Overview

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.

2019 Medical Plans

WinnCompanies offers you a choice of medical plans with a range of coverage levels and costs, so you have the flexibility to select the option that’s best for you. Your medical plan provider is Blue Cross Blue Shield of Massachusetts.

Plan Description
PPO 80/60 Standard Plan Enjoy greater predictability of costs through copays for doctor’s visits and prescriptions, along with a low deductible and higher premiums.
PPO 80/60 Value Plan Balance your paycheck and out-of-pocket costs with a moderate deductible and moderate premiums, along with copays for doctor’s visits and prescriptions.
PPO HSA Saver Plan Take charge of your spending through lower premiums, higher deductibles, and a tax-free Health Savings Account (HSA) (with contributions from WinnCompanies) that you own for life.
HMO NE
(This is a closed plan, no new hires are eligible to enroll in this coverage.)
A Health Maintenance Organization (HMO) plan that provides coverage for in-network care only, coordinated by your primary care provider.
Compare the plans

Key Features

All of WinnCompanies' medical plans offer:

  • Comprehensive, affordable coverage for a wide range of health care services.
  • Free in-network preventive care, with services such as annual physicals, recommended immunizations, and routine cancer screenings covered at 100%. See more covered preventive services.
  • Prescription drug coverage included in each medical plan, with benefits for both retail and mail order pharmacies.
  • Financial protection through annual out-of-pocket maximums that limit the amount you’ll pay each year.
  • Additional BCBS wellness resources, programs, and tools

Eligibility

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, effective January 1, 2020.*

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

  • Your legal spouse
  • 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 1-800-868-0782 to speak with a benefits counselor for more information.

Are you enrolling a spouse?

If you plan to enroll a spouse in benefits coverage, please note that the WinnCompanies medical plans include a spousal surcharge. If you choose to cover your spouse under the WinnCompanies benefits, and he/she has access to other health coverage, you will pay an additional $600 per year for your medical insurance.

*If you are hired between November 1, 2019, and December 31, 2019, and meet the above eligibility requirements, you will be eligible for benefits from WinnCompanies on February 1, 2020.

PPO 80/60 Standard Plan

The PPO 80/60 Standard 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 PPO 80/60 Standard Plan Works

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

copay

Copay

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

deductible

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

Coinsurance

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

out of pocket

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.

Use Your PPO 80/60 Standard 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.

PPO 80/60 Value Plan

Compared to the PPO 80/60 Standard Plan, the PPO 80/60 Value 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 PPO 80/60 Value Plan Works

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

copay

Copay

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

deductible

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

Coinsurance

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

out of pocket

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.

Use Your PPO 80/60 Value 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.

PPO HSA Saver Plan

The PPO HSA Saver Plan 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 PPO HSA Saver Plan Works

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

copay

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

Deductible

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

coinsurance

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

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.

Use Your PPO HSA Saver 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, use helpful tools, and more. Likewise, keep tabs on your HSA by logging in to the HealthEquity 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.

HMO NE Plan

The HMO NE Plan provides 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:This plan is only available to team members working in New England and is a closed plan, no new enrollments will be accepted into this plan.

How the HMO NE Plan Works

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

copay

Copay

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

deductible

Deductible

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

coinsurance

Coinsurance

After you’ve met the annual deductible, the plan pays the full cost of in-network hospital services.

out of pocket

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.

Use Your HMO NE 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.
  • 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 Blue Cross Blue Shield of Massachusetts 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, 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.

Find a Doctor

Using in-network providers saves you money. Here’s how to find doctors in your medical plan network.

  • 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.
iconDon’t have a primary care physician? You should. Here’s why.
  • Better health. Getting the right health screenings each year can reduce your risk for many serious conditions. Preventive care is free, so there’s no excuse to skip it.
  • A healthier wallet. Having a doctor you can call helps you avoid costly trips to the emergency room and decide when you really need to see a specialist.
  • Peace of mind. Advice from someone you trust means a lot when you’re healthy, but it’s even more important when you’re sick. Your primary care physician gets to know you and your health history and can help coordinate any care you need.

Prescriptions

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.

Why use mail order?
  • Prescriptions are shipped to you for free — no waiting in line at the pharmacy.
  • You save money with a reduced cost for a three-month supply.
  • You can set up automatic refills.

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.

Telehealth

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.

Why use telehealth?

Using Well Connection, you’ll be able to:

  • Have live video visits with a doctor from the convenience of your smartphone, tablet, or computer
  • See licensed doctors and other providers anytime, anywhere
  • Have medical and behavioral health visits that are secure and confidential

Save Money and Time

A telehealth visit costs the same as a doctor’s office visit. PPO HSA Saver Plan 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:

Medical Care Behavioral Health
Bronchitis Depression
Flu Anxiety
Pink eye Child behavioral issues
Fever Coping with chronic health problems
Sprains and strains Smoking cessation
Reactions to medications Stress management
Sore throat Weight management
Sinus infections Sleep difficulties
And more And more

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.

Life Events

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. Contact Human Resources to make changes to your coverage.

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. However, voluntary accident insurance, critical illness insurance, and hospital indemnity insurance can be changed anytime by contacting Unum.