Overview
The Company offers two medical plan options administered by Blue Cross Blue Shield of Illinois (BCBSIL): the Standard HSA and the Enhanced HSA. These plans have similar plan designs, including prescription drug coverage, a tax-deductible Health Savings Account (HSA), the same out-of-pocket maximum and 100% coverage for in-network preventive care. The plans differ by their deductibles, coinsurance, member responsibility and paycheck contributions.
To learn more about how these plans work, please review this video on how Consumer-Directed Health Plans (CDHPs) work.
Key features
Both of our medical plans provide:
Comprehensive, affordable coverage
for a wide range of health care services.
Free in-network preventive care
with services such as annual physicals, recommended immunizations, and routine screenings all 100% covered.
Prescription drug coverage
provided by Express Scripts.
Financial protection
through annual out-of-pocket maximums that limit how much you’ll pay each year.
A tax-free savings option
through the Health Savings Account.
How much does Company medical coverage cost?
The Company pays a generous portion (about 80%) of the cost of your medical coverage. You can visit BBU Benefits Center for a summary of your costs.
Our collective behaviors can influence how much everybody pays for medical insurance. Actions like receiving routine preventive care and maintaining a healthy lifestyle can result in us all paying less.
Spousal Surcharge
If your spouse is eligible for medical coverage through their employer but chooses to be covered under a Company medical plan, a $1,000 annual surcharge, divided equally among paychecks, will be applied to your medical contributions for the plan year.
You can certify your spousal surcharge status when you enroll in benefits on BBU Benefits Center:
- Click on the Get Started button > Next button > My Family to verify and/or add new dependents.
- Then go to the My Information tab > Benefits Related Information to review and answer a question related to your spousal surcharge status.
- You can then continue with the enrollment process.
You must finalize your enrollment elections in this session to ensure the spousal surcharge has been applied correctly. At the end of the enrollment process, you will see confirmation of whether the spousal surcharge has been applied. You can also verify your spousal surcharge status via your Confirmation Statement received in your home mail.
Eligibility
You are eligible to participate in Company health care benefits if you are an active Associate and have met your eligibility requirement.
Who Can Enroll
As a benefits-eligible Company associate, you may elect coverage for:
- Yourself
- Your legal spouse*
- Your eligible children up to the end of the month they reach age 26, regardless of student, marital or residential status. You may cover disabled children (as defined by the Social Security Administration) over age 26 if you provide proof that your child’s incapacitation occurred prior to age 26.
*A common law spouse is eligible in Colorado.
If you and your spouse both work for the Company, only one of you may cover your dependent children. You will need to supply separate Social Security numbers for yourself and your spouse when you enroll in benefits.
Dependent Verification
When you enroll your dependents, you will be asked to verify your dependents’ eligibility within 45 days of enrolling by providing documents verifying their status. Follow these steps to ensure you successfully verify your dependents:
- Gather and submit the necessary supporting documentation depending on who you are trying to verify. Click here for a full list of eligible documentation.
- For a spouse, you’ll need a marriage certificate and one of the following documents: a Federal tax return from the previous two years, a mortgage statement from within the last six months or a joint bank account statement from within the last six months (Note: Only a marriage certificate is needed if married within the last 12 months.)
- For a new child, you’ll need a birth certificate, official maternity discharge paperwork, adoption papers or legal guardianship papers
- If you enroll yourself and verify your eligible dependents within 45 days of enrolling, your dependents’ coverage will take effect on the later of:
- The date your coverage becomes effective, or
- The date of the qualified life event, provided any required contributions are made and you have elected dependent coverage within 31 days of the qualified life event.
- Newborn children are covered from birth for the first 31 days. You must elect dependent coverage within 31 days of birth and submit documentation within 45 days of enrolling for coverage to continue. Coverage for a newly adopted or soon-to-be adopted child will take effect on the date the child is placed for adoption.
After 45 days of enrolling, any unverified dependents will be dropped from Company benefits coverage. Contact the BBU Benefits Center for more detailed information about eligibility.
Coverage Levels
For all health care benefits, you choose from the following coverage levels. You may choose different coverage levels for medical/prescription drug, dental and vision:
- You Only
- You + Spouse
- You + Child(ren)
- You + Family
When Coverage Begins
You must make an active election within 31 days of the day you become eligible for benefits or experience a qualified life event. If you make elections, your coverage will be effective as follows:
| If you are… | Any elections you make for yourself, and your eligible dependents will be effective on… |
|---|---|
| A full-time hourly non-union Associate | The first day of the month following 60 calendar days of employment, or when you become eligible for benefits.* |
| A salaried Associate | The first day of the month following or coinciding with your date of hire, or when you become eligible for benefits. * |
| A rehire (full-time) | The date you are rehired |
| Newly eligible due to a transfer or job change | The effective date of your transfer or job change. |
*Temporary Associates, Associates not on Company payroll, leased associates, interns and other non-regular Associates who are later reclassified as regular Associates will be eligible for benefits on their date of reclassification.
Plan Comparison
Use this interactive side-by-side plan comparison to understand key differences between the plans.
| Standard HSA | Enhanced HSA | |
|---|---|---|
| You Only | ||
| Paycheck Contribution | $ | $$ |
| Deductible* | In-network: $3,000 Out-of-network: $6,000 |
In-network: $2,000 Out-of-network: $4,000 |
| HSA Contributions | The Company contributes: $550** | The Company contributes: $750** |
| Coinsurance (what you pay) | In-network: 30% Out-of-network: 50% |
In-network: 20% Out-of-network: 40% |
| Out-of-Pocket Maximum (the most you pay) | In-network: $6,000 Out-of-network: $12,000 |
In-network: $6,000 Out-of-network: $12,000 |
| You + Family | ||
| Paycheck Contribution | $ | $$ |
| Deductible* | In-network: $6,000 Out-of-network: $12,000 |
In-network: $4,000 Out-of-network: $8,000 |
| HSA Contributions | The Company contributes: $1,100** | The Company contributes: $1,500** |
| Coinsurance (what you pay) | In-network: 30% Out-of-network: 50% |
In-network: 20% Out-of-network: 40% |
| Out-of-Pocket Maximum (the most you pay) | In-network: $12,000 Out-of-network: $24,000 |
In-network: $12,000 Out-of-network: $24,000 |
*All eligible charges count toward the deductible and both in-network and out-of-network out-of-pocket maximums. Out-of-pocket maximums listed only apply to reasonable and customary charges and may be higher than the out-of-network amount indicated.
**For 2024, you can contribute a total of $4,150 for single coverage or $8,300 for family coverage, including the Company’s contribution. If you are age 55 or older in 2024, you may contribute an additional $1,000 in catch-up contributions.
***There is an out-of-pocket maximum for each individual family member enrolled in You + Family coverage. No individual family member enrolled will pay more than $6,000/in-network and $12,000/out-of-network for out-of-pocket expenses in 2024.
Note: If you are a part-time associate working less than 30 hours a week who is currently enrolled or had been enrolled in the Company health care benefits prior to January 1, 2014, and you waive coverage during Annual Enrollment or due to a life event, you cannot re-enroll as a part-time Associate.
How the Plans Work
The Standard HSA and Enhanced HSA plans are designed to encourage you to take an active role in your health care decisions and be a smart consumer or shopper of services. You select a provider – either in-network or out-of-network – each time you need care. Your out-of-pocket costs are less when you receive care in-network because the plan pays a greater percentage of the cost, and you are charged lower discounted fees.
You pay the plan Premiums from your paycheck to have coverage. When you receive in-network preventive care, you pay nothing — it’s covered in full! If you need non-preventive care, it works like this:
*In-network preventive care is covered at 100% regardless of whether you have met your deductible. If you use an out-of-network provider for preventive care services, you are responsible for paying any charges above Reasonable and Customary (R&C) Charge limits for those services. These charges will not apply to your deductible or out-of-pocket maximum.
**There is an out-of-pocket maximum for each individual family member enrolled in You + Family coverage. No individual family member enrolled will pay more than $6,000/in-network and $12,000/out-of-network for out-of-pocket expenses in 2024.
Use your HSA to save money and plan ahead!
Contributing to your HSA is a great way to budget for deductibles and other out-of-pocket expenses while also saving money — your HSA contributions are tax-free!* Additionally, you get to keep any unused HSA funds and these savings can be used in retirement or for future unexpected costs.
Keep in mind:
- You can only spend HSA money already deposited into your account. If you don’t have enough money in your HSA when you need it, you can pay another way and reimburse yourself later to take full advantage of your HSA’s tax savings.
- You will never forfeit any money left in your HSA — it rolls over each year. To save for your health care costs in retirement or prepare for future expenses, set aside a little extra each paycheck to grow your balance.
- You can change your HSA contribution amount throughout the year, if needed.
*HSA contributions are not subject to federal income tax but are currently subject to state income tax in CA and NJ. Consult with your tax advisor to understand the potential tax implications of enrolling in an HSA. Money in an HSA can be withdrawn tax-free if it is used to pay for qualified health-related expenses. If money is used for ineligible expenses, you will pay ordinary income tax on the amount withdrawn, plus a 20% penalty tax if you withdraw the money before age 65.
The health care options offered by the Company are considered affordable and generally meet minimum value as defined by the Affordable Care Act (ACA). This means that if you decide to waive health care coverage offered by the Company and enroll under the government sponsored health care marketplace, you will likely not be eligible for a government subsidy or tax credit. If you receive a subsidy while eligible for the Company health care plans, you may be required to pay it back to the government.
Medical and Prescription Drug ID Cards
All Company medical plan participants will receive a BCBSIL ID card that will work for both your medical plan and Express Scripts drug plan.
Find a Medical Plan Provider
Using in-network providers saves you money. Here’s how to find doctors in your medical plan network.
Find a BCBSIL Provider
- Visit the BCBSIL website.
- Click on “Find Care” then “Find a Doctor or Hospital” to see if a doctor is in-network.
- Alternatively, call BCBSIL’s Customer Service at 1-877-239-7449 (Customer Service), 9:00 a.m. to 7:00 p.m., ET, Monday through Friday.
*Alternative networks may be used in Florida, Georgia, Wisconsin, New Jersey, New York, Maryland, Kansas City, MO, Oklahoma City, and District of Columbia.
Don’t have a personal doctor? You should. Here’s why.
- Better health. Yearly health screenings can reduce your risk for many serious conditions. Preventive care is free, so there’s no excuse to skip it.
- Greater savings. Having a doctor you can call helps you avoid costly trips to the emergency room.
- Peace of mind. Your personal doctor gets to know you and your health history, provides advice you can trust, and helps coordinate your care.
Care When you Need it
Life happens. When it does, it is important to get the care you need when you need it. Be sure to familiarize yourself with your care options so you can focus on getting the care you need.
| BCBSIL 24/7 Nurseline | Telehealth | Doctor’s office | Urgent care clinic | Emergency room | Employee Assistance Program (EAP) |
|---|---|---|---|---|---|
| Use it for | |||||
| A non-emergency medical issue and you are not sure where to go. | A non-emergency medical issue that can be diagnosed by phone or online | A condition that can wait until the next day for medical attention | A condition that needs immediate care but is not life- or limb-threatening | A life-threatening or potentially crippling condition that needs immediate attention | Non-emergency mental health concerns |
| Examples | |||||
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| Cost | |||||
| Nothing | You pay: $ Average cost: $118* |
You pay: $ |
You pay: $$ Average cost: $354* |
You pay: $$$ Average cost: $2,188* |
Nothing for up to 5 visits per issues |
| Find it | |||||
| Call 1-800-299-0274 to talk to a nurse today. | Visit the MDLIVE website to get started | Call your regular doctor or search for an in-network provider on your medical plan website | Search for urgent care clinics near you | Call 911 or search online for the nearest hospital | Visit the SupportLinc website (code: Bimbo) to search for in-person or virtual providers. |
*These costs are for illustrative purposes only. These estimates are based on the average allowed amounts for these services from the Company’s active population experience incurred in 2022. There is no adjustment made for geography, plan design, specific services rendered, or provider type.
Additional Information on Telehealth
Want care anytime and anywhere? Your medical plan gives you access to telehealth services through MDLIVE. MDLIVE provides an alternative to traditional doctor visits for non-urgent care or behavioral health visits by offering 24/7 access to board-certified doctors through video or phone consultations. MDLIVE is a helpful option if your doctor is unavailable, one of your family members is sick after hours, or you’re on vacation or away from home. Plus, you will save time; each consultation is only about 15 minutes, and you don’t have to worry about getting to or from your appointment or sitting in a waiting room.
Telehealth is a great option for non-urgent medical conditions, such as:
- Cold and flu symptoms
- Allergies
- Bronchitis
- Urinary tract infections
- Respiratory infections
- Sinus problems
- Short-term prescriptions
- Behavioral health issues*
- Anxiety/depression*
- Child behavioral/learning issues*
- Marriage problems*
- And more
*Additional costs may apply for these services
In addition to offering more flexibility than traditional office visits, MDLIVE makes it easy to save money when you need care. Each general medical consult is $48 until you meet your plan deductible, and then fees will be based on coinsurance.
For more information, visit the MDLIVE website.
Personalized Health Care Support
Navigating a complex medical issue, condition or routine care can be stressful. The Company provides these resources to support you in your healthcare journey.
| Care Need | Personalized Health Care Support Resources |
|---|---|
| Facing a Complex Medical Issue or Surgery? | Medical Ally If you are unsure about a medical diagnosis, path of care or surgery decision and would like to discuss it with a second health care professional, Medical Ally can help you find:
|
| Living with a Chronic Condition or need Support with a Complex Medical Diagnosis? | BCBSIL Personal Health Clinicians If you are currently living with a medical condition, a BCBSIL Personal Health Clinician can help you live better and avoid complications. Based on health care claims data, you and/or your enrolled spouse may receive a call from a BCBSIL Personal Health Clinician — experienced registered nurses, pharmacists, dietitians, and professionals trained in psychology and social work. We encourage you to take the call or contact a BCBSIL Care Manager at 1-877-239-7449 (Customer Service). |
| Managing Diabetes or Hypertension? | Livongo for Diabetes and Hypertension Enroll in Livongo to help you manage diabetes or hypertension. If you enroll in the Livongo Diabetes Management program, you will receive a free glucose meter, unlimited test strips and additional supplies along with real-time support from coaches to help you manage your condition. If you are on high blood pressure medicine and enroll in the Livongo Hypertension Management program, you will receive a wireless-connected blood pressure cuff and have access to a nurse that can support you. Contact Livongo at 1-800-945-4355 for more information on these programs. |
| Need Specialized Care? | Blue Distinction and Blue Distinction+ Centers Certain high-cost, rare/complex and elective procedures across six specialties — maternity, transplants, bariatric surgery, cardiac care, knee/hip replacement and spine surgery — are covered at 100% of the cost after you meet your deductible (no coinsurance will apply) when you use a Blue Distinction or Blue Distinction+ Center. If you need this type of care for yourself or a covered family member, we encourage you to call 1-877-239-7449 (Customer Service) to speak with a BCBSIL Personal Health Clinician. |
| Mental Health Support? | SupportLinc Employee Assistance Program (EAP) Whether you’re looking to manage a stressful situation or you have an ongoing mental health concern, the SupportLinc EAP provides you and your dependents 24/7 access to confidential counseling via phone, text, video, in-person or online. You and your dependents can each get five free counseling sessions per issue you experience. If you need support with a mental health concern, stress, relationship and family issues, legal issues and more, contact SupportLinc at 1-888-881-5462 or visit the SupportLinc website (code: Bimbo). |
| Need Addiction Support? | Pelago Addiction Support Navigate towards brighter days. Looking to stop or cut back your tobacco, alcohol, or opioid use? Pelago will guide and support you with a personalized virtual program that is confidential and free. Visit the Pelago website or call 1-877-349-7755 to get started. |
Tools & Resources
Your medical plan offers additional features to help you get the most from your coverage.
Try the Cost Share Estimator Tool
The Cost Share Estimator Tool in Blue Access for MembersSM (BAMSM) gives members the ability to compare cost-share across in- and out-of-network providers. The tool has enhanced search capabilities and provide real-time, personalized cost-share estimates. To use the Cost Share Estimator:
- Visit the BCBSIL website.
- Click on “Find Care” then “Find a Doctor or Hospital” then “Cost Estimates” then choose the type of visit or procedure to compare prices.
- Alternatively, call BCBSIL’s Customer Service at 1-877-239-7449 (Customer Service), 9:00 a.m. to 7:00 p.m., ET, Monday through Friday to receive pricing quotes over the phone, via email or by mail.
Need a Flu Shot or COVID-19 Vaccine? Get it for Free!
All Associates and eligible dependents can receive a free annual flu shot. Getting a flu shot not only helps lower your chances of catching the flu, but also helps reduce the severity of your symptoms and can keep you out of the hospital if you do come down with it.
If you are enrolled in a Company medical plan, visit a BCBSIL in-network health care provider or pharmacy and show your BCBSIL/Express Scripts ID card to receive your free annual flu shot. Your enrolled dependents can get a free flu shot too!
Flu shots can be processed under a Company prescription card plan at a participating pharmacy of the Associate’s choice. The cost is covered 100% for Associate and their direct dependents who are enrolled in a Company medical plan when they present their medical card to the pharmacist — no out-of-pocket costs apply.
Vouchers are available for Associates and immediate family members age 18 and older. Contact your HR Business Partner for details.
It is also critical that Associates and eligible dependents receive the COVID-19 vaccine. If you have not yet received your COVID-19 vaccine, please make an appointment to do so today. As a reminder, the COVID-19 vaccination is covered at 100% by Company’s medical plans for Associates and their enrolled dependents.
Approaching Medicare Eligibility? Get a Medicare Consultation through HTA
HTA can help you learn about Medicare and how it works so you can make confident Medicare decisions. This resource is provided at no cost to you, and includes:
- Personal guidance from a licensed Medicare client services team member to help you every step of the way
- A detailed overview of your coverage options, including Original Medicare Part A & B, Medicare Advantage plans, Medicare Supplement Insurance and Medicare Part D prescription drug coverage
- Help reviewing your Medicare plan selections and enrollment options
- Answers to questions such as whether to enroll or defer Medicare Part B if you aren’t retiring at age 65, and what happens when you and your spouse do not turn 65 at the same time
After your phone consultation, HTA will send you a detailed summary email and an action plan based on your health and wellness needs and situation. Plus, you’ll have unlimited phone support for future questions and assistance.
You do not need to be enrolled in a Company medical plan to use HTA. You can use this service for a family member or friend, too! Call HTA at 1-610-430-6650, Option 1 for a brief intake session and to schedule a Medicare consultation.
Transparency in Coverage
The Departments of Health and Human Services, Labor, and Treasury (the Departments) released Transparency in Coverage (TiC) rules that put several new compliance mandates on group health plan sponsors. The Company is working with our carriers and third-party administrators (TPAs) to ensure we have the necessary information in the proper format to comply with the new rules.
Learn more about Transparency in Coverage through BCBSIL.