PPO37755_prescription-drugs
Archive
- 2025-05-01_BSW-Health-Plan_ACA-HMO-EPO40788_prescription-drugs
- 2025-05-01_BSW-Health-Plan_ACA-PPO37755_prescription-drugs
- 2025-04-01_BSW-Health-Plan_ACA-HMO-EPO40788_prescription-drugs
- 2025-04-01_BSW-Health-Plan_ACA-PPO37755_prescription-drugs
- 2025-03-01_BSW-Health-Plan_ACA-HMO-EPO40788_prescription-drugs
- 2025-03-01_BSW-Health-Plan_ACA-PPO37755_prescription-drugs