MEDICAL & PRESCRIPTION
Choose from two plan options, both administered through BCBSIL.
ABC Client is thrilled to be able to offer the same level of medical benefits for the January 1, 2024 – December 31, 2024 plan year.
ARE THERE ANY CHANGES TO THE PLAN DESIGNS?
There are no changes to the two medical and prescription plan offerings for the January 1, 2023 plan year. You will be receiving a new ID card this year.
WHO IS ELIGIBLE?
Full-time employees are eligible to enroll a medical plan the 1st of the month following 60 days of full-time employment.
OPTION 1: HSA PLAN
The HSA (Health Savings Account) Plan offers the flexibility of receiving care from in-network and out-of-network providers. However, utilizing in-network providers will maximize your medical benefit.
This plan has a $3,000 single deductible, and a $6,000 family deductible. Until the deductible is satisfied, the employee will pay the full discounted rate for any procedure or service. Once the deductible is satisfied, 80% coinsurance will be applied to in-network covered services with the exception of preventive care (covered at 100%, deductible waived).
ABC Client will continue to match HSA funding up to $500 for single coverage and up to $1,000 for all other tiers. HSA funds can be used on eligible Medical, Dental, Vision, and Prescription Drug expenses.
OPTION 2: HRA PLAN
The HRA (Health Reimbursement Arrangement) Plan offers the flexibility of receiving care from in-network and out-of-network providers. However, utilizing in-network providers will maximize your medical benefit.
The plan has a $4,000 single deductible and a $7,500 family deductible. Until the deductible is satisfied, the employee will pay the full discounted rate for any procedure or service. Once the deductible is satisfied, 80% coinsurance will be applied to in-network covered services with the exception of preventive care (covered at 100%, deductible waived).
ABC Client will continue to provide HRA funding of $1,500 for single coverage and $3,000 for all other tiers. The HRA funds can only be used on eligible Medical and Prescription Drug expenses.
WANT TO LEARN MORE ABOUT ABC Client's MEDICAL & PRESCRIPTION PLANS?
For questions and additional information to help you select a plan, please contact The Graham Company Service Line at 1-888-842-1488 to have a team member walk you through the plan designs. Please view detailed plan comparisons below:
Need Assistance Navigating Your Medical and Prescription Benefits?
Visit BCBSIL.com where you can:
1) Find in-network healthcare professionals
2) Learn how to read an Explanation of Benefits (EOB)
- EOBs are extremely important for both the HRA and HSA plans
3) View an up-to-date Prescription List
3) Calculate and compare costs for procedures
- Includes breakdown in costs for facility, doctor, and ancillary charges
- Mobile app with prescription drug price quote tool to use when you are on the go
4) Access claims history
5) Learn about Discount Programs
6) Access Forms
URGENT CARE VS. EMERGENCY ROOM
More than 10% of all emergency room visits could have been better addressed in either an urgent care facility or a doctor’s office. If you’re suddenly faced with symptoms of an illness or injury, how can you determine which facility is most appropriate for your condition? The Emergency Room (ER) Emergency rooms are equipped to handle life-threatening injuries and illnesses and other serious medical conditions. An emergency is a condition that may cause loss of life or permanent or severe disability if not treated immediately. You should go directly to the nearest emergency room if you experience any of the following examples: - Compound fractures - Deep Knife/Gunshot Wounds - Moderate to Severe Burns Urgent Care Centers Urgent Care Centers are not equipped to handle life-threatening injuries, illnesses, or medical conditions. These centers are designed to address conditions where delaying treatment could cause serious problems or discomfort. Some examples of conditions that require a visit to an Urgent Care Center are the following: - Controlled bleeding or cuts that require stitches - Diagnostic Services (X-Rays, Lab tests) - Ear infections, high fever, or the flu
If you do not require immediate medical attention, consider utilizing an Urgent Care Center to reduce out-of-pocket costs. Choosing the appropriate place of care will not only ensure prompt and adequate medical attention but will also help reduce any unnecessary expenses.
Although Urgent Care Centers are usually more cost-effective, please remember they are NOT a substitute for emergency care!
TELEHEALTH
Access to healthcare is now even easier with MDLive
When your primary doctor isn't available, MDLive, through BCBSIL is available 24/7/365 for treatment of acute conditions.
The MDLive benefit is available to employees and dependents enrolled in a BCBSIL medical plan. You must register online before consulting with a board-certified physician via phone or videoconferencing for non-urgent medical needs.
The doctor can call in prescriptions to your local pharmacy when appropriate. This benefit integrates with your medical plan. For those enrolled in the HRA plan, there is no charge for MDLive services. For those enrolled in the HSA plan, until the deductible is satisfied, the employee will pay the full discounted rate for any procedure or service. Once the deductible is satisfied, 80% coinsurance will be applied to MDLive services. You and your dependents can avoid unnecessary visits to the Emergency Room and/or Urgent Care and long waits for doctor appointments by utilizing telemedicine.
The doctor will provide a diagnoses and advice for many common medical conditions such as:
- Respiratory Infections
- Sinus Infections
- Stomachache/Diarrhea
- Urinary Tract Infections
- Allergies
- Bronchitis
- Cold/Flu
- Headaches/Migraines
- Eye/Ear Infections
- Rash/Skin Irritations