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Table of Content

  1. Header
  2. Open Enrollment 2022
    1. HOW TO ENROLL
    2. QUALIFYING LIFE EVENTS
    3. MEDICAL
    4. Medical Plan
    5. Summary of Benefits and Coverage (SBC)
    6. Extras from BlueCross BlueShield of Texas
    7. PHARMACY
    8. HSA and HRA
    9. DENTAL
    10. Dental Plan Option
    11. VISION
    12. Vision Plan
    13. LIFE AND AD&D
    14. DISABILITY
    15. EMPLOYEE ASSISTANCE PROGRAM (EAP)
    16. WORKSITE BENEFITS
    17. CONTACT US
    18. Overview
    19. Welcome
  3. 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.

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

BlueCross BlueShield of Texas

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.



BCBS Logo

Medical Plan

BlueCross BlueShield of Texas

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)

BlueCross BlueShield of Texas

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.

PHARMACY

BlueCross BlueShield of Texas

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:


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.




DENTAL

BlueCross BlueShield of Texas

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

BlueCross BlueShield of Texas

Your available dental plan is shown in the chart below!




VISION

BlueCross BlueShield of Texas

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?

BlueCross BlueShield of Texas

A summary of your vision benefits is shown in the chart below!




LIFE AND AD&D

BlueCross BlueShield of Texas


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.)