Medical and Prescription

To support your health and financial wellness, WinnCompanies provides valuable benefits that help you and your family stay healthy and pay for care in the event of illness or injury.

2023 Medical Plans

WinnCompanies offers you a choice of medical plans with a wide range of coverage levels and costs, so you have the flexibility to select the option that’s best for you.

To be eligible for benefits from WinnCompanies, you must be an active, regular team member working a minimum of 30 hours a week, and you must have completed 30 days of service.

In addition to enrolling yourself in benefits coverage, you may also enroll certain dependents. Your eligible dependents may include:

• Your legal spouse or domestic partner
• Your children up to age 26
• Any dependents that you are legal guardian of

Only those dependents meeting the eligibility requirements can enroll for coverage. Call 1-855-559-4515 to speak with a benefits counselor for more information.

The $1,250 PPO Plan offers lower out-of-pocket costs in exchange for higher premiums. With this plan, your costs are more predictable, but you’ll likely still have out-of-pocket expenses. You can see any provider you wish, but you will pay significantly less when you stay in network.

How the $1,250 PPO Plan Works

You pay the plan premium from your paycheck to have coverage.

Copay

You pay a fee at the time of service for in-network doctor visits and prescriptions.

Deductible

For care that doesn’t charge a copay, such as hospital services, you pay 100% of the costs until you meet the annual deductible.

Coinsurance

After meeting the deductible, you and the plan share the cost of certain services. The plan pays the majority.

Out-of-Pocket Maximum

You’re protected by an annual limit on costs — the plan pays 100% of any further covered expenses for the rest of the year.

Keep in mind: You pay nothing for in-network preventive care — it’s covered in full.

Note for MA/NH team members: The $1,250 PPO Plan with Hospital Choice Cost Share works the same way as the $1,250 PPO Plan, but your cost share for hospital services will differ depending on which hospital you visit.

Use Your $1,250 PPO Plan Wisely

Here are ways to make the most of your plan all year long.

• Track your stats. Log in to the Blue Cross Blue Shield of Massachusetts website to see how much of your deductible you’ve met, review claims, and more.
• Pair it with a Health Care FSA. If you enroll in the Health Care FSA, you can set aside pre-tax dollars to help pay for your out-of-pocket costs. Keep in mind, you can only carry over up to $500 of unused money in your FSA to the next year; you will forfeit amounts above $500.
• Be cost-conscious. Visit the Blue Cross Blue Shield of Massachusetts website to search for in-network providers and use the tools to compare costs for medical services.
• Know where to get care. You’ll pay more (and likely face a long wait) if you go to the emergency room for issues that could be resolved at an urgent care center, at your doctor’s office, or through a telehealth online visit.

For more information, visit the Winntranet to see the Benefit Guides, including rates.   You can also view detailed plan Certificates in Documents list on MM365+.

Compared to the $1,250 PPO Plan, the $1,850 PPO Plan offers lower premiums in exchange for higher out-of-pocket costs. With this plan, your expenses are still predictable, but you take on more responsibility for the cost of your care. You can see any provider you wish, but you will pay significantly less when you stay in network.

How the $1,850 PPO Plan Works

You pay the plan premium from your paycheck to have coverage.

Copay

You pay a fee at the time of service for in-network doctor visits and prescriptions.

Deductible

For care that doesn’t charge a copay, such as hospital services, you pay 100% of the costs until you meet the annual deductible.

Coinsurance

After meeting the deductible, you and the plan share the cost of certain services. The plan pays the majority.

Out-of-Pocket Maximum

You’re protected by an annual limit on costs — the plan pays 100% of any further covered expenses for the rest of the year.

Keep in mind: You pay nothing for in-network preventive care — it’s covered in full.

Note for MA/NH team members: The $1,850 PPO Plan with Hospital Choice Cost Share works the same way as the $1,850 PPO Plan, but your cost share for hospital services will differ depending on which hospital you visit.

Use Your $1,850 PPO Plan Wisely

Here are ways to make the most of your plan all year long.

• Track your stats. Log in to the Blue Cross Blue Shield of Massachusetts website to see how much of your deductible you’ve met, review claims, and more.
• Pair it with a Health Care FSA. If you enroll in the Health Care FSA, you can set aside pre-tax dollars to help pay for your out-of-pocket costs. Keep in mind, you can only carry over up to $500 of unused money in your FSA to the next year; you will forfeit amounts above $500.
• Be cost-conscious.Visit the Blue Cross Blue Shield of Massachusetts website to search for in-network providers and use the tools to compare costs for medical services.
• Know where to get care. You’ll pay more (and likely face a long wait) if you go to the emergency room for issues that could be resolved at an urgent care center, at your doctor’s office, or through a telehealth online visit.

For more information, visit the Employee Resources page on Winntranet to see the detailed plan certificate and rates.

The $3,000 PPO HDHP with HSA pairs low-premium, high-deductible coverage with a tax-free Health Savings Account (HSA) that helps you save up for future medical expenses. As an added bonus, WinnCompanies will contribute to your HSA — $500 for team member-only coverage and $1,000 for all other coverage levels. Money in your HSA can be carried forward from year to year and is always yours to keep (even if you retire or leave WinnCompanies). With this plan, you can see any provider you wish, but you will pay significantly less when you stay in network.

How the $3,000 PPO HDHP with HSA Works

You pay the plan premium from your paycheck to have coverage.

HSA

You can set aside tax-free money from your paycheck and receive company contributions to help cover your costs — now, or in the future.

Deductible

You pay 100% of costs until you meet the annual deductible.

Coinsurance

After meeting the deductible, you and the plan share the cost of certain services. The plan pays the majority. You will also pay a copay for emergency care and prescription drugs.

Out-of-Pocket Maximum

You’re protected by an annual limit on costs — the plan pays 100% of any further covered expenses for the rest of the year.

Keep in mind: You pay nothing for in-network preventive care — it’s covered in full.

 

Note for MA/NH team members: The $3,000 Plan with HSA with Hospital Choice Cost Share works the same way as the $3,000 PPO HDHP with HSA, but your cost share for hospital services will differ depending on which hospital you visit.

Use Your $3,000 PPO HDHP with HSA Wisely

Here are ways to make the most of your plan all year long.

• Track your stats. Log in to the Blue Cross Blue Shield of Massachusetts website to see how much of your deductible you’ve met, review claims, use helpful tools, and more. Likewise, keep tabs on your HSA by logging in to the MM365+ website to view your balance, submit claims, and more.
• Think about your costs. You pay lower premiums in exchange for assuming more financial responsibility when you receive care, so it’s smart to plan ahead. Try to contribute enough to your HSA to cover your expected out-of-pocket costs, such as your annual deductible and coinsurance.
• Know where to get care. You’ll pay more (and likely face a long wait) if you go to the emergency room for issues that could be resolved at an urgent care center, at your doctor’s office, or through a telehealth online visit.
• Change your HSA contributions anytime. Adjust your contributions as necessary during the year to keep your savings on track with your anticipated expenses. Contact the HRHelpdesk to find out how. Note: You can only spend HSA contributions that have actually been deposited into your account.
• Look long term. You will never forfeit any money left in your HSA — it rolls over year after year. If you know about future expenses — or if you want to save for your health care costs in retirement — set aside a little extra each paycheck so your balance can grow over time.

For more information, visit the Employee Resources page on Winntranet to see the detailed plan certificate and rates.

The Kaiser HMO Plans provide coverage only when you receive care from providers within the HMO network. Your Primary Care Provider (PCP) will coordinate your care to help manage costs.

Note: These plans are only available to team members in California, DC, Virginia, and Maryland who live within the Kaiser service area.

Use Your Kaiser HMO Plan Wisely

Here are ways to make the most of your plan all year long.

• Track your stats. Log in to the Kaiser website to see how much of your deductible you’ve met, review claims, and more.
• Pair it with a Health Care FSA. If you enroll in the Health Care FSA, you can set aside pre-tax dollars to help pay for your out-of-pocket costs. Keep in mind, you can only carry over up to $500 of unused money in your FSA to the next year; you will forfeit amounts above $500.
• Choose the right PCP. Your doctor will manage your care and provide referrals if you need to see a specialist. Search for network providers on the Kaiser website.
• Know where to get care. You’ll pay more (and likely face a long wait) if you go to the emergency room for issues that could be resolved at an urgent care center or at your doctor’s office.

For more information, visit the Employee Resources page on Winntranet to see the detailed plan certificate and rates.

Using in-network providers saves you money. Here’s how to find doctors in your medical plan network if you’re enrolled in a Blue Cross Blue Shield medical plan.

• Visit the Blue Cross Blue Shield of Massachusetts website.
• Click on “Find a Doctor.”
• Scroll down to the blue box and click on “Create an account,” or click “Login” if you already registered on the site.
• You can search providers without logging in (click on “Find a doctor without logging in” in the blue box), but if you log in to your MyBlue account, you can also estimate costs.
• The “Find a Doctor & Estimate Costs” tool allows you to search by condition or specialty, compare costs and provider ratings, and find doctors within a certain geographic area.

When you enroll in a WinnCompanies medical plan, you automatically receive prescription drug benefits.

Drug Tiers

The cost of your prescription drugs depends on the tier of the medication:

• Generic ‒ Generic drugs contain the same active ingredients as their brand-name equivalents and meet the same federal standards for safety, but typically cost significantly less.
• Brand Preferred ‒ Preferred brand-name prescription medications are favored by a prescription plan based on drug effectiveness and cost.
• Brand Non-Preferred ‒ Non-preferred brand-name prescription medications are not on a prescription plan's favored list (or formulary) based on drug effectiveness and cost. Non-preferred drugs still may be covered, but may require prior authorization and cost more.

Mail Order

For ongoing maintenance medication, you can take advantage of the convenience and cost savings of using the mail order program.

Save Money

The cost of prescription drugs is rising faster than many other health care services and supplies. But, there are ways for you to save on the cost of your prescriptions.

• Ask your doctor about generic medications. Generic medications are generally just as effective as brand-name medications, but they cost between 30% and 75% less.
• Use the plan's mail order feature. If you regularly take medication to treat a chronic condition — such as an allergy, heart disease, high blood pressure, or diabetes — the mail order prescription program is a convenient and money-saving option for you.

Finding the care you need is fast, easy, and convenient with Well Connection. Available as a covered benefit with your Blue Cross Blue Shield medical plan, Well Connection offers a convenient alternative to a face-to-face doctor’s office visit.

Video visits through Well Connection enable you and your covered family members to see a doctor online for a range of issues, from minor illnesses and injuries, chronic conditions, and even general health and wellness concerns. Telehealth also provides limited therapy visits with certified professionals. And it’s available 24/7/365.

Save Money and Time

A telehealth visit costs the same as a doctor’s office visit. $3,000 PPO HDHP with HSA participants are subject to the applicable deductible. Telehealth may be less expensive than going to the ER or an urgent care center, and faster than making an appointment and driving to the doctor’s office. Telehealth doctors can diagnose and prescribe medicine for issues such as:

Get Started

• Download the Well Connection app from the Apple App Store or Google Play.
• Or visit wellconnection.com to use your computer instead of a mobile device.
• Create an account and log in.
• Choose the type of service: medical or behavioral.
• Pick an available provider.

Learn more at www.bluecrossma.com/telehealth. Your service key is BCBSMA.

IRS regulations restrict your ability to change your elections during the year unless you experience a qualifying life event such as marriage, divorce, birth or adoption of a child, death of a dependent, changes in your or your spouse’s status, or an involuntary loss of coverage under another plan.

You have 30 days from the date of the qualifying life event to make changes to your coverage, as long as the changes are consistent with the qualifying life event. Initiate your life event and make coverage changes through MM365+, then send documentation of your life event to the HR Helpdesk.

If you are enrolled in the Health Savings Account (HSA), you can make changes to your HSA contributions at any time during the year as long as you don’t exceed the annual IRS limits.

If you don’t have a qualifying life event during the year, your only opportunities to enroll in or change benefits are as a new hire or during our annual Open Enrollment.