Blue Access for Producers

BlueEdgeSM Wellness Rewards HCA

Blue Cross and Blue Shield of Texas offers a variety of consumer-driven health plans (CDHPs) which can help your clients control rising health care costs. The BlueEdgeSM Wellness Rewards HCA plan puts members in charge of their health by empowering them to make their own decisions about how their health care dollars are spent. BCBSTX provides online tools and resources to help members make wise and informed decisions about their health care and better manage their health care benefits.

Here is what makes BlueEdge Wellness Rewards HCA an exciting option.

BlueEdge Wellness Rewards HCA is an incentive-based Health Care Account (HCA) that provides employees the opportunity to earn rewards for completion of healthy activities. As employees make smart choices about their health, funds are earned and added to the HCA. Depending on the plan selected, employees can earn $50 or $100 rewards to a maximum of $150 or $300 per calendar year. Below are qualified healthy activities:

  • Completion of the health risk assessment (HRA)
  • Annual physical exam
  • Prostate cancer screening (male only)
  • Mammogram (female only)

Funds in the Wellness Rewards HCA can be used to pay for PPO eligible expenses. The more money earned toward the HCA, the less the member has to pay out of pocket. Your client only funds claims as they are paid, so unused account balances remain part of the company’s cash flow.

If there is a remaining balance of unused HCA funds at the end of the calendar year, that amount rolls over to the next calendar year and can be used toward charges applied to the next year’s calendar year deductible. If the member changes jobs or medical plans, the HCA funds remain with your client.

The HCA account is coupled with a PPO plan. Benefit levels vary depending on whether care is received in-network or out-of-network. Members must use network providers to receive the higher (in- network) level of benefits.

The BlueEdge Wellness Rewards HCA plan is available to clients through the BlueChoice Network, one of the largest networks in Texas. BlueChoice provides:

  • Access to the national BlueCard® network when members are outside of Texas
  • Over 600 participating hospitals and facilities in Texas
  • More than 800,000 doctors and 6,000 hospitals contracting with Blue Cross and Blue Shield plans nationwide

For care outside of Texas, members have access to the BlueCard national network of providers.

BCBSTX offers a variety of plan options with varying deductible, copayment, and coinsurance choices. All plans include an outpatient prescription drug benefit with a three-tier pharmacy copayment design. The coverage includes three tiers of medications comprised of:

  • Generic drugs
  • Preferred brand-name drugs
  • Non-preferred brand-name drugs

Prescription drugs are available through retail pharmacies throughout Texas and mail order pharmacy services.

For more detailed information on available benefit designs, a description of the services and supplies that are covered, a listing of those services and supplies that are limited or excluded, terms and general administration or for any questions you may have regarding our products and services, contact us for the phone number of the regional sales office near you.

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