Blue Options 1-2-3

Blue Options 1-2-3SM is a plan for businesses that want to provide the benefits of a PPO in a cost effective manner, and don't want to move completely to a high-deductible health plan (HDHP) and/or health savings account (HSA). It is designed to provide the best of both worlds.

View Plan Summary

Blue Options 1-2-3 divides health care services into three benefit levels, from Level 1 where most of the cost of care is covered by a copayment, to Level 3 where more of the costs of care are shared with the member.

The plan supports primary and preventive care at Level 1, while Level 2 and Level 3 coverage for inpatient, outpatient or specialist care encourages closer management of costs.

Blue Options 1-2-3 benefits summary

This summary shows the range of coverage available.

NOTICE: Your actual expenses for covered services may exceed the stated coinsurance percentage or copayment amount because actual provider charges may not be used to determine the health benefit plan's and member's payment obligations. For costs and further details of the coverage, including exclusions, and reductions or limitations and terms under which the policy may be continued in force, see your agent or contact BCBSNC.

  Level 1 Level 2 Level 3
Type of service Primary and Preventive care Inpatient care Outpatient care and professional specialist care
In-Network Copayment or Coinsurance Copayments for services Admission copayment plus coinsurance after deductible Higher coinsurance rate after deductible

In-Network Covered Services
(See plan documents for a more detailed listing of covered services)

Primary care office visits and preventive care Inpatient hospital services and other care Outpatient hospital services and other care
Prescription Drug Coverage Covered by our standard Tier 4 coverage.
Deductible
In-network Out-of-network
Individual $500-$6,350 $1,000-$12,700
Family $1,000-$12,700 $2,000-$25,400
Out-of-Pocket Limit
(maximum amount a member pays including copayments, deductible and coinsurance)
In-Network Out-of-Network
Individual $2,000-$6,350 $5,000-$12,700
Family $4,000-$12,700 $10,000-$25,400

Is it right for your business?

Blue Options 1-2-3 works for businesses looking for a plan with lower premiums that still offers many of the advantages of a traditional PPO plan. If you and your employees are not quite ready to jump into the hands-on cost management encouraged by a high-deductible health plan, Blue Options 1-2-3 provides the opportunity to manage health care costs with a lower level of employee engagement.

Is it right for your employees?

Getting employees more involved in managing their health care costs is a challenge for any business. Blue Options 1-2-3 is designed to give your employees what they want (primary care copayments) while giving you what you want (lower premium costs).

Why BCBSNC?

  • Coverage in all 100 counties in North Carolina and the savings that come with it1
  • Most preferred health insurance company in North Carolina2
  • Get personalized service and a dedicated team including client engagement representative, group service advisor, account manager and member professional
  • HRA and FSA options now available with all of our plans

BCBSNC offers support and programs for members, including:

  • Web and mobile access to benefits and claims information at mybcbsnc.com
  • Health Line BlueSM, our 24/7 nurse line providing support at no additional cost to members
  • Fully integrated case management, condition care and the Healthy Outcomes wellness program3
  • Exclusive member discounts from top retailers on fitness gear, gym memberships, family activities, healthy eating options and much more with Blue365®,4
  • Access to valuable health improvement resources for those who are healthy or those who may need additional support.

All of our plans include:

  • A dedicated team: Client engagement representative, group service advisor, account manager and member professional
  • Turnkey wellness solution with Healthy OutcomesSM1, offering several, flexible options including data-based health assessments with reporting3
  • Exclusive member discounts with Blue365®4
  • Enhanced, integrated HRA options available with all plans

1. Consortium Health Plans, Inc., MarketQuest Network Compare, April 2013.

2. Brand Tracking Study; Prophet; March 2013.

3. BCBSNC contracts with Alere Health Improvement Company, an independent third party vendor, for the provision of certain aspects of Healthy Outcomes programs.

4. Blue365® offers access to savings on items that Members may purchase directly from independent vendors, which are different from items that are covered under the policies with BCBSNC. Any disputes regarding these products and services may be subject to BCBSNC's grievance process. Blue Cross and Blue Shield Association (BCBSA) may receive payments from Blue365 vendors. BCBSA does not recommend, endorse, warrant or guarantee any specific Blue365 vendor or item. This program may be modified or discontinued at any time without prior notice

U9637, 4/13