Medical

 

Medical coverage helps you and your family with the costs of maintaining good health and treating illness or injury. Schneider Electric offers you three options to choose from, or you can decline medical coverage:

  • Core Consumer-Directed Health Plan (CDHP) + HSA
  • Buy-up Consumer-Directed Health Plan (CDHP) + HSA*
  • Core Preferred Provider Organization (PPO)

* If you are not eligible for an HSA, you can enroll in the Buy-up CDHP option with NO HSA.

Learn about your plan options.

All options cover the same features, including:

  • Free, in-network preventive care such as annual physicals, wellness exams, cancer screenings and immunizations;
  • The same BCBSIL network of providers; and
  • Prescription drug coverage through Express Scripts.**

** If you live in Puerto Rico, your medical and prescription drug coverage is administered by Triple S (Blue Cross and Blue Shield of Puerto Rico). You will receive a separate insert regarding coverage details and cost.

Below are some key differences for you to consider.

CDHP + HSA Options: best value at any age

Young and healthy? Nearing retirement? Or somewhere in between? No matter where you are in your health journey, the CDHP + HSA options can save you money on health care. Though they have higher deductibles, you get:

  • Health Savings Account (HSA), which lets you pay for eligible health care expenses with tax-free money. Schneider Electric contributes to your HSA to help offset the deductible — that’s free money for you.
  • Lower costs from your paycheck. Consider contributing to your HSA the difference in your cost for medical coverage between the Core PPO and a CDHP option to use toward the higher deductible or to save and invest in your HSA.
  • Choice. The HSA empowers you to decide when to use your money: now or save it for later.

PPO Option

The Core PPO option has higher employee contributions per pay period but a lower annual deductible than the CDHP + HSA options. And since this option doesn’t include an HSA, you will not receive a Company HSA contribution.

Meeting the deductible

The way you meet your deductible varies by plan option.

In the Core CDHP + HSA and Core PPO…

  • Once one person’s claims reach the single deductible amount, that person can then begin receiving benefits and just pay the coinsurance amount.
  • Once one person reaches the single out-of-pocket maximum, the plan will pay 100% for that person for the remainder of that calendar year.

In the Buy-up CDHP + HSA…

  • All of the family’s eligible expenses added together must reach the family deductible amount before paying coinsurance for any family member.
  • The family deductible can be met by one family member or a combination of family members.
  • All of the family’s eligible expenses added together must reach the family out-of-pocket maximum before the plan will pay 100% for any family member for the remainder of that calendar year.
Is your provider/pharmacy in the network?

BCBSIL provider network

To see if your provider is in the network, or to find a new provider, go to bcbsil.com and click on the Find a Doctor or Hospital link:

  • Search as a guest > Click the search in-network provider link > Answer the questions >
    • Select the Participating Provider Organization (PPO) network.
    • For Georgia, Florida, New Hampshire, St. Louis area, Kansas City area and the Washington D.C./Maryland/Virginia area, select the appropriate network.

For help finding a network provider, call BCBSIL. Your health advocate will help you find skilled providers who are proven to be high performers.

If you use a provider outside of your network, your claim will be processed as out-of-network and subject to a separate out-of-network deductible and out-of-pocket maximum.

Pharmacy network

To find an in-network pharmacy near you, sign in at Express-Scripts.com > Locate a Pharmacy. If you are a first-time visitor to Express-Scripts.com, first register, using your member ID number.

Comparing medical plan options

Plan provision Core CDHP + HSA Buy-up CDHP + HSA Core PPO
You pay
in-network
You pay
out-of-network
You pay
in-network
You pay
out-of-network
You pay
in-network
You pay
out-of-network
Deductible
Single $2,800 $5,600 $1,450 $2,900 $600 $1,200
Family $5,600 $11,200 $2,900 $5,800 $1,200 $2,400
Health Savings Account
Single Company contributes $700 NA
Family Company contributes $1,400 NA
Out-of-pocket maximum1
Single $5,600 $11,200 $4,450 $8,900 $3,700 $7,400
Family $11,200 $22,400 $7,150 $17,800 $7,400 $14,800
Coinsurance2
20% 40% 20% 40% 20% 40%
Office visit
Preventive care Free Not covered Free Not covered Free Not covered
Primary care physician Subject to deductible and coinsurance $30 copayment Subject to deductible and coinsurance
Specialist Subject to deductible and coinsurance $50 copayment Subject to deductible and coinsurance
Telehealth through MDLIVE $44; subject to deductible and coinsurance No coverage $44; subject to deductible and coinsurance No coverage $30 copayment No coverage
Urgent care Subject to deductible and coinsurance $50 copayment
Emergency room Subject to deductible and coinsurance
Hospital admission Subject to deductible and coinsurance
Prescription drugs3
Retail (30 day supply)
Generic 20% (after you meet the annual deductible) 40% (after you meet the annual deductible) 20% (after you meet the annual deductible) 40% (after you meet the annual deductible) $10 copayment
Preferred brand 20% coinsurance
($30 min / $60 max)
Brand 40% coinsurance
($60 min / $120 max)
Mail order (90 day supply)4
Generic 20% (after you meet the annual deductible) No coverage 20% (after you meet the annual deductible) No coverage $25 copayment
Preferred brand 20% coinsurance
($75 min / $150 max)
Brand 40% coinsurance
($150 min / $300 max)

1. The out-of-pocket maximum includes expenses paid toward your deductible, as well as medical and prescription drug copayments and coinsurance amounts.

2. The coinsurance is calculated based on the allowed amount under the medical plan. For out-of-network care, you may be responsible for any amount billed in excess of the allowed amount. The coinsurance for bariatric surgery or certain organ transplants is 10% if treatment received at a BCBSIL Blue Distinction Centers Plus facility.

3. For preventive drugs in the CDHP + HSA options, the deductible does not apply. You pay 20% coinsurance for preferred brand and brand name drugs, nothing for generics.

4. Specialty drugs under the Core PPO will be $75 min/$150 max for preferred brand and $150 min/$300 max for brand for up to a 90-day supply.

Why Scott Simms picked the Core CDHP + HSA.

Tips for better health and savings

Get rewarded for your healthy habits.

Available to you and your spouse (if they’re covered on a Schneider Electric medical plan), Virgin Pulse can help you prioritize well-being goals and activities each day.

  • Healthy habits: Select healthy habits you want to focus on and track your progress.
  • Challenges: Work toward your goals in a fun, competitive atmosphere by joining corporate challenges. You can even challenge yourself – or your friends – to live a healthier life by creating your own personal challenges.
  • Activity tracking: Tracking activities through Virgin Pulse – like steps, workouts and sleep – helps you visualize your progress and earn rewards! Track easily by syncing on your phone or on your activity tracker, or enter your activities manually.
  • Reach your goals: Get help to stay focused on achieving specific health goals with resources like sleep and nutrition guides as well as personal health coaches.
  • So much more: Get more fuel for your daily well-being goals by exploring everything Virgin Pulse has to offer, including Journeys, virtual fitness and mindfulness sessions and more!

Hear how Kara Greer uses the workout reminders from Virgin Pulse.