Blue Options HSA pairs a high-deductible plan with a tax advantaged savings
account employees use to pay for all of their – or their dependents’ – covered
medical expenses, up to the deductible.8, 9
Blue Options HRA pairs a PPO health plan with an employerfunded HRA for
out-of-pocket expenses.7 Employers determine how much employees share in
the cost of their care by selecting deductible, coinsurance and out-of-pocket
maximum levels, as well as how much they will contribute to the HRA.
Blue Options 1-2-3 divides services into three benefit levels. The plan
encourages primary and preventive care and incents shopping for the most
cost-efficient solution when possible.
Level 1 – Copayments for most primary care office visits.4, 5
Level 2 – Rich coinsurance for acute care like admitted hospital stays.
Level 3 – A lower level of coinsurance to incent shopping for services like
specialist visits and outpatient hospital services.
Prescription drugs – Covered for a copayment or coinsurance.6
Our Preferred Provider Organization (PPO) plan
Blue Options is a PPO plan that offers convenient copayments or coinsurance
for things like primary care, specialist office visits and prescription drugs.1
Employees may receive care in or out of network and don’t need a referral to
see a specialist.2 They’ll never have to go far to find a doctor either – the Blue
Cross Blue Shield of NC network includes 95% of all doctors practicing in North
1 Some services and supplies received by members in an office setting or in connection with an office visit are in fact outpatient hospital based services provided by
hospital-owned or operated practices. These services and supplies may be subject to your deductible and coinsurance. Preventive care is limited to in-network
benefits. Blue Options members are covered when they seek services out of network. Members should refer to the Member Guide for complete details.
2 Referrals may be needed for mental health and substance abuse services.
3 Blue Cross Blue Shield of NC (BCBSNC) Internal Data, 2008: Network Management Report, PowerMHS.
4 The benefits listed are for in-network services. Out-of-network benefits will differ.
5 Some services and supplies received by members in an office setting or in connection with an office visit are in fact outpatient hospital based services provided by
hospital-owned or operated practices. These services and supplies may be subject to Level 3 deductible and coinsurance. Please see the Blue Cross Blue Shield of
NC (BCBSNC) provider listing to identify these providers.
6 Please refer to your benefit booklet for details about the Tier 4 Formulary as well as your Blue Cross Blue Shield of NC (BCBSNC) member ID card for the levels of
7 Blue Cross and Blue Shield of North Carolina (BCBSNC) does not administer your HRA. Your HRA administrator is Select Data Service Administrators, Inc. (SDSA).
BCBSNC is not affiliated with your HRA administrator.
8 Withdrawals are tax-free only if used for qualified medical expenses. Visit www.irs.gov for specific tax information.
9 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. Your HSA custodian is Mellon Trust of New England, N.A.
A lower-cost PPO plan that drives employee engagement
A PPO plan with a high-deductible option and a health reimbursement arrangement
A high-deductible PPO plan with a tax-advantaged health savings account
|Group Health Plan Offerings From Blue Cross Blue Shield of North Carolina
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