» Medical plans

	ADVANTAGE PLAN	STANDARD PLAN
100% Preventive Care with no deductible
Deductibles and Coinsurance (included in the out-of-pocket maximum)
Coinsurance after deductible	Same percentage – both plans	Same percentage – both plans
Deductible	In-Network $1,600 if individual coverage; $3,200 if family coverage	In-Network $800 per individual; $2,400 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
Tax-favored HSA		Not eligible
HSA Start-up Contribution*	$600	Not eligible
Health Care FSA
Prescription Drugs	You pay coinsurance once you have met any deductible	You pay coinsurance
Teladoc Medical and Behavioral Health	You pay 10% coinsurance once you have met your deductible	You pay 10% coinsurance
Onsite Health Centers	You pay a co-pay ($3-30) for your appointments until your deductible is met. Once met, there’s no cost to you	No cost

ADVANTAGE PLAN

STANDARD PLAN

100% Preventive Care with no deductible

Deductibles and Coinsurance
(included in the out-of-pocket maximum)

Coinsurance after deductible

Same percentage – both plans

Deductible

In-Network
$1,600 if individual coverage;
$3,200 if family coverage

In-Network
$800 per individual;
$2,400 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

Tax-favored HSA

Not eligible

HSA Start-up Contribution*

$600

Not eligible

Health Care FSA

Prescription Drugs

You pay coinsurance once you have met any deductible

You pay coinsurance

Teladoc Medical and Behavioral Health

You pay 10% coinsurance once you have met your deductible

You pay 10% coinsurance

Onsite Health Centers

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

No cost

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

Program features

Advantage Plan
(In-Network)

Standard Plan
(In-Network)

Preventive Care

Plan pays 100% with no deductible

Primary Care physician office visit

Plan pays 90% after deductible

Walk-in clinic

Plan pays 90% after deductible

Specialist office visit

Plan pays 80% after deductible

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

Plan pays 80% after deductible

	ADVANTAGE PLAN	STANDARD PLAN	ANNUAL DIFFERENCE
Employee Only	$57	$89	$384
Employee + Spouse/Domestic Partner	$214	$280	$792
Employee + Child(ren)	$214	$280	$792
Employee + Family	$372	$472	$1,200

ADVANTAGE PLAN

STANDARD PLAN

ANNUAL DIFFERENCE

Employee Only

$57

$89

$384

Employee + Spouse/Domestic Partner

$214

$280

$792

Employee + Child(ren)

$214

$280

$792

Employee + Family

$372

$472

$1,200


Acute Care – Acute care is the short-term treatment of severe injuries, illness, an urgent medical condition or recovery from surgery.	Generic Prescription (Drug) – A generic prescription is an FDA-approved medication that delivers the same dose, strength, administration and purpose as its branded counterpart. The active ingredients remain the same, but the generic drug is typically cheaper than the branded versions.
Allowed amount – the maximum amount BCBS will pay for a covered health care service. If you use a provider who is not in the BCBS network, you may have to pay the difference.	Health Savings Account (HSA) – An HSA allows you to save and pay for eligible out-of-pocket healthcare costs using pre-tax dollars. The money in your HSA is yours to keep. If you don’t use all of your savings in one plan year, the remaining balance will roll over to the next plan year. You’ll need to sign up the Advantage Plan (a high-deductible health plan) to open an HSA.
Beneficiary – A beneficiary is the person(s) or entity you select to receive the payout benefit from an insurance plan in the event of your death. It is important to ensure your beneficiary designations are up-to-date for insurances and retirement plans such as your Reynolds 401k.	High-deductible health plan – An HDHP offers lower premiums and higher out-of-pocket costs. These costs are capped by the plan’s in-network deductible. When you reach the deductible, your plan will split the cost of services with you. This is known as coinsurance and is also capped at a maximum. When you reach the coinsurance limit, the plan covers the remaining in-network costs. Our Advantage Plan is an HDHP.
Change in Family Status – certain benefit elections can only be made during the Open Enrollment or New Hire period unless you experience a Qualifying Life Event. A change in your family or employment status may allow you to make changes. If you have a change in your family status you have 61 days after the event to revise your elections. Examples include birth, adoption, marriage, divorce, a spouse changing jobs and losing coverage. See the “Making your elections” section for details on when elections can be made.	In-Network Provider – a health care practitioner or service that contracts with BCBS. You may pay more when you use an Out-of-Network provider.
Chronic care – Care provided that helps you to learn more about a chronic condition and how to manage them through a treatment plan. It includes education and oversight for health conditions such as diabetes, high blood pressure and coronary heart disease.	Insurance Claim – An insurance claim is a request for payment from your provider to the health insurance company. It details the services you received and the requested payment. Information about the claim will be a part of the EOB you receive from BCBS.
Coinsurance – the percentage of the cost you pay for covered medical, prescription drug or dental service after you’ve met your deductible. If you reach your out-of-pocket maximum, the medical and prescription plans pay 100% of the allowed amount of all covered services for the remainder of the calendar year.	Out-of-pocket maximum – the most you’ll spend on eligible medical and prescription drug expenses in a single calendar year. Your plan will cover all eligible expenses after this limit is reached.
Co-pay – a fixed amount you pay for a covered healthcare service.	Post-tax payroll deduction – You pay for certain benefits through post-tax deductions. Your premiums come from wages you’ve earned and already paid taxes on. See the “Making your elections” section for details on which premiums are deducted post-tax.
Deductible – the annual amount you pay before the plan begins paying for covered medical or dental services. When a service is covered 100% by the plan, you won’t pay a deductible.	Preferred Prescription – A preferred prescription is drugs that is commonly prescribed and covered by your prescription benefit plan. The list is created to maximize overall value by encouraging use of generic rather than branded drugs. It does not include all formulary medications covered your plan.
Dependent – A dependent for health benefits is any person (aside from the policyholder) eligible for coverage under a policyholder’s plan. Typically, covered dependents are your spouse and biological, adopted, or stepchildren. By law, dependents are allowed to remain on their parents or guardians’ family plan until they are 26 years old.	Premium – A premium is the amount you pay per month for your elected coverage.
Explanation of Benefit (EOB) – you will receive an EOB from BCBS after a claim has been submitted. The EOB shows the price of the service, what the plan pays and how much you owe. You’ll also see how much of your deductible has been met, as well as any coinsurance or other amounts you may owe. The EOB will show the discount received by choosing an In-Network Provider. If your treatment involved multiple providers, you may receive more than one EOB.	Pre-tax payroll deduction – you pay for certain benefits through pre-tax deductions. This means your premiums come from wages you’ve earned, but didn’t pay taxes on. Pre-tax deductions also reduce your taxable wages, so you will likely owe less federal and state income tax and FICA (Social Security and Medicare). See the “Making your elections” section for details on which premiums are deducted pre-tax.
Formulary – A formulary is a list of all prescription drugs covered by your health insurance plan. The list includes both branded and generic medications identified as offering the maximum overall value. Any drugs not included on the list will require prior authorization before they can be dispensed.	Preventive (or Preventative) Care – Preventive care does not treat a medical illness or injury. Instead it helps to prevent or identify health issues ahead of time. Preventive care includes regular visits and tests with your doctor, as well as annual health checks that help you make informed choices to support your overall wellbeing. Preventive care services are 100% covered under both our medical plans.

Acute Care

– Acute care is the short-term treatment of severe injuries, illness, an urgent medical
condition or recovery from surgery.

Generic Prescription (Drug)

– A generic prescription is an FDA-approved medication that delivers the same
dose, strength, administration and purpose as its branded counterpart. The active
ingredients remain the same, but the generic drug is typically cheaper than the
branded versions.

Allowed amount

– the maximum amount BCBS will pay for a covered health care service. If you use a provider who is not in the BCBS network, you may have to pay the difference.

Health Savings Account (HSA)

– An HSA allows you to save and pay for eligible out-of-pocket healthcare costs
using pre-tax dollars. The money in your HSA is yours to keep. If you don’t use all
of your savings in one plan year, the remaining balance will roll over to the next plan
year. You’ll need to sign up the Advantage Plan (a high-deductible health plan) to
open an HSA.

Beneficiary

– A beneficiary is the person(s) or entity you select to receive the payout benefit
from an insurance plan in the event of your death. It is important to ensure your
beneficiary designations are up-to-date for insurances and retirement plans such as
your Reynolds 401k.

High-deductible health plan

– An HDHP offers lower premiums and higher out-of-pocket costs. These costs are
capped by the plan’s in-network deductible. When you reach the deductible, your
plan will split the cost of services with you. This is known as coinsurance and is also
capped at a maximum. When you reach the coinsurance limit, the plan covers the
remaining in-network costs. Our Advantage Plan is an HDHP.

Change in Family Status

– certain benefit elections can only be made during the Open Enrollment or New Hire period unless you experience a Qualifying Life Event. A change in your family or employment status may allow you to make changes. If you have a change in your family status you have 61 days after the event to revise your elections.
Examples include birth, adoption, marriage, divorce, a spouse changing jobs and losing coverage.
See the “Making your elections” section for details on when elections can be made.

In-Network Provider

– a health care practitioner or service that contracts with BCBS. You may pay more when you use an Out-of-Network provider.

Chronic care

– Care provided that helps you to learn more about a chronic condition and how to
manage them through a treatment plan. It includes education and oversight for
health conditions such as diabetes, high blood pressure and coronary heart disease.

Insurance Claim

– An insurance claim is a request for payment from your provider to the health insurance
company. It details the services you received and the requested payment. Information
about the claim will be a part of the EOB you receive from BCBS.

Coinsurance

– the percentage of the cost you pay for covered medical, prescription drug or dental service after you’ve met your deductible. If you reach your out-of-pocket maximum, the medical and prescription plans pay 100% of the allowed amount of all covered services for the remainder of the calendar year.

Out-of-pocket maximum

– the most you’ll spend on eligible medical and prescription drug expenses in a single calendar year. Your plan will cover all eligible expenses after this limit is reached.

Co-pay

– a fixed amount you pay for a covered healthcare service.

Post-tax payroll deduction

– You pay for certain benefits through post-tax deductions. Your premiums come from wages you’ve earned and already paid taxes on. See the “Making your elections” section for details on which premiums are deducted post-tax.

Deductible

– the annual amount you pay before the plan begins paying for covered medical or dental services. When a service is covered 100% by the plan, you won’t pay a deductible.

Preferred Prescription

– A preferred prescription is drugs that is commonly prescribed and covered by your
prescription benefit plan. The list is created to maximize overall value by encouraging use
of generic rather than branded drugs. It does not include all formulary medications covered
your plan.

Dependent

– A dependent for health benefits is any person (aside from the policyholder) eligible
for coverage under a policyholder’s plan. Typically, covered dependents are your
spouse and biological, adopted, or stepchildren. By law, dependents are allowed to
remain on their parents or guardians’ family plan until they are 26 years old.

Premium

– A premium is the amount you pay per month for your elected coverage.

Explanation of Benefit (EOB)

– you will receive an EOB from BCBS after a claim has been submitted. The EOB shows the price of the service, what the plan pays and how much you owe. You’ll also see how much of your deductible has been met, as well as any coinsurance or other amounts you may owe.
The EOB will show the discount received by choosing an In-Network Provider. If your treatment involved multiple providers, you may receive more than one EOB.

Pre-tax payroll deduction

– you pay for certain benefits through pre-tax deductions. This means your premiums come from wages you’ve earned, but didn’t pay taxes on. Pre-tax deductions also reduce your taxable wages, so you will likely owe less federal and state income tax and FICA (Social Security and Medicare). See the “Making your elections” section for details on which premiums are deducted pre-tax.

Formulary

– A formulary is a list of all prescription drugs covered by your health insurance
plan. The list includes both branded and generic medications identified as offering
the maximum overall value. Any drugs not included on the list will require prior
authorization before they can be dispensed.

Preventive (or Preventative) Care

– Preventive care does not treat a medical illness or injury. Instead it helps to prevent or
identify health issues ahead of time. Preventive care includes regular visits and tests
with your doctor, as well as annual health checks that help you make informed choices to
support your overall wellbeing. Preventive care services are 100% covered under both our medical plans.

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 2023 medical and prescription drug expenses is a good place to start. You can find your 2023 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 $384 less during 2024 if you enroll in the Advantage Plan. A family enrolled in the Advantage Plan will pay $1,200 less in premiums in 2024.

In addition, when you enroll in the Advantage Plan, you’ll receive a $600 Start-up 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 Reynolds – 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 pays 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.

On this page you will find:

Medical plans

Coverage for your health journey

What the plan pays

Monthly premiums

Making your health dollars go further

Teladoc

Teladoc Behavioral Health

Preventive care

Put HealthJoy’s Healthcare Concierge to work for you

Nurse Management

SmartShopper

My Pregnancy Blue Cross NC

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