/ Human Resources

Medical Plans at a Glance

2018/19 in-network Plans

  Blue (Traditional) Plan Orange (HDHP) Plan
Preventive Care (per BCBSM Guidelines) 100% coverage. Not subject to deductible. 100% coverage. Not subject to deductible.
Deductible $500 per person; $1,000 family maximum $1,500 if you have single coverage; $3000 if you have two-person or family coverage
Primary Care office visits $20 copay. Not subject to deductible. 80% coverage after deductible is met.
online office visits $10 copay. Not subject to deductible. $40 fee. Not subject to deductible.
urgent care and Specialist Office Visits $40 copay. Not subject to deductible. 80% coverage after deductible is met.
Ambulance $50 copay. Not subject to deductible. 80% coverage after deductible is met.
 Emergency room visits $150 copay. Not subject to deductible 80% coverage after deductible is met.
Most other covered services (see Benefits at a Glance below for exceptions of services covered at lower percent) 80% coverage after deductible is met. 80% coverage after deductible is met.
Annual out-of-pocket maximum $2,500 per person; $5,000 family maximum $4,000 if you have single coverage. $6,650 if you have two-person or family coverage.
auto accident exclusion (benefits are not payable under the plan for injuries received in a accident involving a motor vehicle) FAQ?

Yes, applicable.

Yes, applicable.

 Benefits at a glance Blue BAAG Orange BAAG
 summary of benefits and coverage (for review of both in-network and out-of-network coverage) BCBSM Plan Blue (coming soon) BCBSM Plan Orange (coming soon)
Employee premiums (per pay period, two times/month)

*additional spouse surcharge (+$50 per pay) may apply
Salary <$29K
Single: $32.32
Two-Person*: $88.20
Family*: $116.60

Salary $30K-$70K
Single: $39.43
Two-Person*: $106.98
Family*: $141.42

Salary $70K–$100K

Single: $45.34
Two-Person*: $119.49
Family*: $157.95

Salary >$100K
Single: $46.61
Two-Person*: $122.85
Family*: $162.39
Single: $9.07
Two-Person*: $23.90
Family*: $31.59