Recent Changes in 2026
Some details about our existing plans have changed. We’ve highlighted these changes below to help you compare your options for 2026.*
- Maternity: The Plan will add Doulas as a covered provider for maternity benefits.
- Noom Med: The Plan will add Noom Med, a medically supervised weight management program that combines prescription medications with established behavioral health tools. The program is intended for individuals with obesity or related health conditions.
- Gender Affirming Care: Chemical and surgical modification of an individual's sex traits through medical interventions (to include “gender transition” services) will no longer be covered under the PSHB Program regardless of age.
- Prescription Drug Plan Employer Group Waiver Plan (PDP EGWP): The Carrier will increase the PDP EGWP True out-of-pocket maximum (TrOOP) for prescription drugs to $2,100.
- Premium Rates: Your share of the premium rate will increase for Self Only or increase for Self+1 and Self and Family.
- Catastrophic Maximum: The in-network catastrophic maximum is increasing from $5,500 to $6,500 for Self Only and from $11,000 to $13,000 for Self+1 and Self and Family. The out-of-network catastrophic maximum is increasing from $7,500 to $8,500 for Self Only and from $15,000 to $17,000 for Self+1 and Self and Family.
- Deductible: The in-network deductible is increasing to $1,700 for Self Only and $3,400 for Self+1 and Self and Family. The out-of-network deductible is changing to $3,400 for Self Only and $6,800 for Self+1 and Self and Family.
- Applied Behavioral Analysis (ABA): The Plan will move coverage for ABA Therapy, from Section 5(a), Habilitative Therapy to Section 5(e), Mental Health and Substance Use Disorder Benefits. The Office/Outpatient Professional member cost share will decrease from a $35 copay to a $0 copay. The Plan will remove age restrictions and preauthorization requirements.
- Infertility Services: The Plan will change the coverage for in-vitro fertilization (IVF) from 50% of the plan allowance to benefits are available to the same extent as benefits provided for other services as outlined in section 5(a)- 5(f) of the brochure. Limit to three (3) complete egg retrievals and there is no limit on the number of embryo transfers performed from the egg retrieval.
- Premium Rates: Your share of the premium rate will remain the same for Self Only, Self+1 and Self and Family
- Catastrophic Maximum: The in-network catastrophic maximum is increasing from $6,500 to $7,500 for Self Only and from $13,000 to $15,000 for Self+1 and Self and Family.
- Applied Behavioral Analysis (ABA): The Plan will move coverage for ABA Therapy, from Section 5(a), Habilitative Therapy to Section 5(e), Mental Health and Substance Use Disorder Benefits. The Office/Outpatient Professional member cost share will decrease from a $50 copay to a $15 copay. The Plan will remove age restrictions and preauthorization requirements.
- Infertility Services: The Plan will remove the coverage for in-vitro fertilization (IVF) medical benefits.
*Please note: This is not a complete list of all the changes. To see a complete list of benefit changes with a complete description, please refer to the 2026 BlueChoice Brochure (PDF)