Employees: 2019 Medical Plus Plan

  • The Medical Plus Plan is a preferred provider organization (PPO) plan that provides protection against major health care costs and provides full preventive care benefits. It has a higher deductible than traditional medical plans but offers you an opportunity to contribute to a tax-free health savings account (HSA). The HSA allows you to save tax-deductible money in a special bank account to help you pay eligible out-of-pocket health care expenses. Funds in your HSA continue to accrue from one year to another.

  • The EAP is offered though Premera with ComPsych® GuidanceResources® Program. Services are available to all members of your household and include:

    • EAP services—Up to five visits per incident for counseling, management referral, training/seminars, critical incident stress management response services, management consultation
    • FamilySource®: Referrals to adult care, elder care, child care and concierge services such as event planning and shopping
    • LegalConnect®: Unlimited access to on staff attorneys, as well as referrals
    • FinancialConnect®: Unlimited access to on staff financial experts
    • GuidanceResources® Online: Award-winning website with tips, tools and resources


    24 hours a day, 7 days a week


    When you join Alere’s program they’ll help you create an easy-to-follow Quitting Plan that will show you how to get ready, take action and live the rest of your life as a non-tobacco user.

    Your Quitting Plan will include:

    Quit Guide. We’ll send you an easy-to-use printed workbook you can reference in any situation to help you stick with your Quitting Plan.

    Quitting Aids. We’ll help you decide which type, dose, and duration of nicotine substitute or medication is right for you, and teach you how to use it so it really works.

    Quit Coach. You will have expert phone support and assistance whenever you need it.


    24 hours a day, 7 days a week (excluding Thanksgiving Day, Christmas Day, and Independence Day)


    Deductible $1,350 Employee only
    $2,700 Employee + 1*
    $3,350 Employee + 2 or more**
    Out-of-Pocket Maximum (in-network services) $3,425 Employee only
    $6,850 Employee + 1*
    $7,500 Employee + 2 or more**

    *Individual + 1 -The aggregate deductible and aggregate out-of-pocket maximum will apply. This means that any combination of family members can satisfy the aggregate deductible and out-of-pocket maximum. 

    ** Individual + 2 or more - the aggregate deductible will apply. This means that any combination of family members' expenses can satisfy the aggregate deductible. The out-of-pocket maximum for any individual each year is $6,850. Once an individual has reached this amount, the out-of-pocket max will be considered met for that individual. The balance of the family deductible must be reached by other covered family members for the out-of-pocket max to be considered met for all enrolled family members.

    Preventive Care

    Preventive Care Guidelines

    Routine physical exams, well-child visits, immunizations and sports physicals

    In-network: Covered in full

    Out-of-network: Deductible, then 35%

    Preventive Screenings

    Cancer screenings: mammograms, PAP smears, colonoscopies, prostate PSA screenings and more

    General blood tests: cholesterol, triglycerides, thyroid and more

    Other: bone density studies, type 2 diabetes and sexual health screenings

    In-network: Covered in full

    Out-of-network: Deductible then 35%

    Medical Office Visits

    In-network: Deductible, then 15%

    Out-of-network: Deductible, then 35%

    In-network Pharmacy

    Medical Plan deductible applies

    Retail pharmacy, specialty drugs and mail-service:

    15% after medical deductible.

    Certain preventive generic prescription drugs for the prevention or recurrence of heart disease are covered in full and not subject to the annual deductible. These include medications for high cholesterol, high blood pressure and cholesterol, high blood pressure and diabetes

    Emergency Room Care

    Deductible, then 15%

    Note: Emergency room care is always covered at the highest benefit level, regardless of whether or not the hospital is part of the BlueCard PPO network. However, if you receive emergency care at a non-preferred hospital, you may be responsible for any amount that exceeds the allowed cost.

    Chemical Dependency

    In-network: Deductible, then 15%

    Out-of-network: Deductible, then 35%

    Search for a Preferred Provider in the Premera Find a Doctor tool.

    Mental Health

    In-network: Deductible, then 15%

    Out-of-network: Deductible, then 35%

    Search for a Preferred Provider in the Premera Find a Doctor tool.

    BlueCard Program Access to an extensive nationwide network of doctors, hospitals and other medical-care providers through the BlueCard program. In-network benefits, when you're away from home in the United States and in more than 200 countries.

    Benefits for vision hardware or contact lenses:

    • Adults – covered up to $200 every two calendar years -- no deductible
    • Pediatric (age 0-18) – frames are limited to one pair every two calendar years and lenses are limited to one pair per calendar year OR one year supply of contact lenses.

    You are no longer eligible to contribute to an HSA if any of the following apply during the plan year: 

    • You are enrolled in other medical coverage that is not considered by the IRS to be a Qualified High-Deductible Health Plan*, 
    • You are enrolled in Medicare,
    • You are claimed as a dependent on someone else's tax return*,
    • Your spouse has a health care flexible spending account (FSA) or health reimbursement arrangement (HRA), even if you disclaim coverage,
    • You have received Veterans Affairs (VA) benefits within the last three months or are enrolled in TRICARE.

    If you are receiving VA benefits for a service-connected disability, and are currently not on TRICARE, you may be eligible to contribute to an HSA. 

    *For more detailed information, refer to IRS Publication 969, "Health Savings Accounts and Other Tax-Favored Health Plans," which you can download from the IRS web site or order by calling 800-TAX-FORM. 

    Your HSA is offered through HSA Bank, an independent provider of health savings account products and services. It's an account you own, which allows you to save for health care expenses on a pre-tax basis. Keep the money in your account to earn interest, pay for future health care expenses or use the money to pay for current expenses.

    To determine your eligibility for an HSA, refer to the "Am I Eligible for an HSA?" accordion. If you are not eligible to contribute to an HSA, you can contribute to the regular health care FSA.

    Contribution limits for 2019
    You can contribute up to the yearly maximum to your HSA via pre-tax payroll deductions.

    2019 MPP Coverage Level Total 2019 HSA Annual Limit, including any company contributions* 
    Employee Only $3,500
    Employee +1 or More $7,000

    *This annual limit would include any pre-tax payroll contributions, post-tax contributions or employer contributions, if any.

    If you will be age 55 or older during the plan year, you can contribute an additional $1,000 "catch up" contribution to the amounts.

    Maximums are adjusted for inflation annually by the IRS. Enrollment in plan requires a $52 minimum annual contribution for your HSA, based on $2 per pay period contribution requirement. You may change the amount you contribute monthly by contacting the ESC.

    Using your funds

    The money in your HSA is yours to keep. You take the money with you, even if you change employment. And, you don't have to use the money by a certain date. The longer you leave money in your account, the more interest it will earn.

    In general, your HSA can be used for:

    • Expenses applied to your medical or dental plan deductible
    • Dental care services
    • Vision care services
    • Prescription services
    • Over-the-counter medications prescribed by your doctor**
    • Certain medical equipment

    Beginning 2011, your Health Savings Account may no longer be used for over-the-counter drugs, unless you have a written prescription from your provider.

    For more information about your health savings account, please read HSA Bank Annual IRS Contribution Limits or Standard HSA Rates & Fee Schedule.

    Investing your HSA

    You can increase the potential future value of your HSA by investing money from your account in mutual funds. Your account with HSA Bank gives you access to investing with TD AmeriTrade or Devenir Financial. There's no minimum HSA balance required, so you can choose how much you want to invest, none, some or all of the money in your Health Savings Account.

    TD AmeriTrade offers self-directed investing with access to stocks, bonds and over 11,000 mutual funds. Devenir Financial offers managed accounts with access to a variety of mutual funds. Please note, there may be transaction fees or annual fees associated with these accounts.

    All money transferred into and out of your investment accounts must also pass through your HSA Bank account, and is subject to the distribution rules of the Health Savings Account. Investments with TD AmeriTrade or Devenir Financial are not FDIC-insured.

    For more information about investment options, go to HSA Bank.com

    FSAs help you save eligible out-of-pocket health and dependent care expenses by using pre-tax dollars. You can spend the funds any way you like, for you and your family. WageWorks administers your FSA accounts.

    If you are eligible for and open
    an HSA:

    You can also enroll in the Special Purpose FSA. This account allows you to reduce your taxable income while helping you pay for eligible dental, vision and post-deductible medical expenses. Once your Medical Plus Plan deductible is met, you can use the account to reimburse all eligible health care expenses.

    If you are not eligible for or choose to not open an HSA:

    You can enroll in the regular health care FSA. You can use the account to reimburse all eligible health care expenses. While you are not restricted in using expenses in this account for dental and vision expenses it is "use it or lose it".

    In 2019 the maximum you can contribute to a health care or Special Purpose FSA is $2,700.

    You also have the option of a Dependent Care Flexible Spending Account through WageWorks.

    Important Note : Flexible spending accounts are annual accounts. You must use the money in your FSA by the end of the year or you forfeit the remaining balance.

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