Welcome to your Virtual Benefits Center.
This site was designed to be a centralized resource for you to learn about your benefit offerings during open enrollment and throughout the year.
Here, you can find plan information, enrollment details, and tools to help you choose the right coverage for you and your family.
Plan Year
July 1, 2026 - June 30, 2027
What is Open Enrollment?
Open Enrollment is the one time of year that you are able to enroll in or modify your employee benefits for the upcoming plan year. Elections you make at this time will remain in effect until the next Open Enrollment period, unless you have a Qualifying Life Event that allows for a plan change.
What is a Qualifying Life Event?
A Qualifying Life Event (such as marriage, divorce, birth/adoption of a child, or loss of eligibility under another plan) allows you to make plan changes outside of Open Enrollment. If you experience this type of event during the year, you may modify your benefits within 30 days by notifying HR as soon as possible. Learn more.
How to Enroll
To complete your enrollment, please return completed enrollment form(s) to Amy Smith at asmith@gjsd.net.
Understanding Your Benefits
Covered Health Service: A service could be an office visit, test, prescription, or another medical treatment your health insurance covers. Before seeking care, check to make sure the service is covered.
Claim: The request for payment that's sent to your health insurance company after you receive covered care.
Copay: A fixed fee that you must pay for a covered service as outlined in your plan design, usually at the time you receive the service.
Plan Allowance: The set amount your plan will pay for a health service, even if your provider bills for more.
Deductible: The set amount you pay for a covered health service before your plan will begin to pay. Will be outlined within your plan design.
Coinsurance: The percentage of the cost of your covered health care services, that you must pay after you've met your deductible.
Out-of-Pocket Maximum: The most you'd pay for covered care within the plan period. If you hit this amount, your plan pays 100% after it is reached.
Premium: The monthly amount paid (by your employer, a combination of employer and employee or the employee only if voluntary)
In-Network Provider: A doctor, hospital, or other provider in the plan's network. Network providers accept the plan's payment in full. You pay less when you use an in-network provider. With the exception of care for emergent and urgent conditions, if the plan does not offer out of network coverage, you must seek an in–network provider for all covered services.
Out-of-Network Provider: Provider who does not have a contract with your health insurer to provide services to you at a discount. You will generally pay more to see an out-of-network provider. If you have an EPO or HMO plan, you are not covered for out-of-network services (except for emergency and urgent care services).
Formulary: A list of medications covered by your plan sorted by tier. Lower tiers usually mean lower copays.
Medical
Plan Details
- PPO Blue 1700
Did you know?
- Preventive services are covered at 100% in-network, and copays and deductibles do not apply.
- You pay less out of pocket if you receive care from an in-network provider.
- You do not need a referral to see a specialist.
Download the My Highmark app
Find care, check benefits and coverage, access member ID cards, view claims, and more.
Virtual Health
Get care when and where you need it. With Well360 Virtual Health, you have 24/7 access to virtual urgent care, as well as convenient access to schedule non-emergency virtual visits with various providers.
- Primary Care
- Urgent Care
- Behavioral Health Therapy
- Dermatology
- Women's Health
Access virtual care through the MyHighmark app or member portal.
Added Benefits from Highmark
Mental Well-Being with Spring Health
As a Highmark member, you have rapid access to personalized mental health care and medication management through Spring Health.
- First appointment within 3 days
- Virtual and in-person visits with therapists, psychiatrists, and other clinicians
- Dedicated Care Navigator to provide support and coordinate care
- Wellness coaching
- On-demand, self-guided digital mental wellness exercises
- 24/7 Crisis Line
Begin your well-being journey today. Learn more.
BlueCard
Take your healthcare benefits with you - across the country and around the world. Your Highmark membership gives you a world of choices. Within the United States, you’re covered whether you need care in urban or rural areas. Outside the United States, you have access to doctors and hospitals around the world through the Blue Cross Blue Shield Global Core program.
To find care wherever you are, visit provider.bcbs.com, use the National Doctor & Hospital Finder app, or call BlueCard Access at 1-800-810-BLUE (2583).
Virtual Physical Care with Sword
Combining personalized support with the latest digital tools, Sword gives you the freedom to overcome joint and muscle pain anytime, anywhere. Using a tablet and motion sensor that track and guide your movement, you're matched with a physical therapist who creates a customized, self-guided care plan, then monitors your progress for ongoing support.
To enroll, visit meet.swordhealth.com/thrive/highmarkbcbs.
Baby BluePrints
Everyone’s pregnancy journey is different. Which is why, when you’re expecting, you should have personalized support at each step. This free program offers educational info on all aspects of pregnancy, plus one-on-one support from a women’s health specialist.
You can sign up at any point during your pregnancy, but earlier is better to make the most of the program. Learn more.
Diabetes Care Management
Powered by Onduo, our Diabetes Care Management program helps to effectively control Type 1 (T1D) and Type 2 (T2D) diabetes in between office visits through a combination of virtual clinic, digital monitoring, tools, and coaching. Learn more.
Diabetes Prevention
Achieve sustainable weight loss, make healthier habits, and reduce diabetes risk - all backed by science. Our Noom Diabetes Prevention Program is designed for adults with prediabetes or those at risk for type 2 diabetes. Learn more.
Health and Wellness Programs
Highmark's health and wellness programs can help you reach your goals, lower your risk for illnesses, manage health conditions, and build healthy habits. Our comprehensive suite of employee support tools includes:
- Discounts through Blue365
- Behavioral health resources
- Personalized wellness plan
- Engagement rewards
Get started on your personal wellness journey today.
Medicare Services from NFP
Considering Medicare coverage?
NFP is proud to support you when it comes to Medicare and understanding your coverage options. As trusted advisors in the individual markets for over 20 years, our team is comprised of experienced and knowledgeable agents specializing in Medicare coverage. We offer independent and individualized consultations to help you to:
- Understand your coverage options
- Determine if you are eligible for subsidies to lower your healthcare costs
- Establish a timeline for applying for coverage
- Choose a plan that fits both your lifestyle and your budget
- Find coverage that allows you to access the doctors and hospitals you want most
- Enroll in the plan that works best for you
Best of all, there is never a fee for our services.
HSA
What is a Health Savings Account? A Health Savings Account (HSA) is a tax-advantaged savings account that you can use to pay for qualified medical expenses, such as copays and medications - now or later in life. Contributions to HSAs aren’t subject to federal income tax if used for medical expenses, and earnings in the account grow tax-free. You must be enrolled in a high-deductible health plan (HDHP) to qualify for an HSA. An HSA covers qualified out-of-pocket expenses for you, your spouse, and your dependents, even if they are not covered under an HDHP.
Do HSA funds expire? HSA funds don't expire; they will stay in your account and can be used for medical expenses even after you retire.
How much can I contribute? For 2026, the maximum amount you can contribute this calendar year is $4,400 (individual) or $8,750 (family).
HSA funds can be used for many types of medical expenses, including deductibles, co-pays, prescriptions, dental and vision care, and over-the-counter medication and products. Examples include but are not limited to:
Healthcare Expenses
• Acupuncture
• Ambulance
• Artificial teeth
• Braces
• Chiropractic care
• Contact lenses and supplies
• Crutches
• Diagnostic tests and monitors (blood sugar, blood pressure, etc.)
• Eyeglasses (Rx and reading)
• Hearing aids and batteries
• Insulin
• Laboratory fees
• Laser eye surgery
• Medical alert bracelet
• Orthotic inserts
• Physical therapy
• Surgery (non-cosmetic)
• Vaccines
• Vision exam
• Walker, cane
• Wheelchair
Medicines/Personal Care (OTC)
• Acid controllers
• Allergy and sinus medicine
• Certain skin care products (treatments for acne, eczema, etc.)
• Cold/flu medicine
• Digestive/bowel aids
• Eye drops
• Hemorrhoid treatment
• Nasal sprays or drops
• Nicotine patches
• Pain relievers
• Sleep aids
• Sunscreen
Medical Supplies (OTC)
• Bandages, adhesive, or elastic
• Catheters
• Contact lens solution
• Cold packs/hot packs
• Denture adhesives
• First-aid supplies
• Menstrual care products
• Nursing supplies
• Orthopedic braces and supports
• Pregnancy tests
• Prenatal vitamins
• Thermometers
Contacts
You have dedicated agents ready to handle any situation in a discreet and confidential manner. Contact us for questions and needs such as:
- Understanding your benefit coverage
- Help finding in-network providers
- Assistance with prescription or pharmacy issues
- Questions regarding bills you receive from your doctor, specialist, hospital, or lab
- Claims you believe haven’t been paid properly
Brianna Rainey
Account Executive
brianna.rainey@nfp.com
814-289-4232
Casey Maschue
Producer / Sales Consultant
casey.maschue@nfp.com
814-289-4228