It's time for Open Enrollment!
Enrollment Dates: 10/17/2022 - 10/25/2022
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.
Using your desktop or mobile, you have access to our online benefits enrollment platform 24/7. In your Paycom portal you can:
Download the Paycom Mobile App from Google Play or the App Store to get started or 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.*
Your premiums for medical, dental, vision insurance, and contributions to FSA accounts (Health Care and Dependent Care FSAs) 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:
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.
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 www.bcbstx.com under “Find Care”. Select "Find a Doctor or Hospital" and then you can search by provider/facility name or search by specialty.
Did You Know?
You have 2 medical plans to choose from. Compare the options in the chart below!
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!
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.
Through Blue Access for Members (BAM) our secure member website, you can access health plan information, resources and tools. The information can vary, depending on your plan.
Blue Access Mobile 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
As a BCBSTX member, you have access to a range of programs that can help you get and stay healthy.
Prescription drugs are a vital part of your health care coverage. If you have prescription drug coverage through Blue Cross and Blue Shield 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 www.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.
Review your prescription costs for each plan in the chart below!
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 at www.bcbstx.com under “Find Care”. Select "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 Center 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.
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 Summaries. There is one for each plan!
You have 2 dental plans to choose from. Compare the options in the chart below!
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 https://member.eyemedvisioncare.com/bcbstx/en
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:
Looking for more details about how items are covered? Click on the link below to view the formal Benefit Summary.
A summary of your vision benefits is shown in the chart below!
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 2x your annual earnings up to $250,000. You can get up to $100,000 in coverage without answering any health questions. 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.
Flexible Spending Accounts (FSA) allow you to reduce your taxable income by setting aside pre-tax dollars from each paycheck to pay for eligible out-of-pocket health care expenses for yourself, your spouse and your dependent children.
MAXIMUM ANNUAL CONTRIBUTION
For the 2022 plan year, you can contribute up to $2,850
Up to $570 of unused funds. All other remaining funds will be lost.
The Dependent Care FSA can reimburse you for daycare expenses provided for your dependents so that you (and your spouse, if you are married) can work. Care must be for a dependent child under the age of 13 or a dependent of any age that lives in your household and is incapable of self-care
MAXIMUM ANNUAL CONTRIBUTION
For the 2022 plan year, you can contribute up to $5,000 ($2,500 if married and filing separately).
This coverage is available to you, your spouse, your children, your siblings, and even you and your spouse’s parents and grandparents!
Long term care insurance may help you avoid a far more difficult decision: whether to exhaust your savings or liquidate your assets to pay for a period of long term care. This policy may help you be prepared for the financial realities and help you maintain control of some important decisions, such as:
What is long term care?
Whether it's due to a motorcycle accident or a serious illness, it is the type of care you may need if you couldn't independently perform the basic activities of daily living: bathing, dressing, using the toilet, transferring from one location to another, continence and eating, or if you suffered severe cognitive impairment from a condition such as Alzheimer's disease.
Won't my other insurance pay for long term care?
Only long term care insurance may cover those costs and allow you to maintain as much of your assets as possible.
IMPORTANT: Once eligible for the plan as a new hire, you will have 30 days to sign up for Guarantee Issue coverage. Anyone who enrolls after the Guarantee Issue enrollment period or choose benefits over the Guarantee Issue limits will be required to fill out a medical questionnaire.
As an employee, you are eligible for benefit amounts on a Guarantee Issue basis of up to and including $4,000 and a Facility Benefit Duration of 3 or 6 years. This does not require completion of the Long Term Care Insurance Application (medical questionnaire) if you apply during your initial eligibility period.
The Long Term Care Insurance Application (medical questionnaire) is required if enrolling after your initial eligibility period or if you choose to buy $5,000, $6,000 or the Unlimited Duration coverage.
All Family Members must complete the Benefit Election form, the Long Term Care Insurance Application (medical questionnaire) and must be approved for coverage in order to enroll in the Long Term Care plan.
Your EAP is designed to help you lead a happier and more productive life at home and at work. Call for confidential access to a Licensed Professional Counselor who can help you.
Counselors can help you with:
You can also reach out to a specialist for help with balancing work and life issues. Just call and one of our Work/Life Specialists can answer your questions and help you find resources in your community.
Ask your Work/Life Specialists about: