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  • Learn about the plan

  • Making health care work better

    The Health Connect Plan, offered through Premera, provides personalized, coordinated care and cost predictability to help simplify managing your health.

    The Health Connect network

    The Health Connect Plan is built around a select group of providers on the Eastside, primarily located in Redmond/Bellevue/Kirkland and other areas on the east side of Lake Washington. Health Connect Plan providers share Microsoft’s goal of delivering a more personalized health care experience in an effort to help you achieve improved health outcomes over time. Since Health Connect network providers are primarily concentrated on the Eastside, the Plan is only offered to employees who live in King and Snohomish counties.

    A personalized and coordinated approach to your health care

    In the Health Connect Plan, you are encouraged to work closely with a Health Connect network primary care provider (PCP) of your choice. Your PCP gets to know your health care needs and goals and helps coordinate your care. Learn more about PCPs in the Health Connect Network.

    Predictable out-of-pocket costs when you see Health Connect network providers

    You pay a convenient copay for many basic services, such as office visits and prescription medications, making your out-of-pocket costs predictable. When you see a provider in the Health Connect network, your out-of-pocket costs for other services, like lab work and inpatient care, are also lower. Plus, you do not have to pay an annual deductible.

    The flexibility of no referrals

    Even though you have a PCP, and one benefit of this plan is to coordinate care through your PCP, you still have the freedom to see any provider, including specialists, in the Health Connect network without a referral. You can also see any provider in the Extended network, but your out-of-pocket costs will be higher.

    Less administrative work to save you time

    When you see Health Connect network providers, there may be fewer claims to review or bills to reconcile because you pay copays for many services. Copays are typically due at the time of service, so there is no need to send you another bill after your service.

    A dedicated service center for all your questions

    Call 800-676-1411 and select Health Connect Navigator for personalized service, such as help with finding providers, answering plan questions, making appointments, and much more.

    How you pay for care

    Your out-of-pocket costs depend on the type of provider you use and whether that provider is in the Health Connect network. Your out-of-pocket costs are lower and more predictable when you see a Health Connect network provider. If you see providers in the Extended network, you are still covered by the Plan, but your out-of-pocket costs may be higher.

    There are certain types of services, such as chiropractic and acupuncture, where your costs are the same whether you see a provider in the Health Connect or Extended network. This gives you access to a wide range of these providers.

    Access the Provider Finder tool for a complete list of providers. For more information about plan benefits, see Health Connect Plan at a glance below.

    Costs based on network

    You pay nothing for these services:

    • Preventive care
    • Preventive prescription medications (generic)
    • Routine vision exam
    • Vision hardware (Under age 19: one pair of glasses or one year of contacts; age 19+: up to $350 per calendar year)

    You only pay a copay for many common services, including:

    • Office visits for PCPs and specialists, including chiropractors, acupuncturists, and massage therapists
    • Non-preventive prescription medications
    • Emergency room visits
    • Mental health and chemical dependency outpatient visits
    • Physical, occupational, and speech therapy
    • Telehealth, including Teladoc
    • Nutrition therapy
    • Hearing exams
    • Vision therapy

    For most other services you pay 10% coinsurance and Premera covers the rest:

    • Hospital inpatient care
    • Hospital outpatient care/ASC (surgery)
    • Maternity
    • Diagnostic testing such as lab tests and X-rays

    Remember: If you use Health Connect network providers, you don't have to pay an annual deductible.

    You pay nothing for these services:

    • Preventive care
    • Preventive prescription medications (generic)
    • Routine vision exam
    • Vision hardware (< age 19: one pair of glasses or one year of contacts; age 19+: up to $350 per calendar year)

    40% coinsurance after you meet your annual deductible for most services such as:

    • Office visits for PCPs and specialists
    • Hospital stays

    Copays for certain services, including:

    • Emergency room visits
    • Mental health and chemical dependency outpatient visits

    Note: Certain services are covered at the Health Connect network level even when you visit an Extended network provider, which means lower out-of-pocket costs for you. Examples include:

    • Applied Behavior Analysis (ABA)
    • Audiology
    • Chiropractic, acupuncture, and massage therapy
    • Diagnostic services such as lab tests and X-rays
    • Durable medical equipment
    • Hearing aids
    • Mental health and chemical dependency treatment
    • Naturopathic care
    • Optometry
    • Physical, occupational, and speech therapy
    • Nutritional therapy

    You pay the annual deductible and then 50% of the allowable charges for most out-of-network services. Out-of-network providers may not accept the allowable charge as payment in full. You are responsible for paying the difference between the allowable charge and the amount your out-of-network provider charges.

    Health Connect Plan at a glance

    The table below provides an overview of the Health Connect Plan benefits. For more information, see the Summary Plan Description.

    Feature Health Connect network Extended network Out-of-network
    Annual deductible None $1,000 per person; $3,000 per family, shared with Out-of-network $1,000 per person; $3,000 per family, shared with Extended network
    Copayments $20 PCP visit; $40 specialist/other office visit Not applicable Not applicable
    Annual out-of-pocket maximum $2,000 per person; $6,000 family
    Amount plan pays for covered services
    Ambulance 90% 90%, deductible does not apply 90%, deductible does not apply
    Autism/ABA therapy 90% 90%, deductible does not apply 50% of allowable charges, after deductible
    Chiropractic, massage, and acupuncture services (when medically necessary) 100% after $40 copay; deductible does not apply 50% of allowable charges, after deductible
    Combined 24-visit limit per year for Health Connect, Extended, and Out-of-network
    Contraception 100% 100%, deductible does not apply 50% of allowable charges, after deductible
    Diabetes health education 100% 100%, deductible does not apply 50% of allowable charges, after deductible
    Emergency room care & professional services 100% after $250 copay (waived if admitted)
    Home health care 90% 60% after deductible 50% of allowable charges, after deductible
    Hospice care 90% 60% after deductible 50% after deductible
    Hospital inpatient and outpatient 90% 60% after deductible 50% of allowable charges, after deductible
    Infertility 90% of covered benefits, within the Progyny provider network Not applicable Not applicable
    Lab tests and X-rays 90% 90%, deductible does not apply 50% of allowable charges, after deductible
    Maternity care 90% 60% after deductible 50% of allowable charges, after deductible
    Medical equipment and supplies 90% 90%, deductible does not apply 50% of allowable charges, after deductible
    Mental health, attention deficit disorder, substance abuse, and alcoholism treatment

    *In no event will the outpatient copay exceed 40% of the allowed amount.
    Inpatient: 90%
    Outpatient: 100% after $20 copay per visit
    Inpatient: 90%, deductible does not apply
    Outpatient: 100% after $20 copay* per visit; deductible does not apply
    Inpatient: 50% of allowable charges, after deductible
    Outpatient: 50% of allowable charges, after deductible
    Microsoft CARES
    Employee Assistance Program
    100% of 12 sessions per issue per year (up to 24 sessions per year total) Not covered
    Office visit PCP visit: 100% after $20 copay
    Specialist/other office visit: 100% after $40 copay
    Office visit: 60% after deductible
    Specialist/other office visit: 60% after deductible
    Office visit: 50% of allowable charges, after deductible
    Specialist/other office visit: 50% of allowable charges, after deductible
    Prescription drugs—Retail

    Generic: 100% after $10 copay; deductible does not apply
    Brand preferred: 100% after $30 copay; deductible does not apply
    Brand non-preferred: 100% after $60 copay; deductible does not apply

    Generic: 50% of allowable charges, after deductible
    Brand preferred: 50% of allowable charges, after deductible
    Brand non-preferred: 50% of allowable charges, after deductible
    Prescription drugs—Mail order
    (90-day supply)

    Generic: 100% after $20 copay; deductible does not apply
    Brand preferred: 100% after $60 copay; deductible does not apply
    Brand non-preferred: 100% after $120 copay; deductible does not apply

    Not covered
    Preventive care

    Preventive services: 100%, deductible does not apply
    Preventive generic prescription drugs: 100%, deductible does not apply

    Preventive services: 50% of allowable charges, after deductible
    Preventive generic prescription drugs: 50% of allowable charges, after deductible

    Routine hearing exam and hardware Exam: 100% after $40 copay Exam: 100% after $40 copay Exam: 50% of allowable charges, after deductible
    Hardware: 90% up to $3,000 hardware limit per member in a period of three consecutive calendar years
    Skilled nursing facility (120-day maximum per calendar year) 90% 60% after deductible 50% of allowable charges, after deductible
    Urgent care 100% after $40 copay 60% after deductible 50% of allowable charges, after deductible
    Vision care Exam: 100%, deductible does not apply for 1 routine visit per calendar year Exam: 50% of allowable charges, after deductible for 1 routine visit per calendar year
    Vision hardware: Under age 19 – 1 pair of glasses or one-year supply of contacts; Age 19 and up – $350 maximum per calendar year
    Lasik: The lifetime benefit for Lasik surgery is $1,000. Surgery can be performed by any in-network provider. Additional procedures are included, including implantable lens surgery. Not applicable

    New to Microsoft? Compare medical plans

    Microsoft provides three industry leading medical plan options for Puget Sound employees:

    • Health Connect Plan
    • Health Savings Plan
    • Health Maintenance Organization (HMO) Plan

    Here are some tools to help you decide if the Health Connect Plan is right for you.

    Determine if the Health Connect Plan meets your needs

    What are your priorities when choosing a medical plan?

    • You can continue to see your current providers.
    • Your out-of-pocket costs are as predictable as possible, including prescription medications.
    • You have a complex health issue and want to make managing it as easy as possible.
    • You have covered family members who live outside the Puget Sound area that need access to care.
    • Others?

    See how the Health Connect Plan might work for you based on your priorities.

    Compare plan benefits

    Although the plans all provide comprehensive coverage, the plans work differently and the amount you pay out-of-pocket for the same covered services may vary. Learn more about the key features and important differences between plans before deciding which plan is right for you.

    See a detailed plan comparison or watch a video.

      Health Connect Plan Health Savings Plan Health Maintenance Organization (HMO) Plan
    Plan type Accountable Care Organization High-Deductible Health Plan with a Health Savings Account Health Maintenance Organization
    Availability Residents in Washington’s King and Snohomish counties Residents in all states Residents in Washington and California
    Getting care
    • Work closely with the primary care provider (PCP) of your choice who gets to know you and your health needs and goals and helps coordinate your care with other providers
    • Referrals are not required to see a provider, but you will pay less out-of-pocket if you see a provider in the Health Connect network
    • Most services provided outside the Health Connect and Extended networks are covered at 50% of the allowable charges after the deductible.
    • Choose any provider you like, but you typically pay less when you use a provider in the Premera Blue Cross network
    • You are generally responsible for coordinating your health care needs
    • You and your primary care provider coordinate your care with other providers within the Kaiser Foundation Health Plan of Washington network
    • Generally, you can self-refer for specialty care within the Kaiser network
    • In most cases, services provided outside the Kaiser network are not covered, with the exception of emergency care
    Includes coverage for prescription medications and vision
    Preventive care 100% covered
    Out-of-pocket costs No premiums, no payroll deductions for employees and eligible dependents
    Health Connect Network:
    • Copays for many common health care services, such as office visits and prescription medications, except for preventive care (covered at 100%)
    • No deductible and limited coinsurance
    • The maximum out-of-pocket cost per year is $2,000 individual and $6,000 family (including out-of-pocket costs incurred under the Extended network).
    Extended network:
    • A deductible applies before the plan begins to pay for most services, except preventive care (covered at 100%)
    • The maximum out-of-pocket cost per year is $2,000 individual and $6,000 family* (including out-of-pocket costs incurred under the Health Connect network)
    • A deductible ($1,500-$3,750) applies before the plan begins to pay for services, except for preventive care (covered at 100%)
    • The maximum out-of-pocket cost per year is $2,500 individual and $6,250* and the Microsoft contribution (and any additional employee contributions) to your HSA may be used toward at least a portion of these expenses
    • Copays for most outpatient services except for preventive care (covered at 100%)
    • No deductible and limited coinsurance
    • The maximum cost per year is $1,500–$4,500*
    Provider network Health Connect Network:
    • Eastside Health Network
      • EvergreenHealth
      • Overlake Medical Center & Clinics  
      • Independent physician practices
    • Allegro Pediatrics
    • Living Well Health Center (Redmond campus)
    Extended network:
    • Premera Blue Cross (nationwide)
    • Premera Blue Cross (nationwide), including Eastside Health Network, Allegro Pediatrics, and broader Blue Cross and Blue Shield
    • Living Well Health Center (Redmond campus)
    • Kaiser Permanente (Washington, and during travel to other Kaiser Permanente states)
    • Living Well Health Center (Redmond campus)
    • Allegro Pediatrics
    Cash from Microsoft
    • None
    • Microsoft contributes tax-free money to an HSA: $1,000-$2,500* for employees in levels 40-49 and 59 and above roles†
    • None
    Tax-free savings opportunities for health care
    • Flexible Spending Account
    • Health Savings Account
    • Dental & Vision Flexible Spending Account
    • Flexible Spending Account

    *Based on coverage tier

    †For employees in levels 30-39 and 50-58 roles, the Microsoft HSA contribution is $1,500-$3,750.

    For detailed information about each plan, refer to the Summary Plan Description.

    Explore which plan someone with similar health care priorities might choose

    Sometimes it helps to see which plan others with similar life or health situations might choose. Click on the scenario that is most relevant to you to see additional considerations for choosing a medical plan.

    Balancing family needs

    Managing the health care needs of your family can be complex. Find out which plan can help simplify your health care experience.

    Balancing needs

    New to U.S. health care

    Find out which plan can help ease the burden of learning a new health care system.

    New to U.S. health care

    Managing a complex or chronic health condition

    Learn which plan can help you manage multiple health care providers and unpredictable out-of-pocket costs.

    Complex health care needs

    Low health care needs

    Learn what you should consider, even if you don't use much health care right now.

    Fewer health care needs

    Get answers to your questions

    Check the FAQs for answers to common questions. For personalized service, call the Microsoft-dedicated customer service team at (800) 676-1411 (TTY: 711), 5:00 a.m. to 8:00 p.m. Pacific Time, Monday through Friday, or email Microsoft@premera.com.