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Pelican HRA 1000

Administered by Blue Cross Blue Shield and MedImpact

The Office of Group Benefits (OGB) offers multiple health plans, including the Pelican HRA1000. The claims administrator is Blue Cross and Blue Shield of Louisiana, while the pharmacy benefit manager is MedImpact. It features lower premiums than Magnolia plans in exchange for higher deductibles. The Pelican HRA 1000 utilizes the Blue Cross and Blue Shield of Louisiana Preferred Care Providers and Blue Cross National Providers.

Medical Coverage

The Pelican HRA 1000 includes $1,000 in annual employer contributions for employee-only plans and $2,000 for family plans in a health reimbursement arrangement that can be used to offset deductibles and other out-of-pocket medical, not pharmacy, costs throughout the year.

A Health Reimbursement Arrangement, or HRA, is an account used to reimburse employees’ medical expenses and other medical costs. These funds are available as long as you remain employed by an OGB-participating employer. Any unused funds roll up to the in-network, out-of-pocket maximum (see following chart), allowing members to build up balances that cover eligible medical expenses.

Members do not have direct access to the funds. The out-of-pocket portion of a claim will be paid directly by Blue Cross Blue Shield of Louisiana from the member’s account. Funds can only be used to cover eligible medical expenses, such as coinsurance, co-pays, deductibles, and services. Pharmacy, dental, and vision claims are not considered eligible medical expenses and therefore will not be paid for out of the HRA funds.

Medical Coverage Employee Only Employee + 1 (Spouse or Child) Employee + Children Family
Employer Contribution to HRA $1,000 $2,000 $2,000 $2,000
Deductible (in-network) $2,000 $4,000 $4,000 $4,000
Deductible (out-of-network) $4,000 $8,000 $8,000 $8,000
Coinsurance (in-network) 20% 20% 20% 20%
Coinsurance (out-of-network)** 40% 40% 40% 40%
Out-of-pocket max (in-network) $5,000 $10,000 $10,000 $10,000
Out-of-pocket max (out-of-network) $10,000 $20,000 $20,000

$20,000

*Once a member's deductible for allowable charges is met, he or she will pay 40% of the allowable charge, plus 100% of the difference between the allowable charge and billed amount.

Prescription Coverage

The Pelican HRA 1000 uses the MedImpact formulary. Members will continue to pay a portion of the cost of their prescriptions in the form of a co-pay or coinsurance. The amount members pay toward their prescription depends on whether or not they receive a generic, preferred brand, non-preferred brand or specialty drug.

Tier Member Responsibility Once you pay $1,500
Generic 50% up to $30 $0 co-pay
Preferred 50% up to $55 $20 co-pay
Non-Preferred 65% up to $80 $40 co-pay
Specialty 50% up to $80 $40 co-pay

 

Blue Cross Blue Shield of LA

VISIT BCBS

1-800-392-4089

8:00 a.m. - 5:00 p.m.

MedImpact

visit medimpact

1-800-788-2949

24 hours, seven days a week

OGB

visit OGB

1-800-272-8451

Monday - Friday

8:00 a.m. - 5:00 p.m.

 

Job Aids & Resources

Health Insurance and Dependents can only be changed during Annual Enrollment or due to a Qualifying Life Event (QLE). 

insurance eligibility

LIST OF QUALIFYING EVENTs

benefit job aids and forms

2021 PREMIUMS FOR ACTIVE EMPLOYEES

2021 PREMIUMS FOR RETIREES

2021 HEALTH PLAN COMPARISON

2021 PELiCAN HRA 1000 SUMMARY OF BENEFITS AND COVERAGE

2021 Pelican HRA 1000 Welcome Kit

2021 Pelican HRA 1000 SCHEDULE OF BENEFITS

2021 Pelican HRA 1000 Plan Document

Pelican HRA 1000 BENEFIT PLAN

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