Benefit Overview
Eaton RESA offers employees a selection of medical insurance plans for the 2026 plan year. Coverage includes comprehensive medical, prescription, preventive, and behavioral health benefits with both in-network and out-of-network options.
For the 2026 plan year (effective January 1, 2026), employees will have five total medical plan options across two carriers:
- Four plans through Blue Cross Blue Shield of Michigan (WMHIP)
- One additional PPO HDHP plan through Priority Health
Medical coverage is available to full-time employees regularly scheduled to work 30 or more hours per week. Eligible dependents may be enrolled during open enrollment or within 30 days of a qualifying life event.
BCBS Plan Comparison
Employees may choose from four WMHIP plans administered by Blue Cross Blue Shield of Michigan. These options offer traditional PPO structures and one HSA-eligible HDHP.
Compare the available BCBS plans to see how deductibles, out-of-pocket limits, and coverage levels align with your healthcare and financial goals:
| Option 1 | Option 2 | Option 3 | Option 4 | |
| Group Name | WMHIP | WMHIP | WMHIP | WMHIP |
| Network | BCBS | BCBS | BCBS | BCBS |
| Plan Year | 1/1/25 – 12/31/25 | 1/1/25 – 12/31/25 | 1/1/25 – 12/31/25 | 1/1/25 – 12/31/25 |
| Plan Name | Versatile | Select | HSA Flexible Blue 2 | Simply Blue |
| Type of Plan | PPO | PPO | PPO-HDHP | PPO |
| Plan Basics | In-Net / Out-Net | In-Net / Out-Net | In-Net / Out-Net | In-Net / Out-Net |
| Individual Deductible | $250 / $500 | $250 / $500 | $1,600 / $3,200 | $500 / $1,000 |
| Family Deductible | $500 / $1,000 | $500 / $1,000 | $3,200 / $6,400 | $1,000 / $2,000 |
| Coinsurance Level | 90% / 70% | 100% / 80% | 100% / 80% | 80% / 60% |
| Coinsurance MAX Individual | $1,000 / $1,000 | NA / NA | NA / NA | $2,500 / $2,500 |
| Coinsurance MAX Family | $2,000 / $2,000 | NA / NA | NA / NA | $5,000 / $5,000 |
| Out of Pocket MAX Individual | $2,500 / $2,500 | $2,500 / $2,500 | $2,600 / $5,100 | $4,500 / $4,500 |
| Out of Pocket MAX Family | $5,000 / $5,000 | $4,500 / $5,000 | $5,200 / $10,200 | $9,000 / $9,000 |
In-Network OOP includes deductibles, coinsurance, and copays. Out-Network includes coinsurance.
For more information, please refer to the Documents section below.
Priority Health Medical Plan
Eaton RESA is introducing a fifth medical plan option for 2026 through Priority Health. This plan begins January 1, 2026.
This is a high-deductible PPO plan that covers most services at 100% after the deductible and offers national access through the Priority Health + Cigna Open Access network.
Key Plan Details:
- Type: PPO HDHP (HSA-eligible)
- Deductible: $2,500 individual / $5,000 family
- Out-of-Pocket Max: $4,500 individual / $9,000 family
- Coverage After Deductible: 100% for most in-network services
- Preventive Care: Covered at 100% when in-network
- Pharmacy: Applies to deductible first, then tiered copays
- Network: Priority Health + Cigna Open Access
- Plan Year: 1/1/26–12/31/26
To review full coverage information, see the Priority Health Schedule of Benefits in the Documents section.
How to Choose a Plan
When comparing medical options, consider how often your household uses healthcare, your comfort level with deductibles, and your preferred monthly costs.
- BCBS PPO plans (Versatile, Select) offer predictable copays and broad provider access.
- BCBS flexible HDHP options (Flexible Blue 2, Simply Blue) pair higher deductibles with lower premiums.
- Priority Health PPO HDHP 2500 offers a single-deductible structure and pays 100% after the deductible, with strong national network access.
Employees who expect minimal medical expenses may benefit from an HDHP (Flexible Blue 2, Simply Blue, or Priority Health). Employees who want predictable copays often prefer PPO options like Versatile or Select.
When comparing BCBS and Priority Health, note that provider networks, prescription formularies, and prior authorization requirements may differ. Employees switching carriers should confirm their providers and medications remain in-network and covered.
Coverage Highlights
- Preventive care covered at 100% in-network
- Access to virtual visits and telehealth
- Behavioral health and substance use services included
- Prescription drug coverage included in all options
- Hearing services included in BCBS plans; covered differently under Priority Health (see SoB)
- All HDHP options are HSA-eligible with IRS-qualified deductibles
Note: Employees enrolled in the Flexible Blue 2 plan automatically qualify to open a Health Savings Account (HSA) through HealthEquity.
Who This Benefit Is For
These medical plans are designed for employees who want flexibility in managing healthcare costs and choosing provider networks.
- PPO users benefit from predictable copays and broad networks (Versatile, Select).
- HSA users may prefer lower premiums and long-term tax advantages (Flexible Blue 2, Simply Blue, Priority Health PPO HDHP 2500).
- Employees wanting simplified cost structure may appreciate that Priority Health pays 100% after the deductible.