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Frequently Asked Questions

Sandia Total Health (STH) Plan, Flexible Spending Account (FSA) and Health Reimbursement Account (HRA)

  • What is the Sandia Total Health (STH) Plan with FSA/HRA?

    Sandia National Laboratories puts money each calendar year into an HRA fund that is integrated with your medical STH plan. These funds are used to pay for covered health care expenses, including all eligible 213d expenses. Money you spend from this account for covered services counts toward your deductible and coinsurance. If you enroll in the Flexible Spending Account (FSA), these FSA funds will be used first toward any eligible health care expenses and 213d expenses.

    Plan benefits begin after you meet the annual deductible. You have the freedom to see any doctor without a referral.

    Preventive care and certain cancer screenings benefits received by an in-network provider are fully covered – nothing is deducted from your HRA and you don't need to meet the deductible to enjoy these benefits.

    Online decision resources help increase your awareness and knowledge of health issues and help you keep track of your HRA and health care expenses. Once you are a BCBSNM member, log into Blue Access for Members to take a health risk assessment, access health and wellness information and tracking tools, and more. Your HRA and FSA are administered by Connect Your Care, a preferred vendor of BCBSNM. To access information on the HRA, and FSA if enrolled, go to connectyourcare.com .

  • What is a Sandia Health Plan Network (SHPN) provider?
    The SHPN network was developed by Sandia National Laboratories in conjunction with Imagine Health. There are approximately 500 providers in this network. If you seek services from one of these providers, your out-of-pocket costs (deductible, coinsurance, and out-of-pocket maximum) will be lower. To search for a provider, use Provider Finder®.
  • What is a Preferred Provider?
    A Preferred Provider (in-network provider) is a health care professional or facility that has contracted with BCBSNM, a BCBSNM contractor or subcontractor, or with a Blue Cross and Blue Shield (BCBS) company in another state. To find a Preferred Provider, search the Provider Finder®. You may also call BCBSNM Customer Service at the number on the back of your ID card to request a printed network directory or to ask for help looking for Preferred Providers. For Preferred Providers outside New Mexico, call 1-800-810-2583.
  • What is a Nonpreferred Provider?
    A Nonpreferred Provider (out-of-network provider) has not contracted with BCBSNM or another Blue Cross and Blue Shield (BCBS) company, either directly or indirectly, to be part of the preferred or PPO provider network.
  • Which provider network do I use with my plan?
    You will use the Blue Cross and Blue Shield PPO provider network to access contracted doctors, hospitals, and other health care professionals.
  • How can I search for a SHPN contracted provider?
    To locate a SHPN provider, search our Provider Finder®.
  • How can I search for a BCBSNM PPO contracted provider?
    To locate a provider, search our Provider Finder®.
  • What is preauthorization?

    Certain services require approval from BCBSNM. If approval is not obtained, BCBSNM will not pay for them. This approval is called “preauthorization.” The list of services that require preauthorization is in the Benefit Booklet. To request preauthorization, you or your provider must call BCBSNM Health Services. Call 1-505-291-3585 in Albuquerque, or toll-free at 1-800-325-8334, Monday through Friday, from 8 a.m. to 5 p.m. Mountain Time.

    Note: Your plan includes behavioral health and chemical dependency services. Preauthorization is required for inpatient, residential treatment, partial hospitalization and some outpatient services. Request preauthorization from the BCBSNM behavioral health services administrator. Call toll-free at 1-888-898-0700. Phones are open 7 days a week, 24 hours a day.

  • Am I covered when traveling?
    Yes, with the BlueCard® Program you have help accessing physicians and hospitals contracted as providers with Blue Cross and Blue Shield companies across the country. If you are traveling in the U.S. and need to find a provider when out of the area that BCBSNM serves, contact the local Blue Cross and/or Blue Shield company, call BlueCard Access toll-free at 1-800-810-BLUE (2583), or search the Blue National Doctor and Hospital Finder. If you are outside the U.S. and need emergency medical care, go to the nearest hospital; call toll free 1-800-810-BLUE (2583) or call collect at 1-804-673-1177 if you're admitted. Always carry your BCBSNM member ID card, as it contains important information your provider will need to file claims correctly.
  • What are eligible expenses under the STH/HRA plan?
    To learn about health care/medical and prescription drug and eligible 213d expenses that are eligible for coverage under your STH/HRA plan, please see your Benefit Information.
  • What are eligible expenses under the FSA Health Care Account?
    You can use your designated pre-tax dollars for any medical expenses for which you are responsible. You can also use them for nonmedical-related expenses, such as dental, vision, Lasik surgery, prescription drugs, etc.
  • Can I have my dental claims automatically reimbursed like my medical?
    Yes. If you are enrolled in the Delta Dental plan, Sandia will default you and your dependents to auto-pay. If you do not want your dental claims automatically reimbursed, you will need to go to www.connectyourcare.com and turn off auto-pay, then select "click-to-pay." This option allows you to pick and choose which claims you would like to apply to your FSA and HRA.
  • What should I do if I lose my BCBSNM member ID card?
    You can log in to Blue Access for Members and request a new member ID card, or call Customer Service at 1-877-498-7652. It will take up to two weeks to receive a new card. If you need a new card immediately, you can print a temporary ID card to use until your permanent card arrives.
  • How does my prescription drug plan work?
    Blue Cross and Blue Shield of New Mexico does not administer your prescription drug plan – it is administered by Express Scripts®. For questions about your pharmacy benefits, call Express Scripts toll-free at 1-877-817-1440 or visit www.express-scripts.com .
  • How are my Express Scripts Rx claims files under the STH/FSA/HRA Plan?
    BCBSNM is not integrated with Express Scripts; therefore, you can do one of two actions. Use your debit card from Connect Your Care to pay for your prescriptions, or you will need to purchase your prescription and file a hard-copy claim to Connect Your Care for reimbursement from your FSA (if enrolled and you have funds available). If you do not have FSA funds available, then you will be reimbursed for funds used from your HRA.
  • How does the HRA roll-over feature work?
    If there is a remaining balance in your HRA at the end of the calendar year, it automatically rolls over to the next year and is added to the annual contribution made by Sandia National Laboratories (up to the maximum HRA balance as specified by the STH plan). The total balance remains available to you as long as you participate in the plan. The greater the balance in your HRA, the less you have to pay out-of-pocket.
  • What happens to the HRA balance if I leave the STH plan?
    If you leave the company without continuing your coverage (e.g., under COBRA), the balance in the HRA returns to Sandia National Laboratories.
  • What if I have questions about my STH plan?
    BCBSNM's customer service representatives are available to answer your questions 6 a.m. to 8 p.m. MT, Monday through Friday, and 8 a.m. to 5 p.m. MT on weekends and holidays (closed Thanksgiving and Christmas Day). If you call after hours, you can leave a message and we will return your call by the next business day. Call BCBSNM Customer Service toll-free at 1-877-498-7652. Please have your ID card available when you call.
  • What if I have questions about reimbursement of my Connect Your Care HRA/FSA for expenses?
    View your FSA and HRA balances and claims at www.connectyourcare.com . Call CYC Customer Service at 1-866-808-1444 (available 24 hours/day, 365 days/year).