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Medical

Ensign offers you a choice of three medical plans through Blue Cross Blue Shield of Texas (BCBSTX) to best fit your family’s needs. If you live in California, you may also choose two similar plans through Kaiser.

  • All of our medical plans cover preventive care at no cost to you, as long as you use an in-network provider.
  • Prescription drug coverage is included when you enroll in a medical plan.
  • You may visit a doctor from the comfort of your home through telemedicine.
  • The Kaiser medical plans do not offer out-of-network coverage, and you are required to designate a primary care physician (PCP) to coordinate your care.

This plan lets you keep more of each paycheck because it has lower employee contributions than
the Mid-PPO and Hybrid plans. An HDHP allows you to use a tax-advantaged HSA to help pay for your medical costs (now and in the future).

  • Both plans have the same coinsurance and copays for services. With the Mid-PPO Plan, you will have a higher annual deductible to meet than with the Hybrid Plan, but will have a lower employee contribution deducted from your paycheck.
  • You will generally have lower deductibles and out-of-pocket maximums in exchange for higher premium paycheck deductions (when compared to the HDHP + HSA Plan).
  • You will pay set copays for PCP office and telehealth visits and coinsurance for other services.
  • In-network preventive care is covered at no cost to you.

Nationwide BCBSTX Medical Plan Overview

Nationwide BCBSTX HDHP + HSA
Plan Features In-Network Out-of-Network
Ensign account funding $250 employee only / $500 family
Annual deductible
(employee / family)		 $3,400 / $6,800 $6,600 / $13,200
Out-of-pocket maximum (employee / family)
includes deductible		 $6,000 / $12,000 $10,000 / $20,000
Coinsurance You pay 20% You pay 50%
Preventive care
 100% covered
(no deductible)		 50% after deductible
Office visit - PCP / specialist 20% after deductible 50% after deductible
Telehealth - MDLIVE virtual visit $10 copay In-network coverage only
Urgent care 20% after deductible 50% after deductible
Emergency room 20% after deductible
Hospital services
(semi-private room and board) or outpatient facility		 20% after deductible 50% after deductible
Mental health services - office visit, inpatient or outpatient 20% after deductible 50% after deductible
Prescription Drug Coverage
(Same for both plans)		 Other Participating Retail Pharmacy
(30-Day supply)		 Mail Order Pharmacy
(90-Day supply)
Generic ¹ $10 copay $20 copay
Preferred brand name  20% after deductible 20% after deductible
Non-preferred brand name 20% after deductible 20% after deductible
¹ HDHP + HSA generic drugs are subject to deductible. Copay is applicable after deductible has been met.
Nationwide BCBSTX MID-PPO PLAN
Plan Features In-Network Out-of-Network
Ensign account funding N/A
Annual deductible (employee / family) $1,800/ $3,600 $3,600 / $7,200
Out-of-pocket maximum (employee / family) includes deductible $5,000 / $10,000 $10,000 / $20,000
Coinsurance You pay 20% You pay 50%
Preventive care
 100% covered
(no deductible)		 50% after deductible
Office visit - PCP / specialist PCP: $30 copay
Specialist: 20% after deductible		 50% after deductible
Telehealth - MDLIVE virtual visit $10 copay In-network coverage only
Urgent care 20% after deductible 50% after deductible
Emergency room 20% after deductible
Hospital services (semi-private room and board) or outpatient facility 20% after deductible 50% after deductible
Mental health services - office visit, inpatient or outpatient 20% after deductible 50% after deductible
Prescription
Drug Coverage
(Same for both plans)		 Other Participating Retail Pharmacy
(30-Day supply)		 Mail Order Pharmacy
(90-Day supply)
Generic ¹ $10 copay $20 copay
Preferred brand name  20% after deductible 20% after deductible
Non-preferred brand name 20% after deductible 20% after deductible
Nationwide BCBSTX HYBRID
Plan Features In-Network Out-of-Network
Ensign account funding N/A
Annual deductible (employee / family) $1,250/ $2,500 $2,500/ $5,000
Out-of-pocket maximum (employee / family) includes deductible $5,000 / $10,000 $10,000 / $20,000
Coinsurance You pay 20% You pay 50%
Preventive care
 100% covered
(no deductible)		 50% after deductible
Office visit - PCP / specialist PCP: $30 copay
Specialist: 20% after deductible		 50% after deductible
Telehealth - MDLIVE virtual visit $10 copay In-network coverage only
Urgent care 20% after deductible 50% after deductible
Emergency room 20% after deductible
Hospital services (semi-private room and board) or outpatient facility 20% after deductible 50% after deductible
Mental health services - office visit, inpatient or outpatient 20% after deductible 50% after deductible
Prescription
Drug Coverage
(Same for both plans)		 Other Participating Retail Pharmacy
(30-Day supply)		 Mail Order Pharmacy
(90-Day supply)
Generic ¹ $10 copay $20 copay
Preferred brand name  20% after deductible 20% after deductible
Non-preferred brand name 20% after deductible 20% after deductible

2026 Employee Contribution Rates
BCBSTX Medical Rates
HDHP + HSA Biweekly Rates
Employee Only $41.74
Employee + Spouse $166.58
Employee + Child(ren) $124.45
Employee + Family $243.43
MID-PPO PLAN Biweekly Rates
Employee Only $67.83
Employee + Spouse $228.54
Employee + Child(ren) $178.12
Employee + Family $332.21
HYBRID PLAN Biweekly Rates
Employee Only $100.87
Employee + Spouse $291.03
Employee + Child(ren) $236.96
Employee + Family $421.02

California Only Kaiser Medical Plan Overview

Kaiser HDHP + HSA
Plan Features In-Network Only
Ensign account funding $250 employee only / $500 family
Annual deductible
(employee / family)		 $3,400 / $6,800
Out-of-pocket maximum (employee / family)
includes deductible		 $6,100 / $12,200
Coinsurance You pay 20%
Preventive care
 100% covered (no deductible)
Office visit - PCP / specialist 20% after deductible
Telehealth virtual visit 20% after deductible
Urgent care 20% after deductible
Emergency room 20% after deductible
Hospital services
(semi-private room and board) or outpatient facility		 20% after deductible
Mental health services - office visit, inpatient or outpatient 20% after deductible
Prescription Drug Coverage
 30-Day supply 100-Day supply
Generic  $10 copay after deductible $20 copay after deductible
Brand name  $30 copay after deductible $60 copay after deductible
Specialty 20% after deductible
(not to exceed $150)		 N/A
Kaiser MID-PPO PLAN
Plan Features In-Network Only
Ensign account funding N/A
Annual deductible
(employee / family)		 $1,500 / $3,000
Out-of-pocket maximum (employee / family)
includes deductible		 $3,000 / $6,000
Coinsurance You pay 20%
Preventive care
 100% covered (no deductible)
Office visit - PCP / specialist $20 after deductible
Telehealth  $0
Urgent care $20 after deductible
Emergency room 20% after deductible
Hospital services (semi-private room and board) or outpatient facility 20% after deductible
Mental health services - office visit, inpatient or outpatient $20 after deductible
Prescription Drug Coverage
 30-Day supply 100-Day supply
Generic  $10 (no deductible) $20 (no deductible)
Brand name  $30 (no deductible) $60 (no deductible)
Specialty 20% not to exceed $250
(no deductible)		 N/A

2026 Employee Contribution Rates
Kaiser Medical Rates
HDHP + HSA Biweekly Rates
Employee Only $52.68
Employee + Spouse $186.58
Employee + Child(ren) $143.54
Employee + Family $273.52
MID-PPO Biweekly Rates
Employee Only $76.17
Employee + Spouse $240.30
Employee + Child(ren) $190.68
Employee + Family $350.40
Programs for BCBSTX Members
Livongo for Diabetes Management
Airrosti to Help Resolve Physical Pain
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Carrier Information

Blue Cross Blue Shield of Texas (BCBSTX)
Blue Choice Network
1-800-311-1593
www.bcbstx.com

HDHP + HSA Plan
Group number 275774

Hybrid Plan
Group number 270240

Mid-PPO Plan
Group number 426747

MDLIVE
1-888-680-8646
MDLIVE.com/BCBSTX

Kaiser Permanente Information
1-800-464-4000
www.kp.org

Kaiser Telemedicine
1-877-524-7373 (M-F 7 a.m. to 7 p.m. PST)
1-888-576-6225 (after hours)

Plan Documents
FAQs
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