Payroll, Benefits & Accounting

Medical Benefits - Blue KC

Blue Cross Blue Shield of Kansas City Logo

When it comes to benefits, we recognize that one size doesn't fit all. We understand that people are different with different lifestyles and needs. Situations change. That's why the USD #500 plan offers you five levels of coverage insured through Blue Cross Blue Shield of Kansas City (Blue KC) that include one HMO plan, three PPO plans and the Blue Saver High Deductible Health Plan with H.S.A (Health Savings Account).

The difference in each plan is the out-of-pocket cost to you and the premium you pay. On each plan, you have the option to choose between four levels of coverage: Employee Only, Employee & Spouse, Employee & Child(ren), or Employee & Family.

Weigh Your Options

When choosing a health benefits plan, the most important question is:

Will it provide the right amount of coverage for you and your family? After deciding how much coverage you need, consider the costs - and when you pay them.

There are two ways you contribute to the cost of a health plan:

  1. Up-front costs. This is the part of the health insurance premium you pay. If you're an employee, up-front costs are deducted from your paycheck. If you're retired or on a non-employee plan like COBRA, you write a check or bank draft for the premium. Either way, you pay premium costs regularly, like any bill, no matter how often - or how seldom - you need health care.
  2. Pay-as-you-go costs. These are the out-of-pocket dollars you pay when you see a doctor, go to a hospital or outpatient clinic, or have a prescription filled. Pay-as-you-go costs include copayments, deductibles, and coinsurance. These amounts will accumulate.

If you need medical care often, you might want to pay more up-front and less as-you-go costs. Budgeting is easier because your premium costs are always the same, and you won't have huge expenses for any major, unexpected medical treatment.

If you see a doctor or need prescriptions only two or three times a year, it might make more sense to pay less up-front and more as-you-go. This way, you can save the premiums and avoid paying for more coverage than you might use.

Blue KC Choices

Making the right choices and becoming more knowledgeable about your plan options helps you be a better health care consumer. The plan you choose should simply be the one you're most comfortable with - a plan that fits your health needs, budget, and personal preferences. No matter which plan you enroll in, you'll have the assurance of some financial protection against any major, unexpected medical expenses that are covered by your plan.

Your choices include all of the plans briefly described below. For more details, refer to the plan descriptions on the Blue KC Cost Sheet.pdf

HMO Plan

PPO Plan ($500 Deductible)

PPO Plan ($1000 Deductible)

PPO Plan ($2500 Deductible)

BlueSaver Plan

  • HMO. With an HMO (Health Maintenance Organization), there's no deductible. Your share of the costs includes copayments for many services. You choose a primary care physician (PCP) who will provide most of your care and recommend specialists as needed. To visit a specialist who participates in the Blue Care Network, simply select the specialist and make an appointment. No referral is required. An HMO generally does not cover any services from non-participating providers, except for emergencies.
    • The HMO plan utilizes the Blue Care Network.
    • Preventative care covered at 100%
    • Higher Premiums/No deductible
    HMO Plan Summary.pdf
  • PPO. A PPO (Preferred Provider Organization) allows you to see participating and non-participating providers.
    • The PPO plans utilizes the Preferred Care Blue Network.
    • Preventative Care covered at 100%
    • First Dollar Coverage: Two of the PPO plans offered through BCBS offer first dollar coverage. For each covered person, the plan pays up to the first $250 of eligible expenses for covered services from participating providers. The calendar year benefit does not apply to copayments, office visits, prescription drugs, or any services from non-participating providers. Once the plan has paid the First Dollar Amount, you pay all other expenses until you reach your deductible. The plan offers a good option if you rarely visit the doctor or take prescription medications and it includes a safety net to cover a catastrophic health event, such as serious illness or injury.
    PPO 500 Plan Summary.pdf
    PPO 1000 Plan Summary.pdf
    PPO 2500 Plan Summary.pdf
  • Blue Saver High Deductible Health Plan with Health Savings Account This medical plan consists of two parts:
    1. Blue Saver High Deductible Health Plan: provides health insurance coverage though Blue KC
    2. Health Savings Account (H.S.A.): a special, tax exempt account used in conjunction with the high deductible health plan. This account provides funding to pay for qualified medical expenses NOT covered by the insurance. The H.S.A. account is provided by UMB Bank.
      • The Blue Saver/H.S.A. plan utilizes the Preferred Care Blue Network.
      • In Network Preventative Care covered at 100% with no deductible or co payment.
      • Includes a $2,500 individual /$5,000 Family deductible.
      • Health Savings Account is owned by YOU and is portable in the event you change employers.
      • Funds contributed to your H.S.A are not subject to federal income tax at the time of deposit.
      • H.S.A has no "use it or use it" rule.
      • Interest or earnings that accumulate in your H.S.A are not subject to federal income tax.
      • Funds withdrawn from your H.S.A to pay for qualified medical expenses - at any time - are not subject to federal income tax.
      • In the event of disability or at the age of 65; H.S.A funds can be withdrawn for any purpose without penalty.
      • H.S.A funds can be used to help meet and pay for your deductible.
    Blue Saver Plan Summary.pdf

How Much Can I Contribute?

IRS limits the annual maximum contribution. The maximum annual contribution for 2014 is:

$3,300 individual / $6,550 family

Catch-up contributions of $1,000 are available for employees 55 and over.

What Are the Eligibility Requirements to enroll in an H.S.A?

  • Cannot be enrolled in Medicare, Medicaid, Tricare, VA benefits.
  • Cannot be covered by any other Traditional health plan. (Spouse's FSA or Spouse's Non-HDHP will make you ineligible for HSA).
  • Traditional Flexible Spending Accounts (FSAs) and Health Reimbursement Arrangements (HRAs) will make you INELIGIBLE for an HSA.
  • Must be enrolled in a Qualified High Deductible Health Plan (QHDHP). BlueSaver is a qualified plan.

What If I ...

  • I use my funds for non-qualified expenses, such as a new TV?
    • There is a 20% penalty assessed for non‐qualified expenses, plus taxes
    • Keep your receipts in case of an audit!
  • I turn age 65?
    • You can spend funds on non-qualified expenses with no penalty
    • Would pay normal income tax
  • I change to a Traditional plan next year? What happens to the funds in the account?
    • It's your money, so you can continue to spend the funds on qualified medical expenses; you just can't contribute to the H.S.A.
  • I don't have enough funds in my HSA to cover my service or prescription?
    • You pay out of pocket and like a 401k, can reimburse yourself once your funds are available

Are Your Medical Providers In the Blue KC Network?

To obtain a list of providers participating in network, visit Select the blue box on the top right hand side of the page "Find Blue KC Doctors, Hospitals, & Pharmacies." When selecting your insurance plan, choose:

  • Blue Care Network if you are enrolled in the HMO plan
  • Preferred Care Blue for any of the 3 PPO plans as well as the High Deductible/H.S.A Plan

*Providers are subject to change at anytime.*

Value Based Prescription Drug Program

Blue KC now offers a unique program for members with Diabetes & Coronary Artery Disease. When you seek appropriate treatment, this incentive based program helps reduce financial barriers by combining education and support as well as waived or reduced co pays for selected medications or supplies. For more information regarding this program, contact Blue KC Customer Service by calling the number located on the back of your member ID card.


If you are taking prescription medications on a regular, on-going basis, you can save money by ordering them through the Express Scripts Home Delivery program.

Home Delivery offers the following benefits:

  • Prescriptions are delivered directly to your home - with free standard shipping.
  • You get up to a 3-month supply of your medications for two co pays.
  • You can speak with a pharmacist anytime, day or night.
  • Once you begin using Home Delivery, you can order refills by phone or online.

Monthly Premiums

Medical - Active Full Time EmployeesTotal Monthly Cost
2500 PPO
Employee Only
Employee and Spouse
Employee and Child(ren)
Employee and Family

1000 PPO
Employee Only
Employee and Spouse
Employee and Child(ren)
Employee and Family

PPO 500
Employee Only
Employee and Spouse
Employee and Child(ren)
Employee and Family

Employee Only
Employee and Spouse
Employee and Child(ren)
Employee and Family

Blue Saver HDHP
Employee Only
Employee and Spouse
Employee and Child(ren)
Employee and Family