Medical plans

Coverage for your health journey

RAI offers two medical plan options so you can choose the one that best meets you and your family’s needs. The Advantage and the Standard Plan options use the same Blue Cross Blue Shield (BCBS) network and cover identical medical services. Both plans also provide prescription drug coverage through Express Scripts’ national network of pharmacies.

However, there are some important differences you should consider – like monthly premiums, deductibles and the ability to contribute to a Health Savings Account (HSA). This section will help you compare the two options.

ADVANTAGE PLAN STANDARD PLAN

Tax-favored HSA

HSA Startup Contribution*

$600

100% Preventive Care with no deductible

Coinsurance after deductible

Same percentage – both plans

Same percentage – both plans

Deductible

In-Network
$1,400 if individual coverage;
$2,800 if family coverage

In-Network
$600 per individual;
$1,800 per family

Out-of-Pocket Maximum

In-Network
$5,600 per individual;
$11,200 per family

In-Network
$4,200 per individual;
$12,600 per family

Deductibles and Coinsurance

(included in the out-of-pocket maximum)

Prescription Drugs

You pay the full cost for prescriptions for certain drugs until the deductible is met. Once met, you pay the same coinsurance as on the Standard Plan.

You pay coinsurance

On-site Health Centers

You pay the cost for your appointments ($3 – $30) until your deductible is met. Once met, there’s no cost to you.

No cost to you

Teladoc

You pay the cost for your appointments, $45.00, until your deductible is met. Once met, your cost is $4.50 per visit.

$4.50 per visit

Health Care FSA

*The Startup Contribution amount will be prorated to reflect the first month of enrollment during the calendar year.

What the plan pays

Program features Advantage Plan
(In-Network)
Standard Plan
(In-Network)

Preventive Care

Plan pays 100% with no deductible

Plan pays 100% with no deductible

Primary Care physician office visit

Plan pays 90% after deductible

Plan pays 90% after deductible

Walk-in clinic

Plan pays 90% after deductible

Plan pays 90% after deductible

Specialist office visit

Plan pays 80% after deductible

Plan pays 80% after deductible

Other covered medical services – hospital emergency room, ambulance outpatient services, labs and tests

Plan pays 80% after deductible

Plan pays 80% after deductible

Preventive care

Preventive care is an important part of maintaining your physical and emotional well-being. Tests, check-ups and counseling can help to prevent illnesses, disease and other serious health problems. Covered services include:

  • Blood pressure and cholesterol screenings
  • Cancer screenings
  • Mammograms and Pap smears
  • Contraception
  • Well-baby/Well-child care
  • Immunizations
  • Mental Health screenings

 

To find out more about the range of services available, check out the downloads below or contact BCBS at 888-868-5527.

Regardless of which plan you choose, preventive care services are covered 100%, at no cost to you.

Monthly premiums

ADVANTAGE PLAN STANDARD PLAN

Employee Only

$45

$75

Employee + Spouse/Domestic Partner

$190

$250

Employee + Child(ren)

$190

$250

Employee + Family

$336

$426

Taking the time to think about and analyze your medical plan needs and usage can help to ensure that you don’t overpay for your coverage.

FAQs

How do I know which plan is right for me?

The plan you chose this year might not be right for next year – but looking at your 2019 medical and prescription drug expenses is a good place to start. You can find your 2019 costs on the BCBS and the Express Scripts websites.

Once you know what you’ve spent in the past, think about how this year may be different. Are there expenses that you already know you’ll incur? Check the Express Scripts site to see the cost of your medications under the Advantage and the Standard Plans.

Once you’ve thought about the year ahead, consider your longer-term health care needs. Could you benefit by saving in an HSA so you can use tax-free dollars to pay for health care costs now and in the future? Remember that an HSA helps you build up savings through a triple-tax advantage – you benefit from pre-tax contributions and investments that grow tax-free, and won’t pay tax when you use your account to pay for health expenses.

Want another opinion? Talk to Ayco. They’re available to help you compare the two medical plan options so you can make the best choice for you.

How are the Advantage Plan and the Standard Plan similar?
  • Both use the BCBS network of providers throughout the United States.
  • Both cover the same medical services and prescription drugs.
  • Both have the same coinsurance for covered services.
  • Both cover preventive services at 100% – no cost to you.
  • Both plans include the deductibles and coinsurance in the out-of-pocket totals.
What are the differences between the Advantage Plan and the Standard Plan?

The Advantage Plan has a lower monthly premium than the Standard Plan, meaning that less comes out of your paycheck each month. For single coverage you would pay $360 less during 2019 if you enroll in the Advantage Plan. A family enrolled in the Advantage Plan will pay $1,080 less in premiums in 2019.

In addition, when you enroll in the Advantage Plan, you’ll receive a $600 Startup Contribution towards your HSA to spend on eligible health care costs. This is prorated based on the month you enroll in the Advantage Plan. The money’s yours – so, even if you don’t spend it or you choose to leave RAI – it will stay in your HSA.

In order to let you contribute to an HSA, the Advantage Plan must meet certain IRS requirements. As a result, the Advantage Plan has a higher deductible than the Standard Plan. That means you’ll pay more before the plan starts paying. In addition, if you have family coverage, the entire family deductible must be met before the Advantage Plan starts to pay for any members of your family.

Also because of IRS requirements, the deductible under the Advantage Plan applies to Teladoc, on-site health centers and non-preventive drugs. You’ll have to pay the full cost of these services until you meet your deductible. After you meet the deductible, the Advantage Plan plays the same as the Standard Plan.

The out-of-pocket maximum is higher under the Advantage Plan for single enrollees, but lower for the family.

Tools

Blue Cross Blue Shield
Visit the BCBS website to review your health care expenditure over the last couple of years
Express Scripts (ESI)
Visit the ESI website to review your prescription drug expenditure over the last couple of years.
Express Scripts Price Comparison
Compare the cost of your prescription drugs under the Advantage and Standard Plans. Remember, once the Advantage Plan deductible is met your cost is the same under each medical plan.
Health Equity
Find out more about HSAs and tax-favored savings
Ayco Financial Coaching
Access your financial coach for advice on your health care choices
Health Advocate
Understand your health insurance benefits and find In-Network providers with cost estimates

Downloads

Health insurance terms explained

Summary of coverage (2020)

Advantage Plan preventive medications list (2020)

BCBSNC preventive care services

HSA basics (2020)

Deciding which plan is right for you (2020)

Was this page helpful?

Yes No