HDHP

The HDHP medical coverage option offered by the Board of Pensions is a higher quality version of the typical high deductible health plan available in the commercial marketplace. It would be considered a bronze plan in the Health Insurance Marketplace.

nurse in doctor's office

The HDHP, a qualified high deductible health plan, is the lowest-cost medical coverage option available. A higher quality version of the typical HDHP available in the commercial market, it would be considered a bronze plan in the Health Insurance Marketplace. The HDHP option includes 100 percent coverage for network preventive care and a low flat-dollar copay for certain preventive drugs.

Provider network and deductible

HDHP participants have access to the same Blue Cross Blue Shield physicians, hospitals, and other healthcare providers as PPO and EPO participants, and no referrals are needed for care. The HDHP does not cover out-of-network care; however, 97 percent of current Medical Plan members receive their care from network providers, making the HDHP a viable option for many employers at a lower cost than the PPO and EPO.

The HDHP has a higher annual deductible than the PPO and EPO; however, because it is a qualified plan, members are eligible to enroll in a health savings account. The Board of Pensions urges employers, when selecting the HDHP, to also offer a health savings account to help employees pay for expenses and offset the higher annual deductible.

HDHP participants, along with PPO and EPO participants, also can reduce their deductibles by participating in Call to Health.

Coverage details

Here are key details about HDHP coverage:

  • Members pay out of pocket for all covered services — including doctor's office visits — up to the annual deductible amount of $3,000 ($6,000 if covering any eligible family members) except for
    • preventive medical services (plan pays 100 percent); and
    • certain preventive drugs (member pays a low flat-dollar copay).
  • After the annual deductible is met, the member and the plan share the cost of care through percentage-based copayments:
    • Members pay 20 percent (plan pays 80 percent) for covered services, such as doctor's office or urgent care center visits, telemedicine consultations, in- and outpatient hospital services, surgery, and emergency room visits.
    • Members pay 30 percent (plan pays 70 percent), up to a maximum dollar amount per drug, for covered nonpreventive prescription drugs.
  • Once the annual copayment out-of-pocket maximum of $6,750 ($13,500 for family coverage) is reached, the plan pays 100 percent of allowable charges for the rest of the calendar year. 
  • Members who set up and contribute to an HSA can use HSA funds to pay for the deductible, required copayments, and other eligible out-of-pocket expenses.

Read more details about costs to HDHP participants.

Value-added features

The HDHP includes unique features — available with all Medical Plan options — that provide exceptional value and promote well-being and wholeness.

Eligibility to participate

Employers may choose to offer the HDHP to employees who are regularly scheduled to work at least 20 hours a week. Read more details about eligibility for the HDHP.

Call to Health

Employees enrolled in the Medical Plan have access to Call to Health, the Board's online well-being program. Participants in this initiative complete challenges to improve wholeness in four key areas — spiritual, health, financial, and vocational — and earn points toward reduced deductibles for the following year.

Learn how to answer the call

Board University

Benefits Plan members have access to online and in-person learning opportunities through Board University. These offerings promote wholeness in all areas: spiritual, vocational, health, and financial.

Learn more

Assistance Program

Benefits Plan members have access to online and in-person learning opportunities through Board University. These offerings promote wholeness in all areas: spiritual, vocational, health, and financial.

Learn more