Page 8 - 2016 Benefit Booklet AYN

Page 8

Medical Benefits Provided by BlueCross BlueShield of NC
Blue Options 1-2-3

 Preventive care is covered at 100% with no deductible.
 There is a new hire waiting period: 1st of the month after 60 days of
employment
 Deductibles and coinsurance maximums are accumulated based on benefit
plan year, October 1 to September 30.
 Dependent children can be covered until the age of 26, regardless of student
status.
Employee per pay period cost (pre-tax) for plan year 10/1/16 to 9/30/17

Employee Only $28.23
Emp + Spouse $176.45
Emp + Child(ren) $108.09
Emp + Family $185.00

Health Reimbursement Account for Blue Options 1-2-3
Your group health plan through BCBS has deductibles of $3,500 for an individual
and $7,000 for family.
 For employee only plans, the member is responsible for the first $250, the
HRA pays the next $3,000 and the member pays the remaining $250 of the
deductible. The employee pays the first $1,000 of the coinsurance, the HRA
pays the next $2,000 and the employee pays the last $100.
 For Employee Spouse, Child(ren) or Family plans, the member is responsible
for the first $250, the HRA pays the next $6,000, and the member pays the last
$750 of the deductible. The employee pays the first $1,000 of the coinsurance,
then the HRA pays the next $4,000 and the employee pays the last $1,200 of
coinsurance.
 HRA Funds of Employees with dependent coverage are shared for all family
members.