PPO Blue

For PPO Blue members only without a Health Care FSA: 

As Highmark continues to “go green”, effective May 9, they will discontinue printing/mailing paper Explanation of Benefits (EOBs) when there is a $0 balance, or when there is only an office visit or emergency room copayment, due for a medical claim. You will be able to view these EOBs online at www.highmarkblueshield.com or by calling Highmark member services at 800-914-4384.  

All other types of claims will continue to generate paper EOB’s, unless you have chosen to receive EOBs through the Highmark website only.  

This change does NOT apply to those enrolled in the PPO Blue plan with an FSA or the PPO Savings plan with the HSA. Plan Activity Statements will continue to generate as usual.

It is important you compare each plan to select the plan that best fits your situation.  The PPO Blue plan has a deductible and then coinsurance, which is employee cost-sharing, after the deductible is satisfied.  Please see the link to to "compare each plan" for details regarding the deductible amounts.  If you are covering more than just yourself on the PPO Blue plan, please note that when ONE covered person reaches the $250 individual deductible, that one person's claims begin to pay at 90%; once any combination of other family members reach the remaining $250 FAMILY or $125 PARENT/CHILD deductible, then the plan begins to pay ALL of the family's medical claims at 90%. 

Value-Based Benefit Design (VBBD)

If you enroll in the PPO Blue Plan for 2016, you can take advantage of a new way to save on chronic health care conditions: Value-Based Benefit Design (VBBD).  You must enroll directly with Highmark EACH YEAR in order to receive the VBBD benefit. 

If you are diagnosed by your doctor with high blood pressure, high cholesterol and/or diabetes (type 1 or type 2), you can enroll in VBBD. Office visits, lab work and medical supplies are covered at 100% with no copays or coinsurance for these conditions when you enroll in this voluntary program.

To be eligible for this coverage, you must opt in with Highmark beginning January 1, 2016. You must also remain in the PPO Blue Plan and follow your in-network doctor’s plan of care. For more information on VBBD or to opt-in, call Highmark at 800-914-4384 beginning January 1.

Premiums

2016 PPO Blue Plan (Faculty & Staff)
Plan Type $30,000 $40,000 $50,000 $60,000 $75,000 $85,000 $100,000 $140,000
Individual
(1.81% of Salary)
$45.28 $60.37 $75.47 $90.56 $113.20 $128.30 $150.94 $211.31
2-Person
(4.40% of Salary)
$110.05 $146.74 $183.42 $220.11 $275.13 $311.82 $366.84 $513.58
Parent/Child(ren)
(4.08% of Salary)
$101.98 $135.97 $169.97 $203.96 $254.95 $288.95 $339.94 $475.91
Family
(5.61% of Salary)
$140.37 $187.16 $233.95 $280.74 $350.93 $397.72 $467.91 $655.07

Teamsters Bi-Weekly Premiums

Payroll contributions will be determined based on your annual base salary as of October 31, 2015. Your new payroll contribution amount is effective January 1, 2016 and will remain the same for the entire year.

2016 PPO Blue Plan (Teamsters)
Plan Type $25,000 $30,000 $35,000 $40,000 $45,000 $50,000 $60,000
Individual
(2.37% of Salary)
$22.79 $27.35 $31.90 $36.46 $41.02 $45.58 $54.69
2-Person
(5.12% of Salary)
$49.23 $59.08 $68.92 $78.77 $88.62 $98.46 $118.15
Parent/Child(ren)
(4.78% of Salary)
$45.96 $55.15 $64.35 $73.54 $82.73 $91.92 $110.31
Family
(6.42% of Salary)
$61.73 $74.08 $86.42 $98.77 $111.12 $123.46 $148.15

Additional Resources