Page 5 - 2016 Enrollment
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5
Medical/Prescription Drug Coverage Find In-Network
Care and Save on
Premera Blue Cross Your Expense
Premera Blue Cross will continue to administer our comprehensive 1. Visit www.premera.com/wa/
medical plans for the 2016 plan year. Premera Blue Cross’ network visitor/ind-a-doctor
offers exceptional access to in-network providers and deep discounts on 2. Click on “Search” under the Find
services. This results in lower costs to you and our plan. Premera Blue a Doctor/Specialist heading
Cross also provides extensive online resources including care comparison 3. Follow the instructional prompts
tools. depending on the type of search
you are conducting
Prescription Drugs
You can search for providers and
Premera Blue Cross also administers our pharmacy coverage. facilities by name and by a certain
distance you are willing to travel.
Please review Premera Blue Cross’ formulary information from their You can search for in-network
website at www.premera.com/wa/visitor/pharmacy for more information care based on a specialty,
on the prescription beneit. condition, treatment or service.
It’s important to search for
Monthly Medical Plan Contributions physicians and facilities within the
Premera network to receive the
HRA Plan highest possible beneit coverage
Non-Tobacco Tobacco your plan offers. Browse the
Non-Tobacco Spousal Tobacco Spousal
Surcharge Surcharge providers nearest you!
Employee $86.76 $106.47
Employee + spouse $220.97 $281.97 $271.19 $347.44
Employee + $216.61 $236.33
child(ren)
Family $267.43 $328.44 $317.65 $393.91
HSA Plan You can fund your HSA through a
Non-Tobacco Tobacco one-time transfer from your IRA. The
Non-Tobacco Spousal Tobacco Spousal law allows you to move money from
Surcharge Surcharge your IRA into your HSA and avoid
Employee $70.42 $86.43 the taxation and penalties generally
Employee + spouse $206.14 $267.83 $252.99 $330.10 associated with early withdrawals
Employee + $186.52 $202.52
child(ren) from an IRA. Allowing HSA owners
Family $284.67 $346.36 $331.52 $408.63 to access their IRA funds provides
another option to fund the HSA. Rules
and restrictions apply—contact Human
Resources for additional information.
2016 Benefits Guide
Medical/Prescription Drug Coverage Find In-Network
Care and Save on
Premera Blue Cross Your Expense
Premera Blue Cross will continue to administer our comprehensive 1. Visit www.premera.com/wa/
medical plans for the 2016 plan year. Premera Blue Cross’ network visitor/ind-a-doctor
offers exceptional access to in-network providers and deep discounts on 2. Click on “Search” under the Find
services. This results in lower costs to you and our plan. Premera Blue a Doctor/Specialist heading
Cross also provides extensive online resources including care comparison 3. Follow the instructional prompts
tools. depending on the type of search
you are conducting
Prescription Drugs
You can search for providers and
Premera Blue Cross also administers our pharmacy coverage. facilities by name and by a certain
distance you are willing to travel.
Please review Premera Blue Cross’ formulary information from their You can search for in-network
website at www.premera.com/wa/visitor/pharmacy for more information care based on a specialty,
on the prescription beneit. condition, treatment or service.
It’s important to search for
Monthly Medical Plan Contributions physicians and facilities within the
Premera network to receive the
HRA Plan highest possible beneit coverage
Non-Tobacco Tobacco your plan offers. Browse the
Non-Tobacco Spousal Tobacco Spousal
Surcharge Surcharge providers nearest you!
Employee $86.76 $106.47
Employee + spouse $220.97 $281.97 $271.19 $347.44
Employee + $216.61 $236.33
child(ren)
Family $267.43 $328.44 $317.65 $393.91
HSA Plan You can fund your HSA through a
Non-Tobacco Tobacco one-time transfer from your IRA. The
Non-Tobacco Spousal Tobacco Spousal law allows you to move money from
Surcharge Surcharge your IRA into your HSA and avoid
Employee $70.42 $86.43 the taxation and penalties generally
Employee + spouse $206.14 $267.83 $252.99 $330.10 associated with early withdrawals
Employee + $186.52 $202.52
child(ren) from an IRA. Allowing HSA owners
Family $284.67 $346.36 $331.52 $408.63 to access their IRA funds provides
another option to fund the HSA. Rules
and restrictions apply—contact Human
Resources for additional information.
2016 Benefits Guide
