Frequently Asked Questions

When you choose the CDHP, you will pay for care differently than with the PPO plan:

1. First, you’ll pay for coverage with any money you’ve elected to deduct from each paycheck for deposit into your HSA.
2. When you receive preventive care services during the year, like annual physicals, kids’ check-ups, and immunizations, the plan will pay 100% of the cost.
3. The Partnership will also set aside HSA dollars to help you pay for some of your care during the year. You can use these dollars to pay for health care expenses like doctor’s visits and prescriptions.
4. If you need to see a primary care physician (PCP) or specialist, use urgent care, or even visit the ER during the year, you will pay the full BCBS-discounted cost of the visit. For example, if your specialist has negotiated a $90 office-visit cost with BCBS, then you will pay $90 to go to the doctor.
5. You will continue to pay for your care until you reach an annual deductible. Few employees ever need enough care to meet their deductible during the year.
6. If you need a lot of care and you meet your deductible during the year, the plan will cover 90% of the cost for your care until you reach the out-of-pocket maximum. After that, the plan will pay 100% of in-network covered services for the remainder of the plan year.

Want to see how the PPO stacks up to the CDHP? Click here to see how the plans compare in real-life situations.

1. First, you’ll pay your medical premiums through money deducted from each paycheck.
2. When you receive preventive care services during the year, like annual physicals, kids’ check-ups, and immunizations, the plan will pay 100% of the cost.
3. If you need to see a primary care physician (PCP) or specialist, or use urgent care, you will pay a copay without having to first pay a deductible. If you need to visit the ER during the year, you will pay coinsurance (a percentage of the total cost of the ER visit), but only after you first meet your deductible.
4. If you need a lot of care and you satisfy your out-of-pocket maximum, the plan will pay 100% of in-network covered services for the remainder of the plan year. Few employees ever need enough care to meet their out-of-pocket maximum.

Want to see how the PPO stacks up to the CDHP? Click here to see how the plans compare in real-life situations.

There are several differences between the plans:

• There is a big difference between the paycheck costs. If you enroll in the PPO for Employee + Family coverage for non-tobacco user rates, you’ll pay twice as much as you will for the Employee + Family, non-tobacco user rates in the CDHP.
• With the CDHP, you don’t pay any copays. So, if you are sick or hurt and get care, you will pay the full, BCBS-discounted cost for that doctor or facility. Remember, the Partnership is providing $1,000, $1,500, or $2,000, depending on your coverage level, in your HSA to help with care you may need during the year.
• If you need a lot of care during the year and you reach your deductible, you continue to pay copays, and the plan begins to cover a percentage of the other costs of your care (80% in the PPO and 90% in the CDHP), until you meet your out-of-pocket maximum. Once you reach the out-of-pocket maximum, the plan picks up 100% of the cost of in-network covered services.
• When you select the CDHP, the Partnership will set up an HSA for you and deposit either $1,000 (employee coverage), $1,500 (employee + spouse), or $2,000 (all other coverage levels) to help with your health care expenses. If you are eligible for benefits as of January 1, you will receive one half of your HSA dollars in January and the second half in July. If you are eligible for benefits as of February 1, a portion will be deposited into your HSA each pay period.
• With the CDHP option, you can also put tax-free money aside from your paycheck to pay for health care expenses. Your money will be added to the Partnership’s HSA dollars to pay for expenses now, or even years down the road.

Click here to see how the plans compare in real-life situations.

The CDHP and PPO plans are very different plans, but they do have some things in common. For example:

• Both options provide comprehensive coverage and use the same, nationwide network of doctors and providers, managed by Blue Cross Blue Shield (BCBS).
• When you receive preventive care services during the year, like annual physicals, kids’ check-ups and immunizations, the plan will pay 100% of the cost, regardless of the option you pick.
• If you, or any of your covered family members over the age of 18 use tobacco, you will pay more for coverage in both options. So, if you want to avoid paying more for medical coverage, it’s time to kick the habit and/or encourage your family member(s) to do the same.
• Both options also have a deductible that you must meet before the plan will pay for certain services, as well as an out-of-pocket maximum that limits the amount you pay out of pocket, in the event you need a lot of care during the year.