/ Human Resources

Medical Plans at a Glance

2017/18 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 BCBSM Plan Orange
Employee premiums (per pay period, two times/month)

*additional spouse surcharge (+$50 per pay) may apply
Salary <$29K
Single: $31.53
Two-Person*: $86.05
Family*: $113.76

Salary $30K-$70K
Single: $38.28
Two-Person*: $103.86
Family*: $137.30

Salary $70K–$100K

Single: $43.91
Two-Person*: $115.73
Family*: $152.98

Salary >$100K
Single: $45.03
Two-Person*: $118.70 
Family*: $156.90
Single: $8.22
Two-Person*: $21.96
Family*: $29.03