Plans by Design is a bold new concept from Blue Cross and Blue Shield of Minnesota. It gives you the power to build your own health plan with unmatched flexibility and choice – all with the goal of greater cost savings.
The choice is yours.
Control premiums and offer the benefits employees want. Choose incentives and health support to engage your workforce. Or choose to give employees the option to upgrade their own plan components for an even better fit.
With Plans by Design, you can select a network, drug formulary and benefit design for the unique needs of your organization.
Base Plan
Options Blue: A consumer-directed health plan that can be used with a health reimbursement arrangement (HRA) or health savings account (HSA).
Comprehensive Major Medical: A solid choice with broad access and a variety of cost-sharing options. A wide range of deductibles, copays and coinsurance are available to help you manage costs.
Aware® PPO: An open-access plan that takes advantage of the national BlueCard® PPO network. Choose from a variety of cost-sharing solutions. Office visits, preventive care and hospital services are covered with coinsurance and copay options.
Provider Networks
Value Network: A new network that offers access to quality and cost effective physicians and hospitals in the Twin Cities 11-county metro area.
Accord Network: A new statewide network that provides excellent coverage at less cost. The Accord network includes providers, clinics and hospitals throughout Minnesota.
Aware Network: A statewide open-access network with unparalleled breadth and depth of network, advantageous discounts and network stability.
Pharmacy Options
GenRX: A new formulary focused on maximizing utilization of cost-saving generic drugs. The formulary contains both brand-name and specialty drugs with a special emphasis on money-saving generic equivalents.
FlexRx: A formulary offering the broadest choice of therapeutic safety and effectiveness. It contains a combination of brand-name and generic drugs, including specialty drugs.
Core Benefits
Deductible: The amount employees pay for health care services each year before the health plan begins to pay on their behalf.
Coinsurance: A set percentage of the allowed amount paid by the plan and the employee (after the deductible has been met). For example, 80/20 means the plan pays 80 percent and the employee pays 20 percent of the allowed amount up to the annual out-of-pocket maximum.
Out-of-pocket maximum: This feature protects employees from high expenses if their share of covered costs exceeds a certain maximum amount within the plan year. The plan will pay 100 percent of an employee's eligible charges once he or she has paid eligible charges equaling the out-of-pocket maximum amount.
Copay: For certain services, employees pay a fixed dollar amount or copay. In most cases, copays are paid to the doctor or facility at the time of service.
