What comes out of my pay?How much will I pay out of my own pocket?What will I pay after I meet my deductible?Will my doctor be in-network?
Network Options: Preferred ValueCare or FocalPoint
You’ve built a trusting relationship and you want to keep it. But, did you know that you can also save money by using an in-network provider? That’s why you will be able to choose a provider network that is right for you and your family’s health and wellbeing.
Utah: (888) 675-6570 | Outside Utah: (800) 810-2583 | regence.com | Group #60022180
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Medical Plans |
Regence - Traditional $1,500 PPO Plan
With this Traditional $1,500 PPO Plan you will have access to the Preferred ValueCare (PVC) Network or the FocalPoint Network. An important thing to know about this plan is that both the family deductible and family out-of-pocket maximum are embedded. This means that on a family plan each covered member must meet their individual deductible — up to the maximum family deductible — and each covered member has an individual out-of-pocket maximum — up to the family out-of-pocket maximum.
Click here to learn about how the Garner Reimbursement works and sign up for the service.
With this Traditional $1,500 PPO Plan you will have access to the Preferred ValueCare (PVC) Network or the FocalPoint Network. An important thing to know about this plan is that both the family deductible and family out-of-pocket maximum are embedded. This means that on a family plan each covered member must meet their individual deductible — up to the maximum family deductible — and each covered member has an individual out-of-pocket maximum — up to the family out-of-pocket maximum.
Click here to learn about how the Garner Reimbursement works and sign up for the service.
The Preferred ValueCare Network
The Preferred ValueCare network is Regence's largest network nationwide. Please check with Regence to see if your provider is in the network so that you can take advantage of greater discounts on care for you and your family.
For Utah residents, University of Utah and MountainStar facilities are included in this network along with other providers who participate in the Total Care/Total Cost of Care (TCC) quality program.
How to verify that your provider/facility is in-network:
The easiest way to verify that you are receiving care in-network is to search for providers or facilities while logged into your Regence Member Portal - either online or using their app. Or follow the below steps:
The Preferred ValueCare network is Regence's largest network nationwide. Please check with Regence to see if your provider is in the network so that you can take advantage of greater discounts on care for you and your family.
For Utah residents, University of Utah and MountainStar facilities are included in this network along with other providers who participate in the Total Care/Total Cost of Care (TCC) quality program.
How to verify that your provider/facility is in-network:
The easiest way to verify that you are receiving care in-network is to search for providers or facilities while logged into your Regence Member Portal - either online or using their app. Or follow the below steps:
- Visit regence.com
- Select "Find a Doctor"
- Select "Search Now"
- Select "Choose a Location and Network"
- Enter your zipcode or city
- Enter "Preferred ValueCare Network" in the search bar and confirm selection.
The FocalPoint Network
The FocalPoint network is only available for Utah employees and covers most of Utah, apart from the St. George area. Please check with Regence to see if your provider is in the network so that you can take advantage of greater discounts on care for you and your family.
University of Utah and MountainStar facilities are included in this network along with other providers who participate in the Total Care/Total Cost of Care (TCC) quality program.
How to verify that your provider/facility is in-network:
The easiest way to verify that you are receiving care in-network is to search for providers or facilities while logged into your Regence Member Portal - either online or using their app. Or follow the below steps:
The FocalPoint network is only available for Utah employees and covers most of Utah, apart from the St. George area. Please check with Regence to see if your provider is in the network so that you can take advantage of greater discounts on care for you and your family.
University of Utah and MountainStar facilities are included in this network along with other providers who participate in the Total Care/Total Cost of Care (TCC) quality program.
How to verify that your provider/facility is in-network:
The easiest way to verify that you are receiving care in-network is to search for providers or facilities while logged into your Regence Member Portal - either online or using their app. Or follow the below steps:
- Visit regence.com
- Select "Find a Doctor"
- Select "Search Now"
- Select "Choose a Location and Network"
- Enter your zipcode or city
- Enter "FocalPoint Network" in the search bar and confirm selection.
TRADITIONAL $1,500 PPO PLAN
PREFERRED VALUECARE (PVC) NETWORK OR FOCALPOINT NETWORK
PREFERRED VALUECARE (PVC) NETWORK OR FOCALPOINT NETWORK
In-Network
Out-of-Network*
Annual Deductible
Embedded
January 1 — December 31
Embedded
January 1 — December 31
You pay up to
$1,500 per individual
$1,500 per member / $3,000 per family
$1,500 per individual
$1,500 per member / $3,000 per family
You pay up to
$3,000 per individual
$3,000 per member / $6,000 per family
$3,000 per individual
$3,000 per member / $6,000 per family
Garner™ Reimbursement
$1,000 per individual / $2,000 per family
*Qualifying reimbursements available through Garner — see details
*Qualifying reimbursements available through Garner — see details
Coinsurance
You pay 20% AD
You pay 40% AD
Out-of-pocket Maximum
Embedded
January 1 — December 31
Embedded
January 1 — December 31
No more than
$4,500 per individual
$4,500 per member / $9,000 per family
$4,500 per individual
$4,500 per member / $9,000 per family
No more than
$9,000 per individual
$9,000 per member / $18,000 per family
$9,000 per individual
$9,000 per member / $18,000 per family
Preventive Services
You pay
$0 according to government guidelines
$0 according to government guidelines
You pay
40% AD
40% AD
Office Visits
Primary Care
Specialist
Chiropractic (10 visits/year)
MDLive Telemedicine
Virtual Care Telehealth
Vision Exams (1 per year)
Primary Care
Specialist
Chiropractic (10 visits/year)
MDLive Telemedicine
Virtual Care Telehealth
Vision Exams (1 per year)
You pay
$25 copay
$45 copay
20% AD
$10 copay
$25 copay
$10 copay
$25 copay
$45 copay
20% AD
$10 copay
$25 copay
$10 copay
You pay
40% AD
40% AD
40% AD
Not Covered
40% AD
$10 copay, $45 allowance
40% AD
40% AD
40% AD
Not Covered
40% AD
$10 copay, $45 allowance
Mental Health Services
Office Visit
Inpatient
Office Visit
Inpatient
You pay
$25 copay
20% AD
$25 copay
20% AD
You pay
40% AD
40% AD
40% AD
40% AD
Emergency Services
Urgent Care
Emergency Room
Urgent Care
Emergency Room
You pay
$45 copay
$500 copay
$45 copay
$500 copay
You pay
40% AD
Covered as In-Network
40% AD
Covered as In-Network
Inpatient & Outpatient
Inpatient Hospital
Outpatient Surgery
Inpatient Hospital
Outpatient Surgery
You pay
20% AD
20% AD
20% AD
20% AD
You pay
40% AD
40% AD
40% AD
40% AD
Prescription Medication
Generic / Preferred / Brand
Retail (30-day supply)
Mail Order (90-day supply)
Mail Order (90-day supply)
You pay $10 / 35% / 50%
You pay $30 / 35% / 50%
You pay $30 / 35% / 50%
Health Care Account
Flexible Spending Account (FSA)
AD: After Deductible
* Providers may charge more than the plan allows when you receive services out-of-network. It is recommended that you ask the out-of-network provider about their billed charges before planning care.
This information is designed to help you choose a benefit plan for 2025 only. Please refer to the Plan Documents provided by the carrier for information regarding coverage, limitations and exclusions. If there is a difference between this guide and the Plan Documents, the Plan Documents prevail.
* Providers may charge more than the plan allows when you receive services out-of-network. It is recommended that you ask the out-of-network provider about their billed charges before planning care.
This information is designed to help you choose a benefit plan for 2025 only. Please refer to the Plan Documents provided by the carrier for information regarding coverage, limitations and exclusions. If there is a difference between this guide and the Plan Documents, the Plan Documents prevail.
Regence - Traditional $3,000 PPO Plan
With this Traditional $3,000 PPO Plan you will have access to the Preferred ValueCare (PVC) Network or the FocalPoint Network. An important thing to know about this plan is that both the family deductible and family out-of-pocket maximum are embedded. This means that on a family plan each covered member must meet their individual deductible — up to the maximum family deductible — and each covered member has an individual out-of-pocket maximum — up to the family out-of-pocket maximum.
Click here to learn about how the Garner Reimbursement works and sign up for the service.
With this Traditional $3,000 PPO Plan you will have access to the Preferred ValueCare (PVC) Network or the FocalPoint Network. An important thing to know about this plan is that both the family deductible and family out-of-pocket maximum are embedded. This means that on a family plan each covered member must meet their individual deductible — up to the maximum family deductible — and each covered member has an individual out-of-pocket maximum — up to the family out-of-pocket maximum.
Click here to learn about how the Garner Reimbursement works and sign up for the service.
The Preferred ValueCare Network
The Preferred ValueCare network is Regence's largest network nationwide. Please check with Regence to see if your provider is in the network so that you can take advantage of greater discounts on care for you and your family.
For Utah residents, University of Utah and MountainStar facilities are included in this network along with other providers who participate in the Total Care/Total Cost of Care (TCC) quality program.
How to verify that your provider/facility is in-network:
The easiest way to verify that you are receiving care in-network is to search for providers or facilities while logged into your Regence Member Portal - either online or using their app. Or follow the below steps:
The Preferred ValueCare network is Regence's largest network nationwide. Please check with Regence to see if your provider is in the network so that you can take advantage of greater discounts on care for you and your family.
For Utah residents, University of Utah and MountainStar facilities are included in this network along with other providers who participate in the Total Care/Total Cost of Care (TCC) quality program.
How to verify that your provider/facility is in-network:
The easiest way to verify that you are receiving care in-network is to search for providers or facilities while logged into your Regence Member Portal - either online or using their app. Or follow the below steps:
- Visit regence.com
- Select "Find a Doctor"
- Select "Search Now"
- Select "Choose a Location and Network"
- Enter your zipcode or city
- Enter "Preferred ValueCare Network" in the search bar and confirm selection.
The FocalPoint Network
The FocalPoint network is only available for Utah employees and covers most of Utah, apart from the St. George area. Please check with Regence to see if your provider is in the network so that you can take advantage of greater discounts on care for you and your family.
University of Utah and MountainStar facilities are included in this network along with other providers who participate in the Total Care/Total Cost of Care (TCC) quality program.
How to verify that your provider/facility is in-network:
The easiest way to verify that you are receiving care in-network is to search for providers or facilities while logged into your Regence Member Portal - either online or using their app. Or follow the below steps:
The FocalPoint network is only available for Utah employees and covers most of Utah, apart from the St. George area. Please check with Regence to see if your provider is in the network so that you can take advantage of greater discounts on care for you and your family.
University of Utah and MountainStar facilities are included in this network along with other providers who participate in the Total Care/Total Cost of Care (TCC) quality program.
How to verify that your provider/facility is in-network:
The easiest way to verify that you are receiving care in-network is to search for providers or facilities while logged into your Regence Member Portal - either online or using their app. Or follow the below steps:
- Visit regence.com
- Select "Find a Doctor"
- Select "Search Now"
- Select "Choose a Location and Network"
- Enter your zipcode or city
- Enter "FocalPoint Network" in the search bar and confirm selection.
TRADITIONAL $3,000 PPO PLAN
PREFERRED VALUECARE (PVC) NETWORK OR FOCALPOINT NETWORK
PREFERRED VALUECARE (PVC) NETWORK OR FOCALPOINT NETWORK
In-Network
Out-of-Network*
Annual Deductible
Embedded
January 1 — December 31
Embedded
January 1 — December 31
You pay up to
$3,000 per individual
$3,000 per member / $6,000 per family
$3,000 per individual
$3,000 per member / $6,000 per family
You pay up to
$6,000 per individual
$6,000 per member / $12,000 per family
$6,000 per individual
$6,000 per member / $12,000 per family
Garner™ Reimbursement
$1,500 per individual / $3,000 per family
*Qualifying reimbursements available through Garner — see details
*Qualifying reimbursements available through Garner — see details
Coinsurance
You pay 20% AD
You pay 40% AD
Out-of-pocket Maximum
Embedded
January 1 — December 31
Embedded
January 1 — December 31
No more than
$6,000 per individual
$6,000 per member / $12,000 per family
$6,000 per individual
$6,000 per member / $12,000 per family
No more than
$12,000 per individual
$12,000 per member / $24,000 per family
$12,000 per individual
$12,000 per member / $24,000 per family
Preventive Services
You pay
$0 according to government guidelines
$0 according to government guidelines
You pay
40% AD
40% AD
Office Visits
Primary Care
Specialist
Chiropractic (10 visits/year)
MDLive Telemedicine
Virtual Care Telehealth
Vision Exams (1 per year)
Primary Care
Specialist
Chiropractic (10 visits/year)
MDLive Telemedicine
Virtual Care Telehealth
Vision Exams (1 per year)
You pay
$25 copay
$45 copay
20% AD
$10 copay
$25 copay
$10 copay
$25 copay
$45 copay
20% AD
$10 copay
$25 copay
$10 copay
You pay
40% AD
40% AD
40% AD
Not Covered
40% AD
$10 copay, $45 allowance
40% AD
40% AD
40% AD
Not Covered
40% AD
$10 copay, $45 allowance
Mental Health Services
Office Visit
Inpatient
Office Visit
Inpatient
You pay
$25 copay
20% AD
$25 copay
20% AD
You pay
40% AD
40% AD
40% AD
40% AD
Emergency Services
Urgent Care
Emergency Room
Urgent Care
Emergency Room
You pay
$45 copay
$500 copay
$45 copay
$500 copay
You pay
40% AD
Covered as In-Network
40% AD
Covered as In-Network
Inpatient & Outpatient
Inpatient Hospital
Outpatient Surgery
Inpatient Hospital
Outpatient Surgery
You pay
20% AD
20% AD
20% AD
20% AD
You pay
40% AD
40% AD
40% AD
40% AD
Prescription Medication
Generic / Preferred / Brand
Retail (30-day supply)
Mail Order (90-day supply)
Mail Order (90-day supply)
You pay $10 / 35% / 50%
You pay $30 / 35% / 50%
You pay $30 / 35% / 50%
Health Care Account
Flexible Spending Account (FSA)
AD: After Deductible
* Providers may charge more than the plan allows when you receive services out-of-network. It is recommended that you ask the out-of-network provider about their billed charges before planning care.
This information is designed to help you choose a benefit plan for 2025 only. Please refer to the Plan Documents provided by the carrier for information regarding coverage, limitations and exclusions. If there is a difference between this guide and the Plan Documents, the Plan Documents prevail.
* Providers may charge more than the plan allows when you receive services out-of-network. It is recommended that you ask the out-of-network provider about their billed charges before planning care.
This information is designed to help you choose a benefit plan for 2025 only. Please refer to the Plan Documents provided by the carrier for information regarding coverage, limitations and exclusions. If there is a difference between this guide and the Plan Documents, the Plan Documents prevail.
Regence - HDHP $2,500 - High Deductible Health Plan
With this HDHP $2,500 - High Deductible Health Plan you you will have access to the Preferred ValueCare (PVC) Network or the FocalPoint Network. An important thing to know about this plan is that both the family deductible and family out-of-pocket maximum are non-embedded. With a non-embedded deductible, there is only a family deductible and a family out-of-pocket maximum. All family members’ expenses count toward the family deductible until it is met, and then they are all covered with the health plan’s usual copays or coinsurance.
With this HDHP $2,500 - High Deductible Health Plan you you will have access to the Preferred ValueCare (PVC) Network or the FocalPoint Network. An important thing to know about this plan is that both the family deductible and family out-of-pocket maximum are non-embedded. With a non-embedded deductible, there is only a family deductible and a family out-of-pocket maximum. All family members’ expenses count toward the family deductible until it is met, and then they are all covered with the health plan’s usual copays or coinsurance.
The Preferred ValueCare Network
The Preferred ValueCare network is Regence's largest network nationwide. Please check with Regence to see if your provider is in the network so that you can take advantage of greater discounts on care for you and your family.
For Utah residents, University of Utah and MountainStar facilities are included in this network along with other providers who participate in the Total Care/Total Cost of Care (TCC) quality program.
How to verify that your provider/facility is in-network:
The easiest way to verify that you are receiving care in-network is to search for providers or facilities while logged into your Regence Member Portal - either online or using their app. Or follow the below steps:
The Preferred ValueCare network is Regence's largest network nationwide. Please check with Regence to see if your provider is in the network so that you can take advantage of greater discounts on care for you and your family.
For Utah residents, University of Utah and MountainStar facilities are included in this network along with other providers who participate in the Total Care/Total Cost of Care (TCC) quality program.
How to verify that your provider/facility is in-network:
The easiest way to verify that you are receiving care in-network is to search for providers or facilities while logged into your Regence Member Portal - either online or using their app. Or follow the below steps:
- Visit regence.com
- Select "Find a Doctor"
- Select "Search Now"
- Select "Choose a Location and Network"
- Enter your zipcode or city
- Enter "Preferred ValueCare Network" in the search bar and confirm selection.
The FocalPoint Network
The FocalPoint network is only available for Utah employees and covers most of Utah, apart from the St. George area. Please check with Regence to see if your provider is in the network so that you can take advantage of greater discounts on care for you and your family.
University of Utah and MountainStar facilities are included in this network along with other providers who participate in the Total Care/Total Cost of Care (TCC) quality program.
How to verify that your provider/facility is in-network:
The easiest way to verify that you are receiving care in-network is to search for providers or facilities while logged into your Regence Member Portal - either online or using their app. Or follow the below steps:
The FocalPoint network is only available for Utah employees and covers most of Utah, apart from the St. George area. Please check with Regence to see if your provider is in the network so that you can take advantage of greater discounts on care for you and your family.
University of Utah and MountainStar facilities are included in this network along with other providers who participate in the Total Care/Total Cost of Care (TCC) quality program.
How to verify that your provider/facility is in-network:
The easiest way to verify that you are receiving care in-network is to search for providers or facilities while logged into your Regence Member Portal - either online or using their app. Or follow the below steps:
- Visit regence.com
- Select "Find a Doctor"
- Select "Search Now"
- Select "Choose a Location and Network"
- Enter your zipcode or city
- Enter "FocalPoint Network" in the search bar and confirm selection.
HDHP $2,500 HIGH DEDUCTIBLE HEALTH PLAN
PREFERRED VALUECARE (PVC) NETWORK OR FOCALPOINT NETWORK
PREFERRED VALUECARE (PVC) NETWORK OR FOCALPOINT NETWORK
In-Network
Out-of-Network*
Annual Deductible
Non-embedded
January 1 — December 31
Non-embedded
January 1 — December 31
You pay up to
$2,500 per individual
$5,000 per family 1
$2,500 per individual
$5,000 per family 1
You pay up to
$5,000 per individual
$10,000 per family 1
$5,000 per individual
$10,000 per family 1
Garner™ Reimbursement
Not available on this plan
Coinsurance
You pay 20% AD
You pay 40% AD
Out-of-pocket Maximum
Non-embedded
January 1 — December 31
Non-embedded
January 1 — December 31
No more than
$5,000 per individual
$10,000 per family 1
$5,000 per individual
$10,000 per family 1
No more than
$10,000 per individual
$20,000 per family 1
$10,000 per individual
$20,000 per family 1
Preventive Services
You pay
$0 according to government guidelines
$0 according to government guidelines
You pay
40% AD
40% AD
Office Visits
Primary Care
Specialist
Chiropractic (10 visits/year)
MDLive Telemedicine
Virtual Care Telehealth 2
Vision Exams (1 per year)
Primary Care
Specialist
Chiropractic (10 visits/year)
MDLive Telemedicine
Virtual Care Telehealth 2
Vision Exams (1 per year)
You pay
20% AD
20% AD
20% AD
10% Deductible Waived
20% Deductible Waived
$10 copay
20% AD
20% AD
20% AD
10% Deductible Waived
20% Deductible Waived
$10 copay
You pay
40% AD
40% AD
40% AD
Not Covered
40% Deductible Waived
$10 copay, $45 allowance
40% AD
40% AD
40% AD
Not Covered
40% Deductible Waived
$10 copay, $45 allowance
Mental Health Services
Office Visit
Inpatient
Office Visit
Inpatient
You pay
20% AD
20% AD
20% AD
20% AD
You pay
40% AD
40% AD
40% AD
40% AD
Emergency Services
Urgent Care
Emergency Room
Urgent Care
Emergency Room
You pay
20% AD
20% AD
20% AD
20% AD
You pay
40% AD
Covered as In-Network
40% AD
Covered as In-Network
Inpatient & Outpatient
Inpatient Hospital
Outpatient Surgery
Inpatient Hospital
Outpatient Surgery
You pay
20% AD
20% AD
20% AD
20% AD
You pay
40% AD
40% AD
40% AD
40% AD
Prescription Medication
Generic / Preferred / Brand
Retail (30-day supply)
Specialty (30-day supply)
Mail Order (90-day supply)
Specialty (30-day supply)
Mail Order (90-day supply)
You pay 20% AD / 20% AD / 20% AD
You pay 20% AD / 20% AD / 20% AD
You pay 20% AD / 20% AD / 20% AD
You pay 20% AD / 20% AD / 20% AD
You pay 20% AD / 20% AD / 20% AD
Health Care Account
Health Savings Account (HSA)
Limited Purpose Flexible Spending Account (LPFSA)
Limited Purpose Flexible Spending Account (LPFSA)
AD: After Deductible
* Providers may charge more than the plan allows when you receive services out-of-network. It is recommended that you ask the out-of-network provider about their billed charges before planning care.
1 Overall family deductible and out-of-pocket maximum will need to be satisfied before the plan begins to pay for all services that are not considered preventative. For in-network coverage, an individual on family coverage will not have their out-of-pocket limit exceed $6,850.
2 Virtual Care Telehealth visits not subject to deductible.
This information is designed to help you choose a benefit plan for 2024 only. Please refer to the Plan Documents provided by the carrier for information regarding coverage, limitations and exclusions. If there is a difference between this guide and the Plan Documents, the Plan Documents prevail.
* Providers may charge more than the plan allows when you receive services out-of-network. It is recommended that you ask the out-of-network provider about their billed charges before planning care.
1 Overall family deductible and out-of-pocket maximum will need to be satisfied before the plan begins to pay for all services that are not considered preventative. For in-network coverage, an individual on family coverage will not have their out-of-pocket limit exceed $6,850.
2 Virtual Care Telehealth visits not subject to deductible.
This information is designed to help you choose a benefit plan for 2024 only. Please refer to the Plan Documents provided by the carrier for information regarding coverage, limitations and exclusions. If there is a difference between this guide and the Plan Documents, the Plan Documents prevail.
