Page 8 - 2017 Benefits Enrollment

Medical and Prescription

Resources

2017 Employee Pre-Tax Contributions

HDHP 2000 HDHP 3000 PPO 1000
Medical Bi-weekly Bi-weekly Bi-weekly
Employee Only $60.35 $21.83 $53.67
Employee and Spouse $120.69 $43.65 $107.34
Employee and Child(ren) $108.62 $39.29 $96.60
Employee and Family $188.54 $68.20 $167.68

BlueCross BlueShield of Texas Member Site

The BlueCross BlueShield of Texas member site, www.bcbstx.com, offers many
valuable services including the following.

X Providers and pharmacy searches

X Prescription drug formulary
X Access to temporary ID cards and means to order another ID card

X Information regarding paid and pending claims

X Health and wellness information

You can search for participating providers by completing the following steps.

1. Go to www.bcbstx.com

2. Click on “Find a Doctor or Hospital”

3. Click “Find a Doctor” on the left side under “Quick Links,” then select the state
in which you live
4. Choose “Blue Choice PPO [BCA]” for network

5. Enter additional search criteria

Sulzer
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