Regence BlueCross BlueShield - Online Application

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Benefit Schedule
Evolve HSA 50 | Evolve HSA 80 | Evolve HSA 100 | Optional Dental Coverage
Rate Schedule
Evolve HSA 50 | Evolve HSA 80 | Evolve HSA 100

Regence Evolve HSA Plan

• Preventive care (yearly physical, Pap, PSA, etc.) covered before you meet your deductible
• Simple plans with either 80% or 50% coverage options
• Personal service and help from dedicated Regence HSA Customer Service department

Regence Evolve HSA 100 Plan

• Unique plan that covers you at 100% once your annual deductible is met
• Simple to understand and use
• Personal service and help from dedicated Regence HSA Customer Service department

Regence Evolve Dental Option 1

• $750 Annual maximum that increases on a rewards basis
  • For example, if you have at least one claim and incur less than $500 in claims in year one, we’ll increase your next year’s annual maximum by $250.
  • If you incur less than $750 in claims in year two, we’ll increase the next year’s maximum by another $250.
  • If you incur less than $1,000 in claims in year three, we’ll increase the next year’s maximum by yet another $250.
  • By year four you could have a $1,500 maximum benefit.
• No deductible for preventive care
• Discounts available through the national Regence Dental network

Regence Evolve Dental Option 2

• Annual maximum of $750 (basic, restorative and major services combined)
• Your coinsurance is 0% for the first $200 and then 50% up to the $750 calendar year maximum
• No deductibles
• Discounts available through the national Regence Dental network