Group Health Insurance Coverage  
Group Health Insurance Coverage
When choosing the appropriate health care plan for your business or company many things need to be considered. There are many flexible group health insurance coverage plans for North Carolina employees of small, medium and large businesses. No group is too small or too large.

There are several health and medical care options available for group health insurance coverage. The most popular plan, the Blue Options plan, is the Preferred Provider Organization (PPO) plan. The Blue Options network of doctors, specialists and hospitals is the largest network in North Carolina. Under the PPO plan you can go to in-network specialists without a referral or decide to see a doctor out of the network. As part of the group health insurance coverage plan, prescriptions are also covered. The co-payments on all prescriptions and office visits are also reasonable. The best perk of this plan is the freedom to see any doctor you wish, without having to worry about insurance and filing paperwork. The PPO plan has the best benefit plans and least restrictive doctor visits.

The Blue Care option, is part of the Health Management Organization (HMO) plan. The Blue Care option offers members direct access to the best doctors and specialists. With a large network, and preventative health and prescription benefits members are taken care of. The HMO plan has lower co-payments but a few more restrictions with regard to doctor visits and such.

The Classic Blue Comprehensive Major Medical (CMM) option gives group health insurance coverage members traditional coverage with a lot of flexibility in who you see for your health care.
Designed for companies with up to 50 employees
With Group Coverage, employers can choose from more than 1,000 benefit combinations and make choices based on their particular needs and budget. Employers can customize one of the following plans:
  • Blue Care® HMO – An HMO plan offering direct access to a large network of providers and specialists. Covers worldwide urgent and emergency room services.1 Includes in-network benefits only.
  • Blue OptionsSM PPO – A preferred provider organization (PPO) with the largest network of doctors and specialists in the state. Members have the freedom to choose in- or out-of-network care and are covered across the country and in more than 200 countries and territories worldwide.1
  • HSA – Pairs a high-deductible Blue Options plan with a health savings account (HSA) and offers lower premiums than traditional plans. Both employers and employees can make tax-free contributions to the HSA. Members use HSA funds to pay out-of-pocket health care expenses and enjoy negotiated provider rates, even before meeting their deductible.

The Blue Options and Blue Care provider networks include many of the best doctors, hospitals and specialists in North Carolina. The networks are large and the copayments or coinsurance are predictable.2 In-network doctors handle all the administrative details and file claims automatically. There’s not messy paperwork.

Group Coverage plans offer members a variety of preventive care services, including annual physical exams, Ob/Gyn visits, mammograms and prostate screenings, standard immunizations and annual eye exams.

As Blue Cross and Blue Shield members, employees covered by Group Coverage also have access to a variety of resources and programs designed to maximize their health care experience. Resources include the Member Health PartnershipsSM1, programs that help members manage health conditions like asthma and diabetes, and Blue ExtrasSM, free value-added programs that provide members discounts on everything from vitamins to gym memberships.3

® mark, SM marks of the Blue Cross and Blue Shield Association. SM1 mark of Blue Cross and Blue Shield of North Carolina. 1 Blue Cross and Blue Shield Association Internal Data, 2003. 2 Some services and supplies received by members in an office setting or in connection with an office visit are in fact outpatient hospital-based services provided by hospital-owned or operated practices. These services and supplies may be subject to your deductible and coinsurance. 3 Blue Cross and Blue Shield of North Carolina reserves the right to discontinue or change these program at any time. All plans may not be eligible for these programs.

If you have any questions or would like more information, please contact us 828-256-3224, email us, or use our online request form.





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