BlueEdgeSM Select Direct HCA
(2-150 employees)
BlueEdge Select Direct Health Care Account (HCA) is a consumer-directed health plan that includes a Health Care Account to help employees pay for medical expenses and meet the annual deductible. The chart below presents the different BlueEdge Select Direct HCA plan design options and includes a comparison of in-network versus out-of-network benefits. Prescription drugs are covered at the medical coinsurance benefit noted in the chart below.
In-Network Benefits — 100% / 70% Coinsurance
| Coinsurance |
Deductible (Individual/Family) |
Out-of-Pocket Max* (Individual/Family) |
Office Visit Benefit** |
Emergency Room Benefit |
| 100% |
$1,500 / $3,000 |
$0 / $0 |
100% |
$75 copay |
Out-of-Network Benefits
| Coinsurance |
Deductible (Individual/Family) |
Out-of-Pocket Max* (Individual/Family) |
| 70% |
$1,500 / $3,000 |
$4,000 / $8,000 |
In-Network Benefits — 90% / 60% Coinsurance
| Coinsurance |
Deductible (Individual/Family) |
Out-of-Pocket Max* (Individual/Family) |
Office Visit/Emergency Room Benefit** |
| 90% |
$1,500 / $3,000 |
$1,500 / $3,000 |
Covered at 90%/90% |
| 90% |
$2,000 / $4,000 |
$2,000 / $4,000 |
Covered at 90%/90% |
Out-of-Network Benefits
| Coinsurance |
Deductible (Individual/Family) |
Out-of-Pocket Max* (Individual/Family) |
| 60% |
$1,500 / $3,000 |
$6,000 / $12,000 |
| 60% |
$2,000 / $4,000 |
$8,000 / $16,000 |
In-Network Benefits — 80% / 50% Coinsurance
| Coinsurance |
Deductible (Individual/Family) |
Out-of-Pocket Max* (Individual/Family) |
Office Visit/Emergency Room Benefit** |
| 80% |
$1,500 / $3,000 |
$1,500 / $3,000 |
Covered at 80%/80% |
| 80% |
$2,000 / $4,000 |
$2,000 / $4,000 |
Covered at 80%/80% |
Out-of-Network Benefits
| Coinsurance |
Deductible (Individual/Family) |
Out-of-Pocket Max* (Individual/Family) |
| 50% |
$1,500 / $3,000 |
$6,000 / $12,000 |
| 50% |
$2,000 / $4,000 |
$8,000 / $16,000 |
* The deductible is included in the out-of-pocket max
** The deductible must be met before the indicated benefits for office visit/emergency room applies
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