Blue Access for Producers

BlueEdge Select HCA Overview


The BlueEdge Select HCA plan is available to groups with 51or more employees

Blue Cross and Blue Shield of Illinois offer a variety of Consumer Driven Health Plans (CDHP’s) which can help your clients control rising health care costs. The BlueEdge plan puts employees in charge of their health by giving them the power to decide how their health care dollars are spent, and by providing online member resources to help them manage their health plan and make informed decisions about their health. The BlueEdge Select plans offer a reduction in premium prices since the smaller Blue Choice Select network is used. Here is what makes BlueEdge HCA an exciting option.

ADVANTAGES:

  • The account pays for the client’s covered health care claims until the balance is depleted. These claims are applied to meeting the deductible.
  • Preventative care services are covered at 100 percent in-network even before the deductible is met, so these claims are not deducted from the Health Care Account.
  • BlueEdge provides a seamless approach to claims, paying claims automatically from the Blue Choice Select PPO benefit plan.
  • Employees do not pay for services up front or submit claims for reimbursement.
  • Employers only fund claims as they are paid, so unused account balances remain part of the company’s cash flow.
  • Funds roll over year-to-year as long as the employee remains in the plan.
  • The total balance remains available to the employee as long as he/she participates in the plan; however, to limit the company’s financial liability, the amount that can accumulate in this account can be capped.
  • If the employee leaves the plan, the funds stay with the employer.

BENEFITS:

Preventive Care

  • Well-child and adult care, including immunizations
  • Screenings such as cholesterol, breast cancer, and cervical cancer

Services covered at 100 percent when received in network

Doctor and Hospital Care

  • Office visits
  • Hospital and Surgical care
  • Diagnostic testing
  • Emergency care benefits
  • Maternity care

Other Coverage

  • Rehabilitation therapy (physical, speech, and occupational therapy)
  • Prescription drug card benefits (mail service available for maintenance medications)
  • Vision discounts
  • Hearing aid discounts
  • Reconstructive surgery following a mastectomy

Utilization Management

  • Medical Services Advisory (pre-notify inpatient hospital stays)
  • Mental health/Substance abuse