2024 Employee Benefit Guide

Medical Plan Network Options

Medical Plan Network Options It is important to know your network, and the providers in it, to avoid high er out - of - pocket costs due to being out - of - network. ◼ You might consider a narrow network if you are healthy. The lower premium may balance out the smaller net- work if you usually only visit your doctor for regular health exams. Narrow networks can be enough if you don ’ t see a lot of specialists or need many medical tests. ◼ You might need a larger network if you or a family member needs a lot of care. If you have a chronic health problem like diabetes or heart disease, a narrow network could limit your choices. If you leave your network, your out - of - pocket costs could add up quickly. Be sure to study each network with care to make sure you are able to visit your regular providers. Search the plan ’ s list of providers (available online) by your zip code. See if your provider or how many other providers are close to where you live and work. Below is a sample list of hospitals that are not included in the narrow network:

Alton Memorial

Northwest Healthcare

All Barnes - Jewish Hospitals

Parkland Health Center

Christian Hospital

Progress West Hospital Rehab Institute of St. Louis

Goldfarb School of Nursing

Memorial Hospital East & Belleville

St. Louis Children ’ s Hospital

Missouri Baptist Medical Center & Sullivan

Washington University

This is not a complete list of excluded providers. Be sure to check with your provider to confirm which network they are affiliated with. This also applies to urgent care, outpatient and imaging centers. A complete list of providers can be found on the Anthem website. If you enroll in the narrow network option, you will be required to sign a document stating you understand the provisions of this plan and that if you go to a BJC provider in this option for a non - emergency visit, the cost will be subject to your out - of - network benefits. If you choose to “ waive ” the medical coverage, you will receive a monthly opt out allocation of $150 . In order to receive this allocation, you must return the “ waiver form ” to the Business Office. This form is available on the Benefit Allocation page on the enrollment website.

Employee Share of Medical Premiums (Monthly)

Coverage Type

Base Plan

Buy - Up Plan

QHDHP

Narrow Network

Narrow Network $ 117 .00 $6 96 .00 $ 531 .00 $1,1 84 .00

Narrow Network

Full Network

Full Network

Full Network

$1 65. 00

Employee

$0.00

$0.00

$0.00

$0.00

$4 72 .00 $ 328 .00 $8 72 .00

$ 384 .00 $2 4 8.00 $7 48 .00

$ 240. 00 $1 20 .00 $54 4 .00

$ 173 .00 $6 0 .00 $4 47 .00

Employee/Spouse

$785.00

$ 612 .00

Employee/Children

$1, 309 .00

Family

6

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