Available ServicesAnnual physical exams, annual ob/gyn visits, pap smears, mammography screening, prostate screening, standard immunizations, and an annual eye exam are preventive procedures that are included. Other options offered to you are a 24-hour health information resource, Blue ExtrasSM free value-added discount programs, programs for asthma, diabetes, pregnancy, many chronic conditions, and online healthcare management.
Blue Options PPOBlue Options PPO offers you a convenient copayment for doctor's visits and prescription drugs. Annual physical exams, annual ob/gyn visits, pap smears, mammography screening, prostate screening, standard immunizations, and an annual eye exam are preventive procedures that are completely covered by the plan.
Blue Options SDHPBlue Options Straight Deductible is a consumer-driven health plan. There are no co-payments on this health plan and everything you pay for doctor's visits and prescription drugs goes towards meeting your annual deductible and maximum out of pocket spending allowances. Annual physical exams, annual ob/gyn visits, pap smears, mammography screening, prostate screening, standard immunizations, and an annual eye exam are preventive procedures that are completely covered by the plan. This plan may result in less out of pocket expenses for certain individuals.
Plan PairingIf the employee has no other health insurance, this plan is paired with a Health Savings Account through the Local Government Federal Credit Union into which the County and the employee can contribute money that can be used to pay for eligible medical expenses. If the employee has other health insurance, this plan is paired with a Health Reimbursement Account through TASC into which the County can contribute money that can be used to pay for eligible medical expenses.
CoverageWe have five different levels of coverage for you to choose from when deciding your health insurance. You may choose from the following:
- Employee Only
- Employee + Child
- Employee + Children
- Employee + Spouse
- Employee + Family
Blue Options PPO
Copayments: Primary Care $40, Specialist and Other Services pay 100% until you have met your deductible (20% after deductible is met)
Deductibles: $2,000 per year individual / $4,000 per year family
Coinsurance Maximum: $3,000 per year individual / $6,000 per year family
Prescription Benefit: $150 deductible / $4 – Tier 1, $45 – Tier 2, $60 Tier 3, 75% coinsurance Tier 4
Semi-Monthly / Monthly
Employee Only $38.63/ $77.25
Employee + Child $122.96 / $245.92
Employee + Children $182.22 / $364.43
Employee + Spouse $257.56 / $515.12
Employee + Family $260.63 / $521.26
Straight Deductible Plan
Copayments: Pay 100% until you have met your deductible
Deductibles: $1,500 per year individual / $3,000 per year family
Coinsurance Maximum: $2,000 per year individual / $2,000 per year family
Prescription Benefit: Pay 100% until you have met your deductible
Semi-Monthly / Monthly
Employee Only $25.75 / $51.50
Employee + Child $110.09 / $220.17
Employee + Children $169.34 / $338.68
Employee + Spouse $244.69 / $489.37
Employee + Family $247.76 / $495.51
Dependent EligibilityThe following dependents are eligible for enrollment:
- Your spouse.
- Your (or your spouse's) dependent children till their 26th birthday, including newborn children from date of birth, stepchildren, adoptive children from date of placement for adoption, foster children from date of placement in foster home, and children for whom health benefit coverage is required under a court or administrative order.
- An unmarried dependent child who is either mentally retarded or physically handicapped and incapable of self-support may continue to be covered under the Plan regardless of age if the condition exists and coverage is in effect when the child reaches the age of 26. The handicap must be medically certified by the child's doctor and may be verified annually by BCBSNC.
Enrolling/Making ChangesEmployees have 30 days from the date of a qualifying life event or 30 days from their date of hire to enroll or make changes to their health insurance policies. Otherwise, employees can only make changes during our annual open enrollment period.
Qualifying Life EventsIf you experience a qualifying life event, you must make changes to your health policy within 30 days of the event. Any change that you make must be consistent with your qualifying event. Qualifying events include, but are not limited to:
- Marriage, divorce, or legal separation,
- Birth or adoption (or placement of adoption) of a child,
- Death of a covered dependent
- Loss or gain of eligibility for insurance coverage for you or a covered
- Change in full-time student status