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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 Hybrid and HRA plan. An HDHP allows you to use a tax-advantaged HSA to help pay for your medical costs (now and in the future).

This plan combines a medical plan with an HRA funded by Ensign to pay for your covered medical expenses, including prescription drugs. Once your HRA funds are depleted, you will be responsible for 100% of any remaining charges until you have met your deductible.

If you use providers in-network, you do not have to meet your annual deductible before the plan pays for portions of certain services such as office visits and telemedicine. You are responsible for a set copay for such services, and the plan pays the rest of the cost. For other services, you and the plan share cost (also known as coinsurance) after you meet your deductible.

Nationwide BCBSTX Medical Plan Overview

Nationwide BCBSTX HDHP + HSA
Plan Features In-Network Out-of-Network
Ensign account funding $750 employee only / $1,500 family
Annual deductible
(employee / family)		 $3,200 / $6,400 $6,400 / $12,800
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 20% after deductible 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 and Hybrid generic drugs are subject to deductible. Copay is applicable after deductible has been met.
Nationwide BCBSTX HRA PLAN
Plan Features In-Network Out-of-Network
Ensign account funding $500 employee only / $1,000 family
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 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 and Hybrid generic drugs are subject to deductible. Copay is applicable after deductible has been met.
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 $30 copay /
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 and Hybrid generic drugs are subject to deductible. Copay is applicable after deductible has been met.

2024 Employee Contribution Rates
BCBSTX Medical Rates
HDHP + HSA Biweekly Rates
Employee Only  $29.92
Employee + Spouse $126.95
Employee + Child(ren) $93.53
Employee + Family $185.79
HRA Biweekly Rates
Employee Only $50.84
Employee + Spouse $176.69
Employee + Child(ren) $136.58
Employee + Family $257.05
HYBRID Biweekly Rates
Employee Only $53.95
Employee + Spouse $187.52
Employee + Child(ren) $144.96
Employee + Family $272.81

California Only Kaiser Medical Plan Overview

Kaiser HDHP + HSA
Plan Features In-Network Only
Ensign account funding $500 employee only / $1,000 family
Annual deductible
(employee / family)		 $3,200 / $6,400
Out-of-pocket maximum (employee / family)
includes deductible		 $6,000 / $12,000
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 HRA PLAN
Plan Features In-Network Only
Ensign account funding $500 employee only / $1,000 family
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 $200
(no deductible)		 N/A

2024 Employee Contribution Rates
Kaiser Medical Rates
HDHP + HSA Biweekly Rates
Employee Only  $39.18
Employee + Spouse $158.22
Employee + Child(ren) $117.89
Employee + Family $231.66
HRA Biweekly Rates
Employee Only $59.43
Employee + Spouse $205.15
Employee + Child(ren) $158.88
Employee + Family $298.52
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 and HRA Plan
Group number 275774

Hybrid Plan
Group number 270240

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