Medical Plans

Choosing the right plan starts with understanding your total cost of care and how the plans compare.

About the plans

There are two types of plans offered:

High-Deductible Health Plan (HDHP) with a Health Savings Account (HSA) — Gives you access to a unique tax-advantaged savings account called an HSA. You can contribute pre-tax dollars, the Company adds a contribution, and you can use the combined funds for eligible medical, dental, and vision expenses. The money is yours to keep, year after year.
Preferred Provider Organization (PPO) — Gives you flexibility to see providers without referrals and offers set copays for services. You choose providers by tier, and your copay is based on the provider’s quality ranking.

There are three medical plan options:

HSA Core

The HSA Core plan is an HDHP paired with an HSA. You pay the full cost of care until you meet the out-of-pocket (OOP), then the plan pays 100% of covered services. In-network preventive care is free, and the Company contributes money to your HSA.

HSA Value

The HSA Value plan is another HDHP with an HSA, but with a lower deductible and OOP maximum than HSA Core. After you meet the deductible, you pay 20% coinsurance for in-network services until you meet your OOP maximum, then the plan pays 100% of covered services. In-network preventive care is free, and the Company contributes money to your HSA.

Copay PPO

The Copay PPO plan is a copay-based plan where you know your costs upfront. Providers are ranked in Tier Levels 1, 2, or 3 based on quality and efficiency, and your copay varies by tier. There is no deductible, and once you reach your OOP maximum, the plan pays 100% of covered services. In-network preventive care is free.

What’s the same?

All three plans use the BCBSIL network to offer trusted providers near you, and include:

Free, in-network preventive care, including annual physicals, wellness exams, cancer screenings, and immunizations
Low-cost virtual visits with a doctor and behavioral health coverage
Prescription drug coverage through Prime Therapeutics
Protection for your wallet with an annual OOP maximum
Access to Health Advocacy Solutions (HAS) for support

What’s different?

HSA Core and HSA Value plans:

Give you access to an HSA to contribute pre-tax dollars for eligible medical expenses
Include a Company contribution to a HSA
Have an in-network and out-of-network deductible

Copay PPO plan:

Shows your total cost (copay) upfront, before you seek care
Does not have a deductible
Ranks providers into three copay tiers based on quality and efficiency:‍
- Tier 1: Highest ranking providers / Pay the lowest copay
- Tier 2: Mid-level ranking providers / Pay a moderate copay
- Tier 3: Lower ranking providers / Pay the highest copay

Cost of care

Your payroll contributions—Medical premiums deducted from your paycheck each pay period + Money spent on services—Typically, applied to your deductible, coinsurance, or copays + Company contribution to help pay for care—Some plans are paired with a Health Savings Account (HSA) that both you and the Company can contribute to = Total cost of care—Worth considering all three when you choose your plan

Medical coverage summary

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Benefits costs

Emergency room

Important — If you use the ER for a non-emergency, you’ll be charged an additional $500 that will not count toward your deductible or out-of-pocket maximum. See Where to Go for Care to find the right level of care for your situation.

Find a provider

Find an in-network provider by visiting bcbsil.com/find-care.