Blue Cross Blue Shield of Arizona Plan Information
for the 2020/2021 Plan Year
1) The District will continue utilizing a 4-tier structure of Employee Only, Employee + Spouse, Employee + Child(ren) and Employee + Family (Spouse & Child(ren) for the 2020/2021 Plan year.
Note: this tier stucture only applies to our medical insurance. Our dental and vision insurances utilize a 3-tier structure of Employee Only, Employee + 1 Dependent and Employee + 2 or more Dependents.
2) The District will continue to offer three traditional PPO Plan Options (High, Middle & Low), as well as, a Low Option - Limited Network Plan via the Alliance Network.
The main difference between our traditional PPO Plans and a Limited Network Plan is addressed below:
PPO Plans: Have In-Network doctors and hospitals throughout Arizona. The BCBSAZ Statewide PPO network includes 90% of doctors and hospitals in the state.
Limited Network Plans: Include selected In-Network doctors and hospitals that must be utilized for non-emergency care within the state of Arizona. The Alliance Network is made up of contracted hospitals and doctors that are part of Banner Health and HonorHealth (Formerly Scottsdale Healthcare and John C. Lincoln Health).
The 2020/2021 Blue Cross Blue Shield of AZ Employee Premiums are reflected below.
Plan Tier Monthly Premium Blue Cross/Blue Shield High - Employee Only $ 62.80 Blue Cross/Blue Shield High - Employee + Spouse $ 764.86 Blue Cross/Blue Shield High - Employee + Child(ren) $ 447.52 Blue Cross/Blue Shield High - Employee + Family $ 1,392.56 Blue Cross/Blue Shield Middle - Employee Only $ - Blue Cross/Blue Shield Middle - Employee + Spouse $ 632.98 Blue Cross/Blue Shield Middle - Employee + Child(ren) $ 343.90 Blue Cross/Blue Shield Middle - Employee + Family $ 1,188.46 Blue Cross/Blue Shield Low - Employee Only $ - Blue Cross/Blue Shield Low - Employee + Spouse $ 478.58 Blue Cross/Blue Shield Low - Employee + Child(ren) $ 222.58 Blue Cross/Blue Shield Low - Employee + Family $ 949.50 Blue Cross/Blue Shield Low Alliance Network - Employee Only $ - Blue Cross/Blue Shield Low Alliance Network - Employee + Spouse $ 209.30 Blue Cross/Blue Shield Low Alliance Network - Employee + Child(ren) $ 11.02 Blue Cross/Blue Shield Low Alliance Network - Employee + Family $ 532.76
Plan Details and Documents
Note: Unless stated otherwise, the following FAQs pertain to the Alliance Plan Option Only.
What is the Alliance Network?
The Alliance Network is made up of contracted hospitals and doctors that are part of Banner Health and HonorHealth. All non-emergency services received within the state of Arizona must utilize these providers to be considered In-Network. Note: Sonora Quest is the only contracted lab. For more information on the Alliance Network, please review the Alliance Member Flyer.
How do I Find a Provider Within the Alliance Network?
To check to see if your current healthcare provider is in the Alliance Network or to find a new provider, please review the Find a Doctor (English) or Find a Doctor (Spanish) tools. Note: make sure to select the Alliance PPO Network when using this tool.
Does the Alliance Option offer the same coverage as the other BCBSAZ plan options?
Yes, all the District medical options cover the same services, only the member cost-sharing (deductibles, co-pays, co-insurance percentages, maximums, etc.) is different. Please refer to the applicable benefit summary for specifics. Note: The Alliance option mirrors the cost-sharing design of the Low option except for the In-Network network.
What happens if I use a non-Alliance medical provider for non-emergency care in the state of Arizona?
Claim will be processed as Out-of-Network.
What if I need to go to Urgent Care?
Urgent Care is considered non-emergency so provider must be part of the Alliance Network to be considered In-Network.
What if I need emergency care?
Claim will be processed as In-Network (All Plan Options).
What if I need care Out of State?
Claim will be processed through the PPO Network (All Plan Options).
Can I enroll my dependents into a different plan than mine?
No, the employee is the subscriber on the insurance so any dependents would be enrolled as part of the employee's insurance (All Plan Options).
PUHSD did not make any plan design changes for the 2020/2021 plan year. However, other recent changes worth noting are referenced below.
- Preventative Services Coverage - This benefit plan has made changes to how preventative services will be covered thereby eliminating/reducing most employee cost-sharing. Please see applicable Benefit Plan Summary for specifics.
- Domestic Partner (DP) Coverage - For the purposes of this plan, DPs will fall under the Spouse tiers. Also, per IRS regulations, DP premiums will be deducted Post-Tax. In addition, Employees utilizing this tier will be required to submit an annual Attestation verifying DP status.
- Gender Transition Coverage - This benefit plan will now cover gender transition surgery and medications taken for the purpose of gender transition.
However, there were some Federal mandated changes which were implemented. Please open the below link to reveiw these changes.