Table with glasses and medial equipement

Health Insurance

Quick Stats

Provider

Blue Cross and Blue Shield of Nebraska
Group #: 300190
NEtwork BLUE Network
Pharmacy Network: Network C
Drug List: PDL 10 (Formerly "BCBSNE Standard Formulary")
1-888-592-8961

Tools

BCBSNE Tools and Resources

  • Find a Doctor
  • Rx Benefits
  • Cost Estimator
  • Telehealth

Go Mobile

App Store | Google play

Compare HRA and HSA

D/C  = Deductible/Coinsurance

HSA HRA
Benefit Summary In-Network Out-of-Network In-Network Out-of-Network
Deductible/Coinsurance Aggregate Aggregate
Associate $1,500 $3,000 $2,000 $4,000
Associate Plus $3,000 $6,000 $4,000 $8,000
Coinsurance 25% 40% 30% 50%
Out-of-Pocket Maximum (includes Deductible, Coinsurance and Copays)
Associate $3,000 $6,000 $4,500 $9,000
Associate Plus $6,000 $12,000 $9,000 $18,000
WoodmenLife HSA or HRA Contributions
Associate $500 $1,000
Associate Plus $1,000 $2,000
Office Visit
Primary Care D/C D/C $30 Copay D/C
Specialist D/C D/C D/C D/C
Other Office Visit Services D/C D/C Included in Copay D/C
Preventive Care 100% D/C 100% D/C
Virtual Doctor D/C D/C $15 Fee D/C
Urgent and Emergency Care
Physician D/C D/C $55 Copay D/C
Other Urgent Care Services D/C D/C Included in Copay D/C
Emergency Care D/C Same as In-Network $175 Copay + D/C Same as In-Network
Prescription Drug Retail 30-day supply
Generic D/C In-Network + 25% $15 Copay In-Network + 25%
Formulary D/C In-Network + 25% 30%, $37.50 min to $150 max In-Network + 25%
Non-Formulary D/C In-Network + 25% 30%, $62.50 min to $250 max In-Network + 25%
Specialty D/C Not covered 30%, $75 min to $300 max Not covered
Prescription Drug Retail 90-day supply
Generic D/C Not covered $37.50 Copay Not covered
Formulary D/C Not covered 30%, $93.75 min to $375 max Not covered
Non-Formulary D/C Not covered 30%, $156.25 min to $625 max Not covered

Check out more details of each account.

HRA Details

HSA Details

Pre-Tax Premiums

Total health insurance cost, paid by you and WoodmenLife, is based on actual claims over the prior two years, projected claims, administrative expenses for the upcoming year, the plan and level of coverage you select, and your salary/earnings as of Sept. 30.

Benefits of an HSA

To help understand the benefits of a Health Savings Account, click here.

Tax Reporting

Click here for tax information related to health insurance.