


BCBS PPO National Network
| Deductible: | $1,000 |
| Coinsurance: | 80/20 |
| Out-of-Pocket: | $3,800 |
| Primary Care Co-pay: | $25 |
| Specialist Co-Pay: | $50 |
| Medications: | Generic 10%; Brand 35% (see SBC for more details) |
| Wellness & Teledoc Visits: | No Charge |
(In-network only)
See Health Plan Outline for More Details

Principal PPO Dental Network
| Annual deductible network | Coinsurance network pays | |
| Preventative | $0 | 100% |
| Basic | $50 | 80% |
| Major | $50 | 50% |
Max benefit: $2,000 per calendar year
New Benefit: Implant coverage (see SBC for details).
Out-of-Network Coverage Available (Click Here to See Claim Example)

VSP Vision
| Exams: $10 copay, 1 exam every 12 mo |
| Glasses: $25 copay for single lenses |
| Frames: Up to $250 every 24 mo |
| Contacts: Up to $250 every 12 mo |
At PEO4YOU, we believe comprehensive healthcare should be accessible, transparent, and tailored to your needs. That’s why every member receives a complete benefits package — medical, dental, vision, and life benefits — designed to give you peace of mind and real value.

BCBS PPO National Network
| Deductible: | $1,000 |
| Coinsurance: | 80/20 |
| Out-of-Pocket: | $3,800 |
| Primary Care Co-pay: | $25 |
| Specialist Co-Pay: | $50 |
| Medications: | Generic 10%; Brand 35% (see SBC for more details) |
| Wellness & Teledoc Visits: | No Charge |
(In-network only)
See Health Plan Outline for More Details

Principal PPO Dental Network
| Annual deductible network | Coinsurance network pays | |
| Preventative | $0 | 100% |
| Basic | $50 | 80% |
| Major | $50 | 50% |
Max benefit: $2,000 per calendar year
New Benefit: Implant coverage (see SBC for details).
Out-of-Network Coverage Available (Click Here to See Claim Example)


VSP Vision
| Exams: $10 copay, 1 exam every 12 mo |
| Glasses: $25 copay for single lenses |
| Frames: Up to $250 every 24 mo |
| Contacts: Up to $250 every 12 mo |



5 year average renewal of less than 3% – Trust established in 1958 – BCBS network since 2004 – Enrollment available year round – No underwriting
Features | H&W 125 | DENTAL 125 | VISION 125 | LIFE 10K | ADMIN125 | Union | Total |
|---|---|---|---|---|---|---|---|
Employee Only | $731.00 | $65.00 | $10.00 | $5.00 | $100.00 | $27.00 | $938.00 |
Employee + Spouse | $1,500.00 | $130.00 | $22.00 | $5.00 | $200.00 | $27.00 | $1,884.00 |
Employee + (Children) | $1,146.00 | $130.00 | $22.00 | $5.00 | $200.00 | $27.00 | $1,530.00 |
Employee + Family | $1,636.00 | $190.00 | $35.00 | $5.00 | $200.00 | $27.00 | $2,093.00 |
Waived Employees | $5.00 | $27.00 | $32 |
6 consecutive renewals of 3% or less – Trust established in 1958 – BCBS network since 2004 – Enrollment available year round
Features | H&W 125 | DENTAL 125 | VISION 125 | ACCIDENT | LIFE 10K | ADMIN125 | Union | Total |
|---|---|---|---|---|---|---|---|---|
Employee Only | $746.00 | $75.00 | $15.00 | $12.00 | $10.00 | $100.00 | $27.00 | $985.00 |
Employee + Spouse | $1,530.00 | $150.00 | $30.00 | $12.00 | $10.00 | $200.00 | $27.00 | $1,959.00 |
Employee + (Children) | $1,169.00 | $150.00 | $30.00 | $12.00 | $10.00 | $200.00 | $27.00 | $1,598.00 |
Employee + Family | $1,669.00 | $220.00 | $45.00 | $12.00 | $10.00 | $200.00 | $27.00 | $2,183.00 |
Waived Employees | $10.00 | $27.00 | $37 |

Accident coverage is for Employee/Member only
Groups above 10 have custom ancillary rates
First Year Dental Max is $1,000, Second year increases to $2,000
Surcharge for 4 or more dependent children – Dental :$50 , Vision: $15 per child.



Why Choosing the Right Plan Matters in Vermont
Finding the right Vermont health coverage is a personal decision that has an impact on your health and financial well-being. The right plan can help you afford health care and the services your plan covers, and protect you from unexpected medical bills. Compare plans for limits, premiums, deductibles, and out-of-pocket costs before making a decision.
Research plan options, compare benefits, and find out if you qualify for financial assistance before enrolling in a plan. Use the tools on Vermont Health Connect to easily browse plans, complete an application, and apply during open enrollment or a special enrollment period. Update your income and household changes when they occur to ensure assistance and coverage are accurate.
PEO4YOU can help you, your family, and employees find health coverage through group health and welfare solutions. PEO4YOU is not a direct insurance provider. We work hard for our members to connect them to compliant health insurance options and trusted resources so you can find the most affordable and appropriate coverage to meet your needs and Vermont laws and regulations.
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