/ Human Resources

Medical Plans at a Glance

2024–25 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 $700 per person; $1,400 family maximum $1,700 if you have single coverage; $3,400 if you have two-person or family coverage
Primary Care office visits $25 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 $50 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 $250 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. $7,150 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)
FOR MORE INFO REVIEW:  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 (+$80 per pay) may apply
Salary <$33,500K
Single: $37.43
Two-Person*: $108.70
Family*: $158.66

Salary $33,500K–$70K
Single: $47.93
Two-Person*: $139.71
Family*: $205.65

Salary $70K–$100K

Single: $57.82
Two-Person*: $163.59
Family*: $240.62

Salary >$100K
Single: $62.29
Two-Person*: $177.79
Family*: $258.94
Single: $16.00
Two-Person*: $38.50
Family*: $55.00