Medical Plan Choices
Choices
Alston Construction understands that each individual has different needs for themselves and their families. For this reason, we offer a range of medical plan options from which to choose. The plans vary in style, range of flexibility and freedom, and price.
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HIGH DEDUCTIBLE HEALTH PLAN
This is a High Deductible Health Plan (HDHP) offered by Alston Construction that is designed to work alongside a special Health Care Savings Account (HSA). The HDHP works much like the PPO plan, in that members have the choice of using in-network PPO providers or providers not contracting with the health plan. However, there is no first dollar coverage on a HDHP. The member must first satisfy their deductible.
Consumerism
The intent of the HDHP is to allow the member to see and pay for all claims that are incurred, prior to the deductible. Doing so, the member gains a better understanding of actual plan costs as they are charged. Once the deductible is satisfied, the plan performs much like our traditional PPO plan.
Health Savings Account HSA
The HSA is bank account that the member owns. Pre-tax dollars may be deposited into the HSA accounts that can then be spent on qualified expenses.
Important Note
The below link will take you to the Blue Shield provider search website.
Employees located in California: Choose “Employer Group Plans (101+ employees)”. The sub plan is “Shield Spectrum PPO”. Then click “continue with this plan” and you are ready to search.
Employees located outside California: On the bottom left hand side there is “accessing care outside of CA”. This will link to the national Blue Card network. You will need the first 3 letters of the ID number which is PDQ.
Freedom of Choice
A PPO plan is a program that allows considerable range of freedom. You may make any number of elections as to how and where you receive care. The out-of-pocket expense for the PPO program is best managed by always first seeking care from a contracted PPO preferred provider.
Brief Benefit Description
The HDHP has an in-network $1,800 deductible for individuals and $3,600 for families (out of network deductibles are $8,000/individual and $16,000 for families). All expenses incurred before the deductible are bore by the insured. After the deductible, the Plan pays 80% of the negotiated fees for a PPO preferred provider, and 60% of negotiated fees for a non-contracted provider. Preferred providers accept Blue Shield’s allowable amount as full payment for covered services. Non-preferred providers can charge more than these amounts. When you use non-preferred providers, you must pay the applicable copayment plus any amount that exceeds Blue Shield's allowable amount. Click on the Benefit Summary below for specific details of this plan.
Cost
For premium information based on different enrollment scenarios, go to the “Your Costs” section of this website.
Description Title
Invest in your health, tax-free
A Health Savings Account (HSA) is like an IRA for your healthcare that empowers you to prepare for and manage healthcare costs — both today and tomorrow. The account is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a high-deductible health plan (HDHP). The funds contributed to an account are not subject to federal income tax at the time of deposit.
Usage
Your HSA can be used to pay for all eligible expenses (typically, prescribed medical or health-related services). Such as, medical deductibles, copayments, coinsurance, prescription eye care, dental care expenses, etc.
Tax Benefit
Members or their employers may deposit money into an HSA on a pre-tax basis. Meaning, they won't pay regular federal income tax on the HSA deposit. Additionally, most states will also honor pre-tax deposits into the HSA (California is a state that does not honor HSA deposits). HSA funds spent on eligible expenses are not taxed.
Limits
In 2025, the IRS will allow up to $4,300 for individuals, and $8,550 for families, to be deposited into the HSA account.
Employer Deposit
Your employer will be assisting in funding the HSA account by depositing $1,200 for individuals and $2,400 for families (any tier of coverage above employee only) who participate in the HDHP.
Use it or Keep it
Unlike the Flexible Spending Account (FSA), unspent HSA funds are allowed to roll over into the next plan year.
Rules
To participate in the HDHP, the following rules apply:
- You may not participate in any other health plan
- You cannot also participate in the Flexible Spending Account in a year you are depositing into the HSA; nor can your spouse
- You may not be covered by Medicare
- You cannot be claimed as a dependent on anyone else's tax return
Please consult with a tax professional to learn all aspects of participating and using an HSA.
PREFERRED PROVIDER ORGANIZATION (PPO)
PPO
Alston Construction offers a single Preferred Provider Organization (PPO) plan through Blue Shield of California for all employees across the country. The PPO plan allows you the opportunity to choose from either a participating provider or to use a provider or hospital that is not contracted with Blue Shield. The network of available providers is extensive. The best means of locating a preferred provider in your area is by using the online provider directory.
Freedom of Choice
A PPO plan is a program that allows considerable range of freedom. You may make any number of elections as to how and where you receive care. The out-of-pocket expense for the PPO program is best managed by always first seeking care from a contracted PPO preferred provider.
Brief Benefit Description
The PPO plan includes a $20 co-payment for outpatient office-visits. There is a $250/$500 individual/family calendar-year deductible. The Plan pays 80% of the negotiated fees for a PPO preferred provider, and 60% of negotiated fees for a non-contracted provider. Preferred providers accept Blue Shield’s allowable amount as full payment for covered services. Non-preferred providers can charge more than these amounts. When you use non-preferred providers, you must pay the applicable copayment plus any amount that exceeds Blue Shield's allowable amount. Click on the Benefit Summary below for specific details of this plan.
Cost
For premium information based on different enrollment scenarios, go to the “Your Costs” section of this website.
As a Blue Shield participant, you have access to Teladoc® physician service for a $0 copay per call. Teladoc provides 24/7/365 access to a network of board-certified California doctors who can treat many of your non-emergency medical issues when your doctor is not available. You can talk to a Teladoc doctor, anytime, through the convenience of phone and online video consultations.
Why wait for the care you need? Set up your Teladoc account today so it’s ready when you need it!
Visit www.teladoc.com/bsc
or call 1-800-Teladoc (835-2362).