/ Human Resources

Medical Plans at a Glance

2020/21 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 $600 per person; $1,200 family maximum $1,600 if you have single coverage; $3200 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. $49 fee until deductible met, then 80% coverage.
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 $3,000 per person; $6,000 family maximum $4,000 if you have single coverage. $6,900 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: Blue SOB&C Orange SOB&C
Employee premiums (per pay period, two times/month)

*additional spouse surcharge (+$75 per pay) may apply
Salary <$29K
Single: $33.94
Two-Person*: $94.37
Family*: $128.26

Salary $30K-$70K
Single: $41.40
Two-Person*: $114.47
Family*: $155.56

Salary $70K–$100K

Single: $47.61
Two-Person*: $127.85
Family*: $173.75

Salary >$100K
Single: $48.94
Two-Person*: $131.45
Family*: $178.63
Single: $12.50
Two-Person*: $27.50
Family*: $37.50