BlueEdge allows your clients to give their employees a spending account option, which helps employees pay for qualified health care expenses. One option is to establish a health care account (HCA) for each employee with employer funds.
With the BlueEdge HCA plan, the company sets aside a specific amount of money in a HCA for each employee each benefit year.
Here's how the HCA works:
- The account pays for the member's covered health care claims until the balance is depleted. These claims are applied to meeting the deductible.
- Preventive care services are covered at 100 percent in-network even before the deductible is met, so these claims are not deducted from the HCA. (There is an annual $400 maximum for adult preventive care; the remainder applies to deductible and coinsurance.)
- BlueEdge provides a seamless approach to claims processing, paying claims automatically from the HCA or the PPO benefit plan.
- Employees do not pay for services up front or submit claims for HCA reimbursement.
- Employers only fund claims as they are paid from the HCA, so unused account balances remain part of the company's cash flow.
- Funds roll over year to year as long as the employee remains in the plan.
- If the employee leaves the plan, the funds stay with the employer.
Deductible:
BlueEdge includes an annual deductible that employees must meet before their PPO benefits begin. Claims paid from the spending accounts are applied toward the plan deductible.
Here's how the family deductible works:
If an employee's dependents are covered under the plan, the deductible works like most other Blue Cross and Blue Shield of New Mexico PPOs. No family member has to satisfy more than the individual deductible before receiving PPO benefits, and the PPO benefits will be paid for the whole family once the family deductible is met. Deductible amounts are not included in the out-of-pocket maximum.
Learn More About BlueEdge HCA for Groups:
Overview
Product Summary
Benefit Information
FAQs
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