Health

Medical

We are proud to offer you a choice between three different medical plans that provide comprehensive medical and prescription drug coverage. The plans also offer many resources and tools to help you maintain a healthy lifestyle. Following is a brief description of each plan.

BCBS HDHP with HSA Plan

HDHP WITH HSA PLAN

The High-Deductible Health Plan (HDHP) gives you the freedom to seek care from the provider of your choice. You will maximize your benefits and reduce your out-of-pocket costs if you choose a provider who participates in the BCBS network. In addition, the HDHP comes with a health savings account (HSA) that allows you to save pre-tax dollars* to pay for any qualified health care expenses as defined by the IRS, including most out-of-pocket medical, prescription drug, dental and vision expenses.

* Tax free under federal tax law (state taxation rules may apply).

Here’s how the HDHP with HSA Plan works:

  1. Annual Deductible: You must meet the entire annual deductible before the plan starts to pay for non-preventive medical and prescription drug expenses. NOTE: If you enroll one or more family members, you must meet the full FAMILY deductible before the plan starts to pay expenses for any one individual.
  2. Coinsurance: Once you’ve met the plan’s annual deductible, you are responsible for a percentage of your medical expenses, which is called coinsurance. For example, the plan may pay 80 percent and you may pay 20 percent.
  3. Annual Out-of-Pocket Maximum: Once your deductible and coinsurance add up to the plan’s annual out-of-pocket maximum, the plan will pay 100 percent of all eligible covered services for the rest of the calendar year. NOTE: If you enroll one or more family members, you must meet the full FAMILY out-of-pocket maximum before the plan starts to pay covered services at 100 percent for any one individual.
  4. Health Savings Account (HSA): You may contribute to your HSA through pre-tax payroll deductions to help offset your annual deductible and pay for qualified health care expenses. In addition, we will contribute $1,000 annually to your HSA if you enroll in employee-only coverage and $1,500 annually if you enroll yourself and one or more family members. To be eligible for the HSA, you cannot be covered through Medicare Part A or Part B or TRICARE programs. See the plan documents for full details.

Important: Your contributions, in addition to the company’s contributions, may not exceed the annual IRS limits listed below.

Your HSA is yours for life. The money is yours to spend or save, regardless of whether you change health plans,* retire or leave the company. There is no “use it or lose it” rule. Your account grows tax free over time as you continue to roll over unused dollars from year to year. You decide how or if you want to spend your HSA funds. You can use it to pay for you and your dependents’ doctor’s visits, prescriptions, braces, glasses—even laser vision correction surgery.

*You must be enrolled in a qualified health plan to contribute to an HSA.

BCBS Mid Plan

MID PLAN

The Mid Plan gives you the freedom to seek care from the provider of your choice. However, you will maximize your benefits and reduce your out-of-pocket costs if you choose a provider who participates in the BCBS network. The calendar-year deductible must be met before certain services are covered.

BCBS Buy-Up Plan

Buy-Up Plan

Like the Mid Plan, the Buy-Up Plan is a preferred provider organization (PPO) plan, which means you have access to a network of health care providers who have contracted with BCBS to provide you services at reduced costs. You will typically pay less when you visit a health care provider who is part of BCBS’s network.

Of the three plans, the Buy-Up Plan has the lowest deductibles and out-of-pocket maximums. This means your out-of-pocket costs under the Buy-Up Plan are theoretically lower than under the HDHP or Mid Plan. On the other hand, you will pay higher premiums.

Medical Plan Highlights

Health Risk Assessment

You and your covered spouse must complete an annual health risk assessment (HRA).

What is an HRA?

The annual HRA is a confidential, comprehensive metabolic blood panel that measures cholesterol, diabetes, liver functions, chemistry levels, nutrition, hypertension and more. It is intended to provide you with a snapshot of your overall health. You can then discuss your personal health profile and risk index with a doctor of your choice, prepare a plan of action and track trends that are essential to healthy living.

Important: Each year, you and your covered spouse are required to have an annual HRA to receive preferred health insurance premiums. If you and your covered spouse do not complete get an HRA/comprehensive metabolic blood panel, you will not receive the $50 each (maximum $100) per month discounted premiums for the upcoming plan year.

How do I get an HRA/comprehensive metabolic blood panel?

The easiest way to get a comprehensive metabolic blood panel is to use UTMB’s lab services at 2660 Gulf Fwy. South, Exit 20 (Next to Hobby Lobby).  UTMB has a standing order to provide League City employees and spouses with this lab work. No appointment or physician order is required for an HRA.

Alternatively, you may complete your comprehensive metabolic blood panel using a non-UTMB physician. If your doctor’s office does not provide on-site lab draw services, you will need a doctor’s order and should be directed by your physician to an in-network lab provider. Once Cigna processes your claim and reports it to the City, you will be given credit for completing your HRA. You do not need to file any paperwork with Human Resources.

How much will it cost to get an HRA/comprehensive metabolic blood panel?

A comprehensive metabolic panel billed with a wellness/preventive diagnosis is covered at 100 percent for covered employees. If you are using a non-UTMB provider, make sure that he/she bills the comprehensive metabolic blood panel with a “wellness/preventive” diagnosis code. If the lab work is billed with a “diagnostic” billing code, your deductible and coinsurance could apply.

Health Care Tools & Resources

League City not only provides medical coverage to help you stay well—we also offer a variety of programs, tools and resources to help you make informed health care decisions.

OneRx

OneRx

Save an average of $750 on your prescriptions with the free OneRx app. You can use the app to:

  • View your personal out-of-pocket costs for drugs prescribed at your local pharmacy
  • Access special discounts and coupons
  • Find out whether step therapy or prior authorization is required before you try to fill a prescription
  • Track your medications and stay up to date on the drug list status

For more information and to download the app, go to www.onerx.com.

BCBS Telemedine

BCBS Telemedicine

BCBS members have access to Telemedicine, which is a convenient and cost-effective way to get quick medical advice by phone, online or on your mobile device about many non-emergency conditions including:

  • Allergies
  • Cold and flu symptoms
  • Ear infections
  • Diarrhea and constipation
  • And more!

Whether you are at home, work or on the road, you can get the care you need when and where it’s convenient for you. Even better: doctors can write a prescription, if needed, that you can pick up at an in-network pharmacy.

To get started, log into bcbstx.com.

Urgent & Convenient Care Centers

Urgent Care Centers

Receive immediate care for non-life-threatening illnesses and injuries at a walk-in urgent care clinic. Urgent care centers often cost less than the emergency room, and offer evening, weekend and 24-hour services. Appointments may be needed. For a list of nearby Urgent Care Centers, click here. (Please note: provider network status may change, so you should verify network status prior to receiving care.)

Convenient Care Centers

Located in some pharmacies, drug stores and grocery stores, these small clinics offer lower cost, basic health care services. Get flu shots and treatment for minor illnesses like strep throat, pink eye, cuts and scrapes. Convenient care clinics are open days, evenings and weekends. You do not need to make an appointment beforehand. Convenient care centers are located in the following areas:

Rediclinic

2955 Gulf Fwy S
League City, TX
877-935-0333

Minuteclinic

2469 Bay Area Blvd
Houston, TX
866-389-2727

Minuteclinic

2900 Broadway St.
Pearland, TX
866-389-2727

Minuteclinic

2800 Bayport Blvd
Seabrook, TX
866-389-2727

Dental

We are proud to offer you a choice between three different dental plans.

Cigna DHMO

Cigna DHMO

With this plan, you choose a primary dental provider to manage your care. There are no charges for most preventive services, no claim forms and no deductibles. Reduced, pre-set charges apply to other services.

Cigna Low PPO Plan

Cigna In-Network (Low) PPO Plan

This plan offers you the freedom and flexibility to use the dentist of your choice. However, you will maximize your benefits and reduce your out-of-pocket costs if you choose a dentist who participates in the Cigna network. If you receive in-network services, you will be responsible for any applicable cost sharing, negotiated charges after benefit maximums are met and costs for non-covered services.

Cigna High PPO Plan

Cigna High PPO Plan

This plan offers you the freedom and flexibility to use the dentist of your choice. However, you will maximize your benefits and reduce your out-of-pocket costs if you choose a dentist who participates in the Cigna network. If you receive out-of-network services, you will be responsible for any applicable cost sharing, charges in excess of the benefit maximum, charges in excess of the negotiated fee schedule amount and charges for non-covered services.

Dental Plan Highlights

Vision

We are proud to offer you a vision plan through Davis Vision. This plan gives you the freedom to seek care from the provider of your choice. However, you will maximize your benefits and reduce your out-of-pocket costs if you choose a provider who participates in the Davis Vision network.

Vision Plan Highlights

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