Magnolia Open Access
Administered by Blue Cross Blue Shield of Louisiana and CVS Caremark
The Office of Group Benefits (OGB) offers multiple health plans, including the Magnolia Open Access Plan. The claims administrator is Blue Cross and Blue Shield of Louisiana, while the pharmacy benefit manager is CVS Caremark. The Magnolia Open Access offers moderate deductibles and coinsurance in exchange for a higher premium. It differs from the other Magnolia plans in that members enrolled in the Open Access plan will not pay copayments at physician visits. Instead, once a member’s deductible for allowable charges is met, he or she will pay 10% of the allowable amount for in-network care and 30% of the allowable amount for out-of-network care. Out-of-network care may be balance billed. Coverage is provided within the Blue Cross nationwide network, as well as out-of-network.
|Medical Coverage||Employee Only||Employee +1 (Spouse or Child)||Employee + Children||Family|
|Employer Contribution to HRA/HSA||$0||$0||$0||$0|
|Out-of-pocket max (in-network)||$3,500||$6,000||$8,500||$8,500|
|Out-of-pocket max (out-of-network)||$4,700||$8,500||$12,250||$12,250|
*Once a member's deductible for allowable charges is met, he or she will pay 30% of the allowable charge, plus 100% of the difference between the allowable charge and billed amount for out-of-network care.
OGB uses the CVS Caremark formulary to help members select the most appropriate, lowest-cost options. Members will continue to pay a portion of the cost of their prescriptions in the form of a co-pay or coinsurance. The amount members pay toward their prescription depends on the tier of medication -generic, preferred brand, non-preferred brand, or specialty drug.
|Tier||Member Responsibility||Once You Pay $1,500|
|Generic||50% up to $30||$0 co-pay|
|Preferred||50% up to $55||$20 co-pay|
|Non-Preferred||65% up to $80||$40 co-pay|
|Specialty||50% up to $80||$40 co-pay|