Health Saving Account

The Blue Cross Blue Shield Health Savings Account is a comprehensive medical plan that covers both in-network and out-of-network providers. You pay a deductible and co-insurance and the insurance pays the remaining costs.It also meets the federal definition of a Qualified High Deductible Plan (QHDP) which allows you to contribute to a tax-advantaged Health Savings Account (HSA).

Click the Link Below to View

Plan Information

 
In-Network
Non-Network
ANNUAL MAXIMUM BENEFITSUnlimitedUnlimited
Employer Health Savings Account (HSA) Match Contribution 1/1/18 Prorated for New Hires
    Single

$500

DEDUCTIBLES
    Single

$2,700

    Family

$5,400

OUT-OF-POCKET MAXIMUMS (includes deductible)
    Single
$2,800 $13,000
    Family
$5,600 $26,000
PLAN CO-PAYMENTS
    Office Visit
0% after deductible40% after deductible
    Specialist Office Visit
0% after deductible40% after deductible
    Preventive Care
Covered at 100%40% after deductible
    Urgent Care Visit
0% after deductible40% after deductible
    Emergency Room

0% after deductible

    Hospitalization
0% after deductible40% after deductible
    Outpatient Surgery
0% after deductible40% after deductible
PRESCRIPTION DRUG COPAY
    Retail Generic

Preventative Generic: covered at 100%
Generic, Preferred, and Non-Preferred: 0% after deductible

Deductible, then 50% after applicable copays
Generic:$10
Preferred Brand: $40
Non-Preferred:50%

    Retail Preferred Brand
    Retail Non-Preferred
    Mail Order