Blue Options HSA
Blue Options HSASM is a high-deductible PPO plan packaged with a health savings account (HSA) that offers tax-advantages.1 Employees use funds that they, their employers, or anyone, contribute to the HSA to pay for qualified medical expenses, both before and after the deductible is met.2
How it Works
For your business
- Low premiums. Employers can expect premium savings of up to 26% when compared to a traditional PPO plan.3 These are savings you can invest right back into your business. The coinsurance options can also help lower plan premiums.
- Take advantage of additional tax deductions. As always, the premiums you pay for your employees' health care are tax-deductible, but in addition, the contributions you make to their HSAs are also tax-deductible.
- By contributing, businesses jump-start the accounts, which help employees transition into the plan more easily.
For your employees
- Employees use a HSA debit card or checkbook to access the funds that you or they have contributed. Using these funds, they pay 100% of all medical expenses until their deductible is met. Even before the deductible is met, however, the member enjoys BCBSNC-negotiated rates, which offer significant savings. After the deductible is met, the employee pays coinsurance on covered services.4 Plan options include full coverage for certain preventive care services, like routine physical exams, to encourage this important aspect of health care.5
- If employees have funds in their HSA account, the account can be used to pay for medical expenses before any deductible and coinsurance (if applicable) amounts are met.2 So while employees pay a greater portion of the total cost of their health care, this cost-sharing can be offset by the lower premiums and tax-savings offered by the HSA. Employees save tax-free, earn interest tax-free and spend tax-free, which can amount to significant savings, depending on their tax bracket.6
- HSA funds accumulate and roll over if not used each year. Since the account is the employee's, it stays with the employee and can also be used after the employee retires.
Blue Options HSA 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.
|In-Network (Member Liability)||Out-of-Network (Member Liability)|
0%-50% coinsurance after deductible
30%-70% coinsurance after deductible
(maximum amount a member pays including copayments, deductible and coinsurance)
Covered at no charge (waive deductible)
70% after deductible
Included within medical deductible, coinsurance and out-of-pocket limit
|Contribution Limits for the HSA||
Each member on a plan who is over 55 can make an annual catch up contribution of $1,000 per member. These limits are established by the IRS, not BCBSNC.
Why Blue Options HSA?
Is it right for your business?
Blue Options HSA works for businesses looking for a plan that's easier on the bottom line. Employees should be able to manage higher deductibles and more hands-on requirements of an HSA plan.
Is it right for your employees?
Employees save tax-free, earn interest tax-free, which can amount to significant savings, depending on their tax bracket.6
- Coverage in all 100 counties in North Carolina and the savings that come with it8
- Most preferred health insurance company in North Carolina9
- Get personalized service and a dedicated team including client engagement representative, group service advisor, account manager and member professional
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 program10
- Exclusive member discounts from top retailers on fitness gear, gym memberships, family activities, healthy eating options and much more with Blue365®,11
- Access to valuable health improvement resources for those who are healthy or those who may need additional support.
What You Get With All Plans
All of our plans include:
- A dedicated team: Client engagement representative, group service advisor, account manager and member professional
- Turnkey wellness solution with Healthy OutcomesSM, offering several, flexible options including data-based health assessments with reporting10
- Exclusive member discounts with Blue365®11
1. Blue Options HSA combines a high-deductible health plan and a health savings account (HSA). BCBSNC does not administer your HSA and is not affiliated with your HSA custodian or administrator.
2. A full list of qualified medical expenses can be found in IRS publication 502, available at irs.gov.
3. BCBSNC Internal Data 2013. Based on PPO copayment plans that include a $1,500 deductible and $3,500 out-of-pocket max and $10/$35/$50 copayment structure for prescription drugs.
4. When using out-of-network providers, in addition to deductible and coinsurance amounts, you may be responsible for the difference between the BCBSNC allowed amount and the provider's actual charge.
5. Certain preventive care benefits include in-network annual routine physical exams, well-baby and well-child care, and certain immunizations and screenings. Other covered services may be subject to deductible and coinsurance. For more details around preventive care benefit options, visit www.bcbsnc.com/preventive or your Benefit Booklet.
6. Withdrawals are tax-free only if used for qualified medical expenses. See irs.gov for specific regulations.
7. These amounts may be updated each year to align with IRA guidelines. For the most up-to-date information, visit bcbsnc.com
8. Consortium Health Plans, Inc., MarketQuest Network Compare, April 2013.
9. Brand Tracking Study; Prophet; March 2013.
10. BCBSNC contracts with Alere Health Improvement Company, an independent third party vendor, for the provision of certain aspects of Healthy Outcomes programs.
11. 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