The Health Connect Plan, offered through Premera, provides personalized, coordinated care and cost predictability to help simplify managing your health.
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.
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.
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.
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
Starting January 1, 2021, we’re simplifying the paperwork for maternity care with the new Maternity Bundle. Microsoft members enrolled on the Health Connect Plan are eligible. You will pay a single $500 copay for your routine maternity care, including
professional prenatal and delivery care. This new benefit is available to employees, their enrolled spouses/domestic partners, and eligible dependent children. In addition, the Health Connect Plan now offers a $1,000 allowance, per pregnancy,
for doula services. More information is on the FAQ.
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.
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.
Within the Health Connect network
You pay nothing for these services:
You only pay a copay for many common services, including:
For most other services you pay 10% coinsurance and Premera covers the rest:
Remember: If you use Health Connect network providers, you don't have to pay an annual deductible.
Within the Extended network
You pay nothing for these services:
40% coinsurance after you meet your annual deductible for most services such as:
Copays for certain services, including:
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:
Out of network
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.
The table below provides an overview of the Health Connect Plan benefits. For more information, check the Summary Plan Description.
2021 Benefits at a glance
When you see providers in the Extended network, each dependent only needs to meet the individual deductible before the Plan starts paying coinsurance for that family member. And, once you meet
the family deductible, the Plan pays coinsurance for the whole family, even those who haven't met their individual deductible, up to the out-of-pocket maximum.
Your out-of-pocket maximum works in the same way: each family member can reach their individual out-of-pocket max, and you can reach the family out-of-pocket max without reaching each individual's
Once you reach your out-of-pocket max, the Plan pays for the full cost of care.
Generic: 100% after $10 copay, deductible does not applyBrand preferred: 100% after $30 copay, deductible does not applyBrand non-preferred: 100%
after $60 copay, deductible does not apply
Generic: 100% after $20 copay, deductible does not applyBrand preferred: 100% after $60 copay, deductible does not applyBrand non-preferred: 100%
after $120 copay, deductible does not apply
Check the Health Connect Plan Drug Formulary.
Preventive services: 100%, deductible does not applyPreventive generic prescription drugs: 100%, deductible does not apply
Check the Preventive Care Services List.Check the Preventive Drug List.
Preventive services: 50% of allowable charges, after deductiblePreventive generic prescription drugs: 50% of allowable charges, deductible does not apply
Microsoft provides three industry leading medical plan options for Puget Sound employees:
Here are some tools to help you decide if the Health Connect Plan is right for you.
What are your priorities when choosing a medical plan?
See how the Health Connect Plan might work for you based on your priorities.
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.
Plan comparison chart
When you see providers in the Extended network, each dependent only needs to meet the individual deductible before the Plan starts paying coinsurance for that family member. And, once
you meet the family deductible, the Plan pays coinsurance for the whole family, even those who haven’t met their individual deductible, up to the out-of-pocket maximum.
Your out-of-pocket maximum works in the same way: each family member can reach their individual out-of-pocket max, and you can reach the family out-of-pocket max without reaching each
individual’s out-of-pocket max.
Individual (Subscriber-Only) Deductible The “Individual Deductible” is a fixed amount the subscriber must incur and satisfy before benefits of this plan are provided.
Family Deductible The “Family Deductible” is the amount the entire family (subscriber plus one or more enrolled dependents) must incur and meet in total each calendar
year before benefits are provided. The family deductible is an “aggregate” amount, meaning that it can be met by one family member, or all family members in combination. Benefits
are not provided for any family member until the total family deductible has been reached.
*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.
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.
Managing the health care needs of your family can be complex. Find out which plan can help simplify your health care experience.
Find out which plan can help ease the burden of learning a new health care system.
Learn which plan can help you manage multiple health care providers and unpredictable out-of-pocket costs.
Learn what you should consider, even if you don't use much health care right now.
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.