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The State offers three medical plan options so that employees can select the plan that best meets their needs as well as access providers in their geographic area. Each medical plan provides comprehensive coverage, with different levels of out-of-pocket expenses and premium contribution rates. A Vision Benefit and Prescription Drug Coverage are included with medical plan enrollment. All benefit eligible employees also have access to an Employee Assistance Program (EAP) and Wellness Resources. Deductibles and benefits for all plans are provided on a fiscal year, from July 1 through June 30.
Summaries of Benefits & Coverage (SBC):
FY22 PPO Plan FY22 Traditional Plan FY22 High Deductible PlanMedical Plan Comparison & Plan Contracts
| Feature Name | PPO In-Network | PPO Out-of-Network | Traditional | High Deductible |
|---|---|---|---|---|
| FY21 Plan Contracts | Active PPO - Updated | Active PPO - Updated | Active Trad - Updated | Active HDHP - Updated |
| FY21 Plan Summary | FY21 PPO SBC | FY21 PPO SBC | FY21 Trad SBC | FY21 HDHP SBC |
| Deductible - Individual | $350 | $600 | $450 | $2000 |
| Deductible - Family | $950 | $1,700 | $1,250 | $6,000 |
| Out-of-Pocket Limit - Individual | $3,250 | $6,500 | $4,300 | $5,000 |
| Out-of-Pocket Limit -Family | $6,750 | $13,500 | $8,600 | $10,000 |
| Plan Payment (% of allowable charges after deductible) | ChoiceDocs $10-$20 copay / 85% Non-ChoiceDocs $20-$40 copay / 85% | 70% | 80% | 70% |
| Wellness/Preventive Care | No copay for listed services | 70% | 100% | 100% |
| Telehealth/MDLive | $10 copy (Covered 100% during the Federal State of Emergency) | N/A | 80% (Covered 100% during the Federal State of Emergency) | 70% (Covered 100% during the Federal State of Emergency) |
For details about premiums, please see Premium Rates.
PPO Highlights
- You save money when you use In-Network Blue Cross of Idaho providers
- Most employees choose this plan
Traditional Highlights
- Less restrictive provider options, particularly useful for rural, out-of-network areas
- For non-BCI contracted providers, patient may be responsible for the balance of the bill after insurance has paid their portion
High Deductible Highlights
- Now HSA compatible therefore all services and prescriptions that are not preventive in nature are subject to the deductible before the plan begins to pay.
Please keep in mind that deductibles and benefit payments are based on allowable charges.
Details about the medical plans, exclusions and waiting periods, can be found in each medical plan document and Summary of Benefits & Coverage (SBC).
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