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Choosing Your Health Plan:

Plan A, Plan B or Plan C - QHDHP with HSA

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You have access to all health plans regardless of where you live.

You have choices when it comes to your health care coverage. Choosing the appropriate health plan for you and your family may be easier than you think!

The State Employee Health Plan offers three health options:

plan a

plan b

plan c

Please review the Health Plan Comparison Chart to see the differences of the deductible, coinsurance and annual coinsurance maximums for Plans A and B.

Click Here for State Health Comparison Chart

Click Here for Non-State Groups Health Comparison Chart

Here are a few differences to note:

  • Plan A has a deductible - Plan B does not
  • The Primary Care and Specialists office visit copays for dependents under the age of 18 are lower on Plan B
  • Coinsurance percentages are different
  • Coinsurance maximums are lower on Plan A

Both plans A and B have the Quest Lab Card available. The Plan A Lab Card benefit is new this year.

Plan C has a few differences including:

  • Premiums paid for coverage are lower than those paid for Plan A and Plan B.
  • The deductible you must pay under Plan C is higher but your employer provides you with a contribution to your Health Savings Account that can be used to help you meet your deductible. See "Health Savings Account" below for details.
  • With Plan C, the Caremark Preferred Drug List is the same as Plans A and B however, the benefits are different. Plan C coverage requires prescription drugs to be subject to the overall plan deductible and then you will pay copayments. Also, under Medicare Part D rules, Plan C drug coverage is not considered "creditable coverage."
  • Plan C drug coverage includes a generic incentive program. Members who have generics available to them will pay more for brand name drugs.
  • When you choose dependent coverage under Plan C, you must meet the entire family deductible before the plan pays benefits.
  • Most covered services are subject to the deductible and coinsurance. See the Health Plan Comparison Chart included with this booklet to see the deductibles, coinsurance and annual coinsurance maximums for Plan C.

Health Savings Account with Plan C

Each option is designed differently (for example, deductibles, coinsurance and annual maximums).

There are four health plan vendors:

  • Blue Cross and Blue Shield (Plans A & B Only)
  • Coventry Health Care
  • Preferred Health Systems
  • UMR, A United Healthcare Company

Each health plan vendor has a different network of preferred providers. Network providers have agreed to accept the plan allowance as payment in full. Non network providers have not agreed to accept the plan allowance so any amount above that will be your responsibility.

In addition, each health plan vendor offers unique features. Be sure that you take into consideration these features before making your selection.

All options offer the following:

  • Access to a broad network of providers nationwide which allows you flexibility in obtaining care with coverage for both network and non network providers.
  • 100 percent coverage for certain preventive care services, such as annual exams, colonoscopy screenings, mammograms and age-approporiate immunizations (including flu shots and allergy shots).
  • No dollar limit on the care you may need during the lifetime of the policy.
  • Prescription drug coverage through Caremark. Click here for more information about CVS Caremark.