Online Benefits Directory
MEDICAL – PPO
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 | BCBSNC Member Pays In-Network |
|---|---|
| Primary Care Physician Office Visit | $35 |
| Specialist Office Visit | $70 |
| Preventative Medical Services | 0% (Plan covers 100% |
| Telehealth Services | $0 |
| Hospital/Emergency | |
| Emergency Room | $500 (Waived if admitted) |
| Urgent Care | $70 |
| Lab, X-Ray and Diagnostic- Outpatient | Deductible + 20% |
| Major Diagnostic and Imagining –Outpatient | Deductible + 20% |
| Inpatient Hospitalization Services | Deductible + 20% |
| Outpatient Facility & Physician Charges | Deductible + 20% |
| Prescription Drugs | |
| Generic | $10 |
| Preferred Brand | 25% up to $100 |
| Non-Preferred | 50% up to $100 |
| Specialty | 25% minimum of $100; up to $500 |
| Deductibles and Maximums | |
| Individual Annual Deductible | $2,500 |
| Individual Annual Out-of-Pocket Maximum | $7,000 |
| Family Annual Deductible | $5,000 |
| Family Annual Out-of-Pocket Maximum | $14,000 |
Out of Network Benefits are available
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
Finding a Provider
Visit the BCBSNC BlueConnect to find a provider or facility near you.
Cost of benefit
EMPLOYEE BI-WEEKLY PPO DEDUCTIONS EFFECTIVE 1-1-2024
| Employee Only | Employee & Spouse | Employee & Child(ren) | Employee & Family | |
|---|---|---|---|---|
| Buy-up PPO | $58.00 | $236.00 | $188.00 | $363.00 |
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 | $780.30 | $1448.40 | $1280.10 | $1953.30 |
Online Forms & Documents
2024 GW Equip Benefits Enrollment Guide
2024 Enrollment-Change Form
BCBSNC Drug Formulary NC
2024 BCBS Additional Dependent Form
2024_ACA_Preventive_Standard_Member_List
Blue Connect How to Register
Blue Connect Brochure