- Core Consumer-Directed Health Plan (CDHP) + HSA
- Buy-up Consumer-Directed Health Plan (CDHP) + HSA1
- Core Preferred Provider Organization (PPO)
1. You must meet certain eligibility requirements to make or receive contributions to an HSA, including the Company contribution. If you are not eligible for an HSA, you can enroll in the Buy-up CDHP option with no HSA. See HSA and the SPD for more details.
Learn about your plan options.
All options2 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.
2. 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). If you live in Hawaii, your medical and prescription drug coverage is administered by UHA Health Insurance.
Below are some key differences for you to consider.
CDHP + HSA Options: a good 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),3 which lets you pay for eligible health care expenses with tax-free money. Schneider Electric contributes to your HSA, which can be used 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.
3. You must meet certain eligibility requirements to make or receive contributions to an HSA, including the Company contribution. If you are not eligible for an HSA, you can enroll in the Buy-up CDHP option with no HSA. See HSA and the SPD for more details.
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 qualify for an HSA, you will not be able to contribute to an HSA or receive a Company HSA contribution.
Meeting the deductible and out-of-pocket maximum
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.
- 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.
- The family deductible and/or family out-of-pocket maximum can be met by one family member or a combination of family members.
Is your provider in the network?
To see if your provider is in the BCBSIL network, or to find a new provider, go to bcbsil.com and click on the Find a Doctor or Hospital link. Seach as a guest > enter the location where you would like to search for care and then select the Participating Provider Organization (PPO) network.
- NOTE: In certain areas, you must select the applicable network: Florida, Georgia, Kansas City area, New Hampshire, New Jersey, St. Louis area, Tennessee, the Washington D.C./Maryland/Virginia area and Wisconsin. Find your network in the SPD or through Rewards@Schneider.
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.
Travel & lodging reimbursement
If you need a covered medical procedure or service that isn’t available within a 50-mile radius of your home, the Core CDHP, Buy-up CDHP, and Core PPO options administered by BCBSIL cover eligible travel & lodging with a $10,000 lifetime maximum reimbursement if received from an in-network provider (or a provider who is approved to provide services on an in-network basis) outside of that 50-mile radius, subject to certain IRS and administrative requirements.
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 (combined with prescription drug)|
|Health Savings Account|
|Single||Company contributes $700||NA|
|Family||Company contributes $1,400||NA|
|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||$48; subject to deductible and coinsurance||No coverage||$48; subject to deductible and coinsurance||No coverage||$30 copayment||No coverage|
|Urgent care||Subject to deductible and coinsurance||$50 copayment|
|Emergency room||Subject to in-network deductible and coinsurance|
|Hospital admission||Subject to deductible and coinsurance|
- The out-of-pocket maximum includes expenses paid toward your deductible, as well as medical and prescription drug copayments and coinsurance amounts.
- 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 and certain organ transplants, as well as cardiac, knee, hip, maternity and spine services is 10% if treatment is received at a BCBSIL Blue Distinction Centers+ facility.