Signature HSA Compatible Plan

(HDHP)

• Out-of-pocket maximums will be $5,000 for single coverage, and $10,000 for family coverage
• For 2026 coverage and price details, please refer to the Benefit Guide
• NEW! Navitus Prescription Plan – see Benefit Guide for more information
  • Navitus Customer Care
  • (855) 847-1025
  • Navitus Member Portal
• Your spouse is eligible for primary medical coverage on the Schupan plan if he/she is not employed or if he/she is not eligible for his/her employer’s medical plan. Please have your spouse’s employer complete this form and send back to TMR@schupan.com 
• Coordination of Benefits Questionnaire – BCBS

Health Savings Account (HSA)

• Single Coverage Annual Limit: $4,400 (increase for 2026)
• Double and Family Annual Limit: $8,750 (increase for 2026)
• Catch-Up Contribution (ages 55+): additional $1,000
• Employer Funding Annual Amount: Single – $750; Double and Family – $1,500
  Annual limits are a combination of both employee and employer contributions.

• • HSA Quick Guide
  • HSA Contribution Rules – Married
  • Top Questions About HSAs
  • Qualified Medical Expenses
  • Schedule of Fees
  • HSAs and Medicare
  • How to Open Your HSA

Click here to open your HSA Account!

Use enrollment verification number: THA0001-161045

Traditional Health Plan

Simply Blue PPO ASC

• For 2026 coverage and price details, please refer to the Benefit Guide
• NEW! Navitus Prescription Plan – see Benefit Guide for more information
  • Navitus Customer Care
  • (855) 847-1025
  • Navitus Member Portal

• Your spouse is eligible for primary medical coverage on the Schupan plan if he/she is not employed or if he/she is not eligible for his/her employer’s medical plan. Please have your spouse’s employer complete this form and send back to TMR@schupan.com 
• Coordination of Benefits Questionnaire – BCBS