Name of Manual - Blue Cross and Blue Shield of Minnesota

Health Care Options
Blue Selections Benefit plans that use the Blue Precision network of tiered
providers based upon quality of care and cost effective care.
Members receive the highest level of benefits by utilizing
providers in Tier 1.
Options Blue HRA/HSA Options Blue is the suite of consumer-directed health care
solutions. The components of Options Blue are a high-deductible
open access health plan (CMM or PPO), alongside an account that
is funded by the employer or employee, or both, that helps pay for
eligible out-of-pocket expenses (please note that HRAs can only
be funded by the employer). In most cases, any dollars that are
unused in the account at the end of the benefit year will roll over
and be added to new dollars in the next benefit year. The dollars
can be used to help pay for future out-of-pocket health care
expenses. Additionally, the Blue Cross Health Support member
health improvement tools (including Dedicated Nurse support,
Healthy Start and 24-Hour Nurse Advice Line) add to the overall
value of the product.
Comprehensive Major
Medical
From a health plan perspective, this plan works like any other
high-deductible health plan. Members are responsible for paying
providers for services that are not paid by the health plan.
Available account funds can be used by members to pay their
provider(s) for eligible care not reimbursed by the health plan.
Employers have an option to allow employees to have account
funds go directly to the provider. Providers will receive a check
directly from SelectAccount ® , the account administrator.
The Comprehensive Major Medical (CMM) plan is designed for
employer groups and individuals who are willing to pay a small
portion of their medical bills and still receive protection against the
costs of major illness or injury. This plan covers eligible medical
services, such as inpatient and outpatient hospital services, at a
percentage after a deductible. Preventive Care and well-child care
is covered at 100 percent under this plan.
Several calendar-year deductible and out-of-pocket maximum
options are available. Generally, the higher the deductible, the
lower the cost for comprehensive coverage.
Once the deductible has been met, CMM pays a percentage of the
allowed amount for all eligible expenses, up to an established outof-pocket
maximum. If eligible expenses during a calendar year
exceed the out-of-pocket maximum, CMM pays 100 percent of the
allowed amount through the end of that calendar year.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (12/27/10) 5-7