Individual and Family Health Plans

The following are Presbyterian's Individual Products.  Check our Forms and Documents page for benefit briefs and rates.  All documents on this page are Adobe Acrobat files.

Active Individual Plans

Individual and Family Plan

• Subscriber Agreement
• Schedule of Benefits

Individual and Family Plan - Child Only

• Subscriber Agreement
• Schedule of Benefits

Dental and Vision

• Delta Dental Plan Summary
• Vision Service Plan Summary

Non-Active Individual Plans (not available for purchase)

Select Plan (not available for purchase)

• Select Plan Subscriber Agreement with Standard Dental
• Select Plan Subscriber Agreement with Comprehensive Dental
• Schedule of Benefits 

Classic Plan (not available for purchase)

• Classic Plan Subscriber Agreement without Dental
• Classic Plan Subscriber Agreement with Comprehensive Dental
• Schedule of Benefits

Classic for Kids Plan (not available for purchase)

• Classic for Kids Plan Subscriber Agreement without Dental
• Classic for Kids Plan Subscriber Agreement with Comprehensive Dental
• Schedule of Benefits

Savvy100 Plan (High Deductible Health Plan - HDHP) (not available for purchase)

• Savvy100 Plan Subscriber Agreement without Dental
• Savvy100 Plan Subscriber Agreement with Comprehensive Dental
• Schedule of Benefits 
• Health Savings Account Information - Presbyterian has partnered with HealthEquity to manage the HSAs for Savvy100 members,  offering the convenience of complete integration by providing online claims management and combined billing. 

Dental & Vision (not available for purchase)

• Delta Dental Benefits (Select, Classic, Classic for Kids & Savvy100 Plans)
• VSP Benefits (Select Plans) 

PresSolo Plan Standard Dental (not available for purchase)

• $500 deductible Standard Dental
• $750 deductible Standard Dental
• $1000 deductible Standard Dental
• $2000 deductible Standard Dental
• $5000 deductible Standard Dental
  PresSolo Plan Subscriber Agreement with Standard Dental

PresSolo Plan Enhanced Dental (not available for purchase)

• $500 deductible Enhanced Dental
• $750 deductible Enhanced Dental
• $1000 deductible Enhanced Dental
• $2000 deductible Enhanced Dental
• $5000 deductible Enhanced Dental
  PresSolo Plan Subscriber Agreement with Enhanced Dental

PresMetro Standard Dental (not available for purchase)

• $500 deductible Standard Dental
• $750 deductible Standard Dental
• $1000 deductible Standard Dental
• $2000 deductible Standard Dental
• $5000 deductible Standard Dental
  PresMetro Plan Subscriber Agreement with Standard Dental

 PresMetro Enhanced Dental (not available for purchase)

• $500 deductible Enhanced Dental
• $750 deductible Enhanced Dental
• $1000 deductible Enhanced Dental
• $2000 deductible Enhanced Dental
• $5000 deductible Enhanced Dental
  PresMetro Plan Subscriber Agreement with Enhanced Dental

Individual Care (not available for purchase)

• $500 deductible 
• $750 deductible 
• $1000 deductible 
• $1500 deductible 
• $2000 deductible $2500 deductible 
  Individual Care Subscriber Agreement

Advantage Care (not available for purchase)

• $1200 deductible with Rx
• $1200 deductible without Rx
• $2500 deductible with Rx
• $2500 deductible without Rx
• $5000 deductible with Rx
• $5000 deductible without Rx
  Advantage Care Subscriber Agreement

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Other Individual Plans

K-1 or Individual Conversion Plans

• Individual Action Form (application)
• K-1 Benefit Summary
• Presbyterian Insurance Company Individual Conversion Benefit Summary
• Presbyterian Health Plan Individual Conversion Benefit Summary