New Health Insurance Rates

New health insurance rates have been set. You will see these new rates reflected in your February 18 paycheck.

Here are the details:

Health Insurance – Blue Cross Blue Shield HMO Blue NE w/2000 with HCCS and 4-tier RX plan.

Dental Insurance – Blue Cross Blue Shield Dental Blue

Vision Insurance – Blue Cross 20/20

Effective February 1, 2021 through January 31, 2022

	Blue Cross Blue Shield HMO Blue NE 2000 Hospital Choice Cost Sharing*
PCP Office	$25 per visit
Preventative Care	$0
Specialist Office Visit or Chiropractor Visit	$40 per visit
Labs, Diagnostic, X-ray, Including CT scans, MRIs, PET scans & Nuclear cardiac imaging	Deductible, then 100%*
Emergency Room	$150 per visit
Inpatient Hospital Co-pay Surgical Day Care (Outpatient surgery)	Deductible, then 100%*
Annual Deductible Individual / Family	$2,000 / $4,000
Prescription Drugs
Rx Deductible (calendar yr.)	$0
Generic / Preferred / Non-Preferred	$20/$40/$60/$120
Mail Order (90 days)	$40/$80/$120/$360
Out-of-Pocket Limit
Individual Out-of-Pocket Max.	$4,000
Family Out-of-Pocket Max.	$8,000

*additional fees may apply if you receive services at a higher cost hospital

RATES