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. For Frequently Asked Questions regarding Gender Dysphoria, please review the Gender Dysphoria FAQs (PDF).
- 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)