Online Benefits Directory
MEDICAL – HSA PLAN
Eligibility
You and your legal dependents are eligible for medical coverage on the first day of the month following 30 days of employment.
What is covered
| Physician Services | Deductible |
|---|---|
| Primary Care Physician Office Visit | Deductible then Covered at 80% |
| Specialist Office Visit | Deductible then Covered at 80% |
| Preventative Medical Services | 0% (Plan covers 100% |
| Telehealth Services | $0 |
| Hospital/Emergency | |
| Emergency Room | Deductible then Covered at 80% |
| Urgent Care | Deductible then Covered at 80% |
| Lab, X-Ray and Diagnostic- Outpatient | Deductible then Covered at 80% |
| Major Diagnostic and Imagining –Outpatient | Deductible then Covered at 80% |
| Inpatient Hospitalization Services | Deductible then Covered at 80% |
| Outpatient Facility & Physician Charges | Deductible then Covered at 80% |
| Prescription Drugs | |
| Generic | Deductible then Covered at 80% |
| Preferred Brand | Deductible then Covered at 80% |
| Non-Preferred | Deductible then Covered at 80% |
| Specialty | Deductible then Covered at 80% |
| Deductibles and Maximums | |
| Individual Annual Deductible | $3,200 |
| Individual Annual Out-of-Pocket Maximum | $5,000 |
| Family Annual Deductible | $6,400 |
| Family Annual Out-of-Pocket Maximum | $10,000 |
Out of Network benefits are available
The Health Savings Account (HSA) is available for those enrolled on this plan only.
Create your BCBSNC account
It’s important that you create an account with BCBSNC to give you full access to claim and other services.
REGISTER NOW
From your Blue Connect account you can see your account details and perform important tasks with ease.
+ Access and print a digital ID or request new member cards
+ View all your Blue Cross NC plans (health, prescription, dental) all in one place
+ Check claim status, access digital Explanation of Benefits (EOBs), and view accumulation toward deductibles and out-of-pocket limits
+ Update your contact information and preferences
+ Communicate securely with Customer Service via personal inbox
Employer Contribution to Health Equity
G&W contributes annually to Health Equity to help you pay for health care related items and expenses throughout the year. You may use this money to pay for deductibles, co-pays, coinsurance, prescriptions, eye glasses, contacts, dental visits, and other related items. This money is free to you if you enroll in either of the health insurance plans, and should be used to help with your out-of-pocket expenses for health care related items.
Note: These amounts are automatically deposited based on your insurance election. No action is required by you for the Employer Contribution.
| Employee Group | HSA 2024 | FSA (PPO) 2024 |
|---|---|---|
| Employee Only | $1,000 | $750 |
| Employee & Spouse, Children & Family | $2,000 | $1,000 |
If you are hired or begin coverage during benefit year, the amount you receive will be prorated for the remainder of the benefit year
What is a Health Savings Account?
A health savings account (HSA) is an account funded to help you save for future medical expenses. There are certain advantages to putting money into these accounts, including favorable tax treatment
Who Can Have an HSA?
Any adult can have an HSA if you:
- Have coverage under an HSA-qualified, high deductible health plan (HDHP)
- Have no other health coverage (certain types of insurance, such as specific injury or accident, disability, dental care, vision care or long-term care, are permitted)
- Are not enrolled in Medicare – Contributions to the account must stop once you are enrolled in Medicare. However, you can still use your HSA funds to pay for medical expenses tax-free.
- Cannot be claimed as a dependent on someone else’s tax return
Contributions
Contributions to your HSA can be made by you, your employer or both. However, the total contributions are limited annually. If you make a contribution, you can deduct the contributions (even if you do not itemize deductions) when completing your federal income tax return.
You can make a contribution to your HSA each year that you are eligible. You can contribute no more than:
- Single coverage: $4,150 for 2024
- Family coverage: $8,350 for 2024
- Individuals ages 55 and older can also make additional “catch-up” contributions of up to $1,000 annually.
Using Your HSA
You can use money in your HSA to pay for any qualified medical expense permitted under federal tax law. This includes most medical care and services, dental and vision care. You can use your HSA to pay for medical expenses for yourself, your spouse or your dependent children, even if your dependents are not covered by your HDHP. Any amounts used for purposes other than to pay for qualified medical expenses are taxable as income and subject to an additional 20% penalty.
Finding a Provider
Visit the BCBSNC BlueConnect to find a provider or facility near you.
Cost of benefit
Employee bi-weekly HSA Plan deductions effective 1-1-2024
| Employee Only | Employee & Spouse | Employee & Child(ren) | Employee & Family | |
|---|---|---|---|---|
| Medical Insurance HSA Plan | $43.00 | $161.00 | $118.00 | $287.00 |
These are current costs and are subject to change from time to time.
Continuing coverage after I stop working
You may continue coverage for you and your legal dependents at your own expense. Certain conditions apply. You will be provided with the proper forms, information, and costs upon leaving your employment with G & W Equipment.
| Benefit | Employee Only | Employee & Spouse | Employee & Child(ren) | Employee & Family |
|---|---|---|---|---|
| COBRA Monthly Costs for Copay Plan | $693.60 | $1259.70 | $1116.90 | $1683.00 |
Online Forms & Documents
2024 GW Equip Benefits Enrollment Guide
2024 Enrollment-Change Form
2024 Enrollment-Change Form
2024 BCBS Additional Dependent Form
2024_HSA_Preventive_Standard_Member_List
Blue Connect How to Register
Blue Connect Brochure