Table of Content
- Header
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Open Enrollment 2022
- HOW TO ENROLL
- QUALIFYING LIFE EVENTS
- MEDICAL
- Medical Plan
- Summary of Benefits and Coverage (SBC)
- Extras from BlueCross BlueShield of Texas
- PHARMACY
- HSA and HRA
- DENTAL
- Dental Plan Option
- VISION
- Vision Plan
- LIFE AND AD&D
- DISABILITY
- EMPLOYEE ASSISTANCE PROGRAM (EAP)
- WORKSITE BENEFITS
- CONTACT US
- Overview
- Welcome
- Footer
It's time for Open Enrollment!
Enrollment Dates: 9/2/2022 through 9/12/2022
Open enrollment is your once a year opportunity to make changes to your benefit elections! You can change your plans, add or remove dependents, add new coverage, or waive coverage that you no longer need. Your new benefits will go into effect 10/1/2022 - 9/30/2023.
HOW TO ENROLL
Using your desktop or mobile, you have access to our online benefits enrollment platform 24/7. In your Hill Country Payroll portal you can:
- View and select benefits for yourself and dependents
- View per-pay-period amounts
- Submit qualifying events
- Add and edit beneficiaries and dependents
To get started, click on the link below to head to your enrollment portal!
*IMPORTANT: The Benefit choices you make during your initial enrollment or annual open enrollment remain in effect for the entire plan year unless you experience a qualifying life event.*
QUALIFYING LIFE EVENTS
Your premiums for medical, dental, and vision insurance are deducted through a Cafeteria Plan established under Section 125 of the Internal Revenue Code (IRC) on a pre-tax basis. Under Section 125, changes to an employee's pre-tax benefits can be made ONLY during the Open Enrollment period unless the employee or qualified dependents experience a qualifying event and the request to make a change is made within 30 days of the qualifying event.
Under certain circumstances, employees may be allowed to make changes to benefit elections during the plan year, if the event affects the employee, spouse, or dependent’s coverage eligibility. Any requested changes must be consistent with and on account of the qualifying event.
Examples Of Qualifying Events:
- Legal marital status (for example, marriage, divorce, legal separation, annulment);
- Number of eligible dependents (for example, birth, death, adoption, placement for adoption);
- Work schedule (for example, full-time, part-time);
- You, your spouse, or other covered dependent become enrolled in Part A, Part B, or Part D of Medicare
- Death of a spouse or child;
- Change in your child’s eligibility for benefits (reaching the age limit);
- Becoming eligible for Medicaid; or
- Your coverage or the coverage of your Spouse or other eligible dependent under a Medicaid plan or state Children’s Health Insurance Program (“CHIP”) is terminated as a result of loss of eligibility and you request coverage under this Plan no later than 60 days after the date the Medicaid or CHIP coverage terminates; or
- You, your spouse or other eligible dependent become eligible for a premium assistance subsidy in this Plan under a Medicaid plan or state CHIP (including any waiver or demonstration project) and you request coverage under this Plan no later than 60 days after the date you are determined to be eligible for such assistance.
IMPORTANT: If you experience any of these qualifying life events during the year, be sure to reach out to your HR Department within 30 days to make changes to your benefit elections. If you miss that special enrollment window, you will have to wait until the next open enrollment period to make a change.
MEDICAL
NETWORK: BlueChoice PPO
How do I find an In-Network Provider?
Use the helpful link below! In-Network providers can also be found on your provider’s website at Texas Health Insurance | Blue Cross and Blue Shield of Texas (bcbstx.com) under “Find Care”. Select "Find a Doctor or Hospital" and then you can search by provider/facility name or search by specialty. You can also use the link below.
Did You Know?
- Preventive Services are covered at 100% In-Network and copays & 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.
Medical Plan
Your available medical plan is shown on the chart below!
Video: Primary Care vs Urgent Care vs ER
Video: Primary Care vs Urgent Care vs ER
Video: Prescription Drugs Benefits Overview
Video: Prescription Drugs Benefits Overview
Summary of Benefits and Coverage (SBC)
Looking for more details about how items are covered? Please refer to the formal Summary of Benefits and Coverage (SBC) below. There is one for each plan!
HSA PPO Summary of Benefits
HSA PPO Summary of Benefits
Extras from BlueCross BlueShield of Texas
As a BCBS member, you have access to a plethora of services and resources!
This is only a brief description of some of the plan benefits. For more complete details, including benefits, limitations and exclusions, please login to your BAM portal.
Blue Access for Members (BAM)
Through Blue Cross Blue Shield - Login (hcsc.net) our secure member website, you can access health plan information, resources and tools. The information can vary, depending on your plan.
- Review benefits, account balances, claims status and more.
- Order a replacement ID card or print a temporary card.
- View and print an Explanation of Benefits (EOB) for a claim.
Blue Access Mobile
Blue Access Mobile | Blue Cross and Blue Shield of Texas (bcbstx.com) makes it easy for you to access your information while on the go. You can view coverage details, health and wellness information, check claim status and access member ID card information. You can also sign up to get text or email alerts and tips
Valuable Member Programs
As a BCBSTX member, you have access to a range of programs that can help you get and stay healthy.
- Health and Wellbeing Programs | Blue Cross and Blue Shield of Texas (bcbstx.com) programs can help you manage your health conditions, get pregnancy support, talk to a nurse 24/7 and more.
- Blue365 Discount Program | Blue Cross and Blue Shield of Texas (bcbstx.com) offers discounts on health-related products, health and fitness clubs, weight-loss programs and much more.
PHARMACY
Prescription drugs are a vital part of your health care coverage. If you have prescription drug coverage through BlueCross and BlueShield of Texas (BCBSTX), this information can help you and your doctor get the most from your prescription drug coverage. The Pharmacy Benefit Manager for BCBS is Prime Therapeutics. You can access more information about your pharmacy coverage by visiting Home (myprime.com).
A drug list is a list of drugs that are covered under your prescription drug benefit. How much you pay out of pocket is determined by whether your drug is on the list and at what coverage level, or tier. A generic drug is often at the lower tier. See if your drug is covered by reviewing your formulary drug list using the link below!
Express Scripts® Pharmacy, the mail order pharmacy for members with BCBSTX prescription drug coverage, provides safe, fast and cost-effective pharmacy services that can save you time and money. With this program, you can obtain up to a 90-day supply of long-term (or maintenance) medications through Express Scripts® Pharmacy.
Ordering Through Express Scripts® Pharmacy
Getting Started Online
You have more than one option to fill or refill a prescription online or from a mobile device:
- Visit Express Scripts Online Pharmacy (express-scripts.com) Follow the instructions to register and create a profile.
- Log in to Home (myprime.com) and follow the links to Express Scripts® Pharmacy.
Order Over the Phone
Call 1-833-715-0942, 24/7, to refill, transfer a current prescription or get started with home delivery. Please have your member ID card, prescription information and your doctor’s contact information available.
HSA and HRA
HEALTH SAVINGS ACCOUNT (HSA)
- Allows you to set aside pre-tax dollars to pay for eligible expenses. By contributing to an HSA you reduce your taxable income, so you pay less in taxes — which saves you money.
- R Bank contributes $25 per pay period to your HSA
- You may contribute up to $3,650 annually as an individual or $7,300 as a family for 2022. That amount increases in 2023 to $3,850 annually as an individual or $7,750 as a family. Your employer contribution counts towards your maximum contribution amount.
- You must be enrolled in a qualified HSA-eligible health plan, but you or your spouse may not participate in an FSA or Health Reimbursement Account (HRA)
How the HSA Plan Works
You may use your HSA funds to pay for eligible medical, prescription drug, dental or vision expenses. Unused funds remain in your account for future use and roll over each calendar year. You can change your HSA contribution at any time during the plan year for any reason.
Health Reimbursement Arrangement (HRA)
Plan Year: January 1, 2023 through December 31, 2023
- HRAs are employer sponsored group health plans that help reimburse in-network deductible expenses for covered employees and dependents.
- Employer funding only – no employee contributions
- Reimburses in-network deductible expenses
- Covers employees and dependents enrolled in the R Bank medical plan
How The HRA Plan Works
Employee only coverage:
-- Employee meets at least $2000 dollars in in-network deductible expenses between January 1 and December 31
-- Employer reimburses incurred in-network deductible expenses from $2001 up to $1000 total
Family coverage:
-- Employee or covered dependents meet $2800 in in-network deductible expenses between January 1 and December 31
-- Employer reimburses incurred in-network deductible expenses from $2801 up to $2000 per family
DENTAL
NETWORK: BlueCare Dental
How do I find an In-Network Provider?
Use the helpful link below! In-Network providers can also be found on your provider’s website, please use the link below to access your network providers, through this link go to, "Find a Dentist" and then you can search by provider/center name or search by location.
Research shows there may be a link between oral health and illnesses like heart disease, stroke, diabetes and premature birth. That's why Blue Cross and Blue Shield of Texas created BlueCare Dental Connection. This program offers dental plan members tools and information through the Dental Wellness Summary (link below) to help you make better dental health care choices.
Did You Know?
You have the freedom to select the dentist of your choice; however, when you visit a participating in-network dentist, you will have lower out-of-pocket costs, no balance billing, and claims will be submitted by your dentist on your behalf.
Pre-treatment Estimate
If your dental care is extensive and you want to plan ahead for the cost, you can ask your dentist to submit a pre-treatment estimate. While it is not a guarantee of payment, a pre-treatment estimate can help you predict your out-of-pocket costs.
Looking for more details about how items are covered? Click on the links below to view the formal Benefit Summary.
Video: Dental Insurance
Video: Dental Insurance
Dental Plan Option
Your available dental plan is shown in the chart below!
VISION
NETWORK: EyeMed
How do I find an In-Network Provider?
Use the helpful link below! In-Network providers can also be found on your provider’s website at Vision Benefits (eyemedvisioncare.com)
DID YOU KNOW?
Eyes can give doctors a clear picture of overall wellness. That’s why vision care—and vision benefits—can help employees stay healthy. A comprehensive eye exam can detect early signs of serious health problems, such as:
- Diabetes
- Heart disease
- High blood pressure
- High cholesterol
- Glaucoma and cataracts
Looking for more details about how items are covered? Click on the link below to view the formal Benefit Summary.
Video: What is Vision Insurance?
Video: What is Vision Insurance?
A summary of your vision benefits is shown in the chart below!
LIFE AND AD&D
Basic Life and Accidental Death & Dismemberment (AD&D)
Life insurance is an important part of your financial security as it helps protect your family from financial risk and sudden loss of income in the event of your death. AD&D (Accidental Death & Dismemberment) insurance is equal to your Life benefit in the event of your death being a result of an accident, and may pay benefits for particular injuries sustained.
Basic Life / AD&D insurance is a company paid benefit, provided to you at no cost. The benefit on this plan is equal to $50,000. Keep in mind, your life insurance benefit will reduce to 65% of the original amount at age 70 and to 50% of the original amount at age 75.
Voluntary Life and AD&D
In addition to your employer provided Basic Life insurance coverage, you have the opportunity to enroll in Voluntary Life insurance coverage. Coverage is also available for your spouse and/or child dependents, however, it is required that you elect coverage for yourself in order to elect coverage for your dependents. See the grid to the right for the plan specifics!
*Guaranteed Issue (GI) and Evidence of Insurability (EOI)
When you are first eligible (at hire) for Voluntary Life and AD&D, you may purchase up to the Guaranteed Issue (GI) for yourself and your spouse without providing proof of good health (EOI).
Any amount elected over the GI will require EOI. If you elect voluntary life coverage and are required to complete an EOI, it is your responsibility to complete the EOI and send to the provider (address will be listed on your form). In addition, your spouse will need to provide EOI to be eligible for coverage amounts over GI, or if coverage is requested at a later date.
*Special Note for your 2022 Enrollment of Supplemental Life Insurance*
Your employer has elected Blue Cross and Blue Shield of Texas as your new life insurance carrier. During this transition of coverage, Blue Cross and Blue Shield of Texas is offering a Special One Time Modified Open Enrollment to currently enrolled employees. During this Special One Time Modified Open Enrollment, you may elect or increase coverage amounts for yourself, your spouse and/or your children, based on the guidelines below:
• Employee
Currently enrolled employees may increase current coverage amounts up to the plan’s Guarantee Issue amount of $150,000 without completing Evidence of Insurability.
• Spouse
Currently enrolled spouses may increase current coverage amounts up to the plan’s Guarantee Issue amount of $30,000 without completing Evidence of Insurability.
• Child
We do not require EOI for coverage amounts of $10,000 or less
As you consider new or additional coverage amounts during this Special One Time Modified Open Enrollment, we have included a Benefit Summary and Rate Grid that will provide plan details and cost associated with coverage options. (For more information, see the Supplemental Life Open Enrollment link below.)