As a HALO employee, you have two medical plan options through BCBS IL with access to a comprehensive national network (Blue Edge). Regardless of your enrollment, the plans are in the same network! If you are unsure of where to get care, please refer to the Provider Service Overview.
- For additional plan details, please see the applicable Summary of Benefits Coverage under the “Plan Documents & Contact Information” section below.
PPO
The PPO plan offers richer benefit provisions when compared to the High Deductible Health Plan. The PPO offers Copays for items such as Office & Specialist Visits, Urgent Care, Emergency Room Care, and Prescription Drugs.
The PPO has an embedded deductible structure. This means if you have Family Coverage and a single family member reaches the individual Deductible shown above, he or she will be eligible for benefits provided during that benefit period and does not have to wait for other family members to satisfy their program Deductibles. A family member may not apply more than the individual Deductible amount toward the family Deductible amount. Note that your deductible and out-of-pocket maximum renew on a calendar year basis.
| PPO | In-Network | Out-of-Network |
| Calendar Year Deductible |
| Individual | $750 | $3,000 |
| Family | $1,500 | $6,000 |
| Calendar Year Out-of-Pocket Maximum (Includes Deductible) |
| Individual | $4,500 | $13,600 |
| Family | $9,000 | $27,200 |
| Copays/Coinsurance |
| Preventive Care | No Charge | 40% coinsurance |
| Office Visit | $20 copay | 40% coinsurance |
| Specialist Visit | $40 copay | 40% coinsurance |
| Diagnostic test (x-ray, blood work) | 20% coinsurance | 40% coinsurance |
| Virtual Visits | No charge | 40% coinsurance |
| Imaging (CT/PET scans, MRIs) | 20% coinsurance | 40% coinsurance |
| Inpatient Hospital Stay (Facility Fee/Physician Fee) | 20% coinsurance | 40% coinsurance |
| Outpatient Surgery | 20% coinsurance | 40% coinsurance |
| Urgent Care | $50 copay | 40% coinsurance |
| Emergency Room Care | 20% coinsurance | 40% coinsurance |
| Emergency Medical Transportation | 20% coinsurance | 20% coinsurance |
| Prescription Drugs - Retail Supply (30 days) |
| Generic | $10 copay | Not Applicable |
| Preferred | $30 copay | Not Applicable |
| Non-Preferred | $50 copay | Not Applicable |
| Specialty | 30% up to $200 Copay | Not Applicable |
| Prescription Drugs - Mail Order (90 days) |
| Generic | $20 copay | Not Applicable |
| Preferred | $60 copay | Not Applicable |
| Non-Preferred | $100 copay | Not Applicable |
| Specialty | Not Applicable | Not Applicable |
The cost that you pay for medical insurance is based on your salary classification, completion of wellness activities, and tobacco status. The chart below reflects bi-weekly contributions for the PPO.
- Administrative Employees are classified into the groupings below, based on your salary or calculated salary.
- Classification into groupings: Over $200k, Over $100k, Over $60k, Under $60k.
- If you move classification within the year, your cost will be updated as of the 1st of the month, following the date of the change.
- Sales Employees are responsible for paying the costs associated with the Commissions-Based Classification below.
| PPO | Employee Only | Employee + Spouse | Employee + Child(ren) | Employee + Family |
| Over $200k |
| Wellness | $149.47 | $414.81 | $329.05 | $540.67 |
| Non-Wellness | $217.51 | $566.45 | $478.24 | $730.45 |
| Over $100k |
| Wellness | $122.36 | $334.57 | $268.63 | $445.42 |
| Non-Wellness | $184.41 | $475.32 | $406.14 | $609.98 |
| Over $60k |
| Wellness | $103.76 | $291.10 | $228.47 | $392.48 |
| Non-Wellness | $162.54 | $421.31 | $358.10 | $553.22 |
| Under $60k |
| Wellness | $90.48 | $265.11 | $204.13 | $370.43 |
| Non-Wellness | $136.11 | $374.77 | $299.20 | $504.59 |
| Tobacco Surcharge | $17.31 added per pay period, per tobacco user |
High Deductible Health Plan (HDHP)
Enrollment in HALO’S High Deductible Health Plan allows for you to open and contribute to a Health Savings Account (HSA). Learn more about Health Savings Accounts
You must meet your deductible below before coinsurance begins. If you meet your out-of-pocket maximum, you will not pay any more for the cost of your care for the rest of the year. Note that your deductible and out-of-pocket maximum renew on a calendar year basis.
The HDHP has an embedded deductible structure. This means if you have Family Coverage and a single family member reaches the individual Deductible shown above, he or she will be eligible for benefits provided during that benefit period and does not have to wait for other family members to satisfy their program Deductibles. A family member may not apply more than the individual Deductible amount toward the family Deductible amount. Note that your deductible and out-of-pocket maximum renew on a calendar year basis.
The HDHP has an aggregate out-of-pocket maximum. The plan pays 100% of the allowable covered in-network cost for the remainder of the calendar year, when the out-of-pocket maximum has been met. If you have other family members in this plan, they have to meet their own out-of-pocket limits, until the overall family out-of-pocket limit has been met.
| High Deductible Health Plan | In-Network | Out-of-Network |
| Calendar Year Deductible |
| Individual | $1,650 | $4,800 |
| Family | $3,300 | $9,600 |
| Calendar Year Out-of-Pocket Maximum (Includes Deductible) |
| Individual | $6,000 | $14,250 |
| Family | $12,000 | $27,300 |
| Copays/Coinsurance |
| Preventive Care | No charge | 40% coinsurance |
| Office Visit | 20% coinsurance | 40% coinsurance |
| Diagnostic test (x-ray, blood work) | 20% coinsurance | 40% coinsurance |
| Virtual Visits | 20% coinsurance | 40% coinsurance |
| Imaging ((CT/PET scans, MRIs) | 20% coinsurance | 40% coinsurance |
| Inpatient Hospital Stay (Facility Fee/ Physician Fee) | 20% coinsurance | 40% coinsurance |
| Outpatient Surgery | 20% coinsurance | 40% coinsurance |
| Urgent Care | 20% coinsurance | 40% coinsurance |
| Emergency Room Care | 20% coinsurance | 20% coinsurance |
| Emergency Medical Transportation | 20% coinsurance | 20% coinsurance |
Prescription Drugs - Retail Supply (30 days)
|
| Generic | $10 after deductible | Not Applicable |
| Preferred | $30 after deductible | Not Applicable |
| Non-Preferred | $50 after deductible | Not Applicable |
| Specialty | 20% up to $200 Copay after deductible | Not Applicable |
| Prescription Drugs - Mail Order (90 days) |
| Generic | $20 after deductible | Not Applicable |
| Preferred | $60 after deductible | Not Applicable |
| Non-Preferred | $100 after deductible | Not Applicable |
| Specialty | Not Applicable | Not Applicable |
The cost that you pay for medical insurance is based on your salary classification, completion of wellness activities, and tobacco status. The chart below reflects bi-weekly contributions for the HDHP.
- Administrative Employees are classified into the groupings below, based on your salary or calculated salary.
- Classification into groupings: Over $200k, Over $100k, Over $60k, Under $60k.
- If you move classification within the year, your cost will be updated as of the 1st of the month, following the date of the change.
- Sales Employees are responsible for paying the costs associated with the Commissions-Based Classification below.
| HDHP | Employee Only | Employee + Spouse | Employee + Child(ren) | Employee + Family |
| Over $200k |
| Wellness | $109.75 | $330.21 | $240.54 | $407.76 |
| Non-Wellness | $174.43 | $490.57 | $392.27 | $604.02 |
| Over $100k |
| Wellness | $92.19 | $271.56 | $207.98 | $342.78 |
| Non-Wellness | $147.88 | $411.64 | $333.28 | $508.04 |
| Over $60k |
| Wellness | $76.50 | $237.67 | $172.81 | $301.93 |
| Non-Wellness | $129.96 | $361.79 | $261.19 | $457.69 |
| Under $60k |
| Wellness | $62.35 | $206.05 | $158.41 | $284.91 |
| Non-Wellness | $108.72 | $318.87 | $229.89 | $409.80 |
| Tobacco Surcharge | $17.31 added per pay period, per tobacco user |
Plan Documents & Contact Information
Plan Documents:
Plan Information & Provider Resources:
Additional Resources:
