Choosing a medical plan is one of the most important benefits decisions you can make. It has a big impact on your health coverage and your finances, so take the time to consider all the options WSI offers.
Note that eligibility and enrollment options may vary by plan and where you live, so be sure to carefully review all the information provided in the Benefits Guide and on the benefits enrollment portal. You may also contact the WSI Benefits Resource Center at 800.413.1444.
Depending on where you live, you may have access to a Local Plus Network (LPN). An LPN is a smaller network of providers and facilities that have met certain measures of medical care quality and efficiency. An LPN has lower associate payroll contributions; however, these networks will include a smaller number of providers. If you are in an area that offers an LPN, you will have more than three medical plan choices (for example, you will see both the Open Access and Local Plus networks if available in your area).
High Deductible Health Plan with HSA Plan
The High Deductible Health Plan with HSA (HDHP) works similar to other WSI medical plan options, but with some important differences. If you enroll in the HDHP plan, you are able to contribute pretax dollars to an HSA. An HSA is an individual custodial account that eligible individuals may use to pay out-of-pocket qualified health care expenses, including medical, dental, vision and prescription drug costs.
With the HDHP plan, eligible expenses, such as a doctor’s visit when you are sick or a prescription drug, will be paid in full by you until you meet your “coverage level” deductible. Unlike the Standard and Premium plans, if you have any dependents covered on your medical plan, you must meet the “family” deductible amount before the plan pays any eligible expenses. You can choose to pay for this care from funds available in your HSA, or not. It is your choice. Just like the other medical plan options from WSI, the HDHP will pay for certain preventive services, screenings and drugs at 100 percent with no deductible when you see an in-network provider.
The out-of-pocket maximum is the most you will have to pay in the plan year for covered health care expenses and protects you from financial risk. The medical plan pays 100 percent of all remaining covered expenses for the rest of the plan year once you have met your out-of-pocket maximum. The out-of-pocket maximum includes your deductible, coinsurance and covered prescription drug expenses.
Like the Standard and the Premium plans, with the HDHP, if you have any dependents covered on our medical plan, each member can meet the single (or individual) out-of-pocket maximum until the overall family out-of-pocket maximum is met before the plan pays 100 percent of all remaining covered expenses for the rest of the plan year.
Standard and Premium Plans
In selected ZIP code areas, Premium, Standard and HDHP plans may include both the Open Access Network plan and the Local Plus Network options. The LPN plans cover the same services and have the same deductibles, coinsurance, out-of-pocket maximums, etc. as the broad network plan options. The LPN has a limited list of participating providers chosen for having met certain measures of medical care quality and efficiency, such as:
- Lower hospital readmission rates
- Fewer complications
- Treatments proven to show positive results
Local Plus Network Option
The LPN option will cost less in premium contributions (deductions from your pay).
LPN plan providers may offer a better health care experience while you make the most of your health care dollars. Keep in mind, these options may not be right for you if you have dependents who live elsewhere (such as at college), if you travel frequently or if your current provider is not in the LPN and you prefer to not change providers.
If an LPN is available in your area, you will see this option included when you enroll on the Benefits Portal.
Comparing Your Options
The Premium Care Plan, Standard Care Plan and the High Deductible HSA plan all offer a network of hospitals and physicians for in-network services. You can find participating providers and in-network facilities on your carrier’s website. You can access your carrier’s website via the Benefits Portal.
The Kaiser HMO plan uses its own network of doctors and facilities. Find participating providers and in-network facilities at kp.org.
Saving on Prescriptions
By spending just a few dollars less on your regular prescriptions, you can enjoy considerable savings in the long run. Here are some tips for getting the greatest value on your prescriptions if you’re enrolled in a WSI medical plan.
By using a mail order pharmacy service, you can get larger quantities of your prescriptions, often at the same price you’d pay for a smaller quantity at your traditional pharmacy.
Most commonly used prescription drugs are available in less expensive generic forms. If a generic form isn’t available, ask the pharmacist if there’s an equivalent drug that has a generic form.