GBS DLL booklet 2016_Flip

2016 DLL Benefits Guide
Medical Insurance Coverage
The health and well being of you and your family is
important to DLL. DLL recognizes that, for many
people, medical coverage is the most important benefit,
and DLL is choosing to lead the market by subsidizing
the majority of the cost of your medical coverage. DLL
is partnered with Independence Blue Cross powered by
Highmark. DLL will continue to offer three plans: Blue
Cross EPO, Blue Cross PPO and Blue Cross HDHP
with HSA.
Important Note:
Preventive care is covered 100% at no cost to
you — no copays, no deductibles.
What is the Blue Cross Exclusive Provider
Organization (EPO) Plan?
The EPO is a more restrictive type of preferred provider
organization plan under which employees must use
providers from the specified network of physicians and
hospitals to receive coverage; there is no coverage for
care received from a non-network provider except in an
emergency situation. You do not have to select a PCP,
and you may go directly to any network provider
without a referral.
What is the Blue Cross Preferred Provider
Organization (PPO) Plan?
The PPO gives you preferred benefits when you use
providers who participate in the PPO network. Through
the PPO plan, you have the freedom to choose how
you access your health care. You do not have to select
a PCP, and you may go directly to any participating
provider (network provider) without a referral. You
may also visit nonparticipating providers at the nonpreferred
level of benefits, under which you are
responsible for paying a deductible and coinsurance
amount. It is recommended that you use network
providers to maximize the plan’s in-network benefit
schedule. Network providers are preferred providers
who have contractual arrangements with the plan to
provide medical services at a reduced rate.
What is the Blue Cross High Deductible Health Plan
with Health Savings Account (HDHP with HSA)?
The HDHP with HSA is a plan design similar to the PPO
plan with both in-network and out-of-network coverage,
giving you the freedom to choose how you access your
health care. You must meet your individual or family
deductible before the schedule of benefits begins.
By enrolling in a qualified high deductible health plan you
may be eligible to open an HSA account. The HDHP with
HSA gives you more control over how you spend, or
save, your health care dollars. It is a medical plan and a
savings account all in one. You can save for future
medical expenses by allowing your HSA funds to remain
in the account and earn interest, or you can use your
debit card to get instant access to your HSA dollars to
pay for qualified out-of-pocket expenses quickly and
easily. If the money in your HSA is used for qualified
medical expenses, it is tax-free upon withdrawal. DLL
will make biweekly contributions to your HSA, and the
amount and frequency that DLL contributes may vary
by year. You may make additional contributions on a
pretax basis into your HSA, subject to the IRS annual
HSA contribution limit. Members age 55 and over can
make an additional HSA catch-up contribution up to the
IRS limit. For additional information about HSAs,
including annual contribution limits, please refer to
IRS Publication 969 (www.irs.gov).
Important Note:
When you are using a lab for a blood draw, it is
important that you confirm the lab you are
utilizing is in the Blue Cross network. You can
check the current in-network labs at any time
on mybenefitshome.com. If you have blood
taken in your doctor’s office it will be
considered in-network as long as your
physician is in the network.
Deductible
The deductible is the dollar amount of covered
expenses you must pay before the medical plan starts
paying benefits. For example, if the plan has a $200
deductible, you pay the first $200 of your covered
expenses each year and this is referred to as “meeting
the plan deductible”. Once you have met the deductible,
the plan pays part of a covered expense and you pay the
rest (your copayment).
Copayment
A copayment (copay) is a flat fee that you pay each time
you receive certain in-network covered services, for
example doctor’s office visits.
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