We’re pleased to announce very small premium increases to the medical plan ($1 – $4 per month depending on coverage level); and dental and vision premiums are staying the same for 2021.
We’ve expanded the provider networks under the Sandia Total Health Plan — for both Blue Cross Blue Shield of New Mexico (BCBSNM) and UnitedHealthcare (UHC) — giving you greater choice for high-quality, lower cost providers beginning Jan. 1, 2021.
- BCBSNM is replacing the Sandia Health Provider Network (SHPN) in New Mexico with the Blue Preferred Plus Provider Network. This new network features an expanded number of providers who offer high-quality services at the lowest cost (also called “Tier 1”).
- UHC will also offer a NEW lower-cost Tier 1 network, called UnitedHealthcare Choice Plus Premier Provider Network, to all employees except California residents (due to current state regulations). Learn more about the Tier 1 network at www.whyuhc.com/snl.
- With these new lower-cost network options, employees in New Mexico can compare Blue Cross Blue Shield New Mexico and UnitedHealthcare based on their 3-Tier networks and choose the benefit administrator that best fits their needs.
UHC and BCBS Tiered Plans
- The Deductibles cross-apply between the Tier 1 In-Network and Tier 2 In-Network. The Deductibles do not cross-apply between Tier 1 in-network and out-of-network, or Tier 2 and out-of-network.
- In addition to your Deductible, if applicable, you pay Coinsurance of 10% of the Covered Charge for the Tier 1 in-network, 20% of the Covered Charge for Tier 2 in-network services, and 40% of the Covered Charge for out-of-network services.
- The Out-of-Pocket Limits cross apply between Tier 1 In-Network and Tier 2 In-Network. The Out-of-Pocket Limits do not cross apply between Tier 1 In-network and out-of-network, or Tier 2 In-network and out-of-network.
- UHC or BCBSNM will send an Explanation of Benefits (EOB) form after each service, and the EOB explains when the Deductible has been reached, and when the out-of-pocket maximum has been reached.
Example: A member has several visits to their Tier 1 doctor and meets the $500 deductible. Their remaining Tier 1 visits/services will be covered at the 10% co-insurance with the $2000 out-of-pocket maximum. The member’s doctor refers the patient to a Tier 2 provider for a service. The $500 deductible already paid applies towards the Tier 2 deductible of $750 and the member is only responsible for $250 before the 20% co-insurance for Tier 2 kicks in. Anything paid in out-of-pocket applies to both the Tier 1 and Tier 2 out-of-pocket maximums. The same applies if a member sees a Tier 2 provider, any cost paid towards the Tier 2 deductible and out-of-pocket maximum applies to the Tier 1 deductible and out-of-pocket maximum.
Find a Tier 1 provider through the links below:
|UnitedHealthcare Choice Plus Premier
Tier 1 providers are flagged with a blue dot that says “Tier 1” and are also referred to as UnitedHealthcare Choice Plus Premier.
|Go to bcbsnm.com/sandia > Search Our Provider Finder
Tier 1 providers are listed as
Blue Preferred Plus. Be sure to note the change to our provider
network name. You’ll no longer use the term “Sandia Health Provider Network.”
Copays for virtual visits will decrease to $10 per visit for BCBSNM and UHC members.
Here’s how to connect with a virtual provider with your medical plan:
||Go to myuhc.com
to access Amwell or Doctor on Demand, or download the UHC mobile app. You can also call the Nurseline number on the back of your
UHC ID card.
Go to mydoctor.kp.org/ncal/get-care
to schedule a video visit with your doctor or an e-visit with a clinician, or call 866-454-8855 to speak with a nurse.
Remember to review your 401(k) contribution and investment elections any time at www.401k.com. And effective Sept. 30, 2020, you can automatically convert new after-tax contributions to Roth in the NTESS 401(k) Plan. Check out Fidelity’s virtual booth at our Virtual Benefits Fair for more information about the new Roth conversion provision and other savings strategies.
Whether you need a bigger home for your growing family, are downsizing, or relocating to a new city, Welcome Home Funding and Berkshire Hathaway Home Services’ team of experts can help you find the perfect place for you and your family.
Home buyers receive up to $5,000 in discounts on the costs associated with buying a home. And first-time home buyers can receive a down payment matching grant up $1,500 with the Home Fund It program. Local experts can research the market, arrange home tours, provide information about the community, and more.
Rental services include researching available rental properties, finding the right neighborhood for you and your family, scheduling tours, and viewing properties with you.
Go to mysandiaextras.com to learn more about this new program.