Sandia High Deductible Health Plan (HDHP) Administered by BCBSNM and UHC
For 2022, Sandia will offer you more flexibility and choice with an additional medical plan, called the Sandia High Deductible Health Plan. It is administered by Blue Cross and Blue Shield of New Mexico (BCBSNM) and UnitedHealthcare (UHC).
Please note: To comply with IRS rules, we cannot offer a Health Reimbursement Account (HRA) or a Health Savings Account (HSA) with the new Sandia High Deductible Health Plan.
Sandia’s HDHP is a key element of Sandia’s strategy to manage healthcare costs by encouraging retirees to make informed decisions about their healthcare. Whether you choose to move to the new plan, or to stay with your current plan in 2022, you can take advantage of integrated resources that support your health and wellness — and in doing so, improve your overall health.
KEY FEATURES OF THE NEW PLAN
With the new Sandia HDHP, in-network preventive care and certain preventive medications are free. Preventive care includes services like annual physical exams and certain cancer screenings. Be sure your in-network provider codes the service with a “preventive” Current Procedural Terminology (CPT) code to ensure 100% coverage.
With the new Sandia HDHP, you meet one annual deductible (for both medical services and prescription drugs), then the plan shares costs with you. Your annual deductible is the amount you pay out of-pocket each year for medical and prescription expenses. Your deductible amount is based on your coverage tier and which network of providers you use.
Once you meet your annual deductible, Sandia’s HDHP pays a percentage of your covered medical care and prescription drug costs and you pay the remaining percentage.
This is the maximum amount you’ll pay out-of-pocket for medical care and prescription drugs during a calendar year. Once you reach this limit, your remaining eligible expenses for the calendar year are covered at 100%.
ENHANCED PRESCRIPTION DRUG COVERAGE
The new Sandia HDHP comes with an enhanced prescription drug benefit. You’ll pay nothing for generic preventive medications included on the Express Scripts “standard plus” drug list.
For all other prescription drugs, you’ll pay 100% – but only until you meet your annual combined deductible. At that point, the plan will begin to share costs as noted in the Open Enrollment guide, based on the type of medication you use (generic, formulary brand, or non-formulary brand).
Also, the Sandia HDHP has one combined out-of-pocket limit for medical services and prescription drugs. So, you may notice that the total out-of-pocket limit under the new plan is lower.
HEALTH REIMBURSEMENT ACCOUNT (HRA)/HEALTH SAVINGS ACCOUNT (HSA) OPPORTUNITY
Sandia’s HDHP does not include an HRA or an HSA. If you decide to enroll in the new plan, and you have any funds in your current HRA, you will need to use your HRA funds by December 31, 2021. If you do not use your HRA balance, the funds will be forfeited on January 1, 2022.
ONLINE HEALTH ASSESSMENT
If you enroll in the HDHP, you are not required to complete an Online Health Assessment.