A A A 
Loading
SUPERIOR COURT MEDICAL BENEFITS

MEDICAL BENEFITS

Medical Plan Comparison Chart

2015 Premium Rates

2014 Premium Rates

Glossary of Health Coverage and Medical Terms

Understanding Your Medical Choices

Blue Shield CSAC Website

 

MEDICAL PLANS

BLUE SHIELD EPO (Exclusive Provider Organization)

Under the EPO plan, the network of contracted physicians and hospitals are known as Preferred Providers. Under an EPO plan, you do not have an assigned Primary Care Physician (PCP).  You are allowed to access medical services from any Blue Shield in-network PPO physician, specialist or facility without having to obtain a referral. All covered services, except for Emergency Care, must be provided by a Preferred Provider. The EPO plan does not provide out-of-network benefits.

2014 EPO PLAN INFORMATION

 

2015 EPO PLAN INFORMATION

 

BLUE SHIELD PPO (Preferred Provider Organization)

The PPO plan is designed to provide choice, two levels of service, and flexibility. Participants may go directly to any physician without a referral and have a choice of using preferred (PPO/in-network) or non-preferred (non-PPO/out-of-network) providers. Generally, there are annual deductibles to meet before benefits apply. Participants are also responsible for a certain percentage of the charges (co-insurance), and the plan pays the balance up to the agreed upon amount.

2014 PPO PLAN INFORMATION

 

2015 PPO PLAN INFORMATION

 

BLUE SHIELD HDHP (High Deductible Health Plan)

The HDHP provides choice and two levels of service; in-network and out-of-network. The HDHP uses the Blue Shield national PPO networks so you have a choice of using in-network preferred providers or any out-of-network physician that you choose. There are no copayments; only co-insurance with coverage for in-network providers at a higher benefit level and lower cost to you. This plan has a higher annual deductible that must be met before it begins to pay the appropriate co-insurance amount.

An HSA (Health Savings Account) is available to you if you are enrolled in a HDHP. An H.S.A. account allows you to contribute using pre-tax dollars and the funds roll over and accumulate year to year if not spent. H.S.A. funds can be used to pay any qualified medical expenses. This type of health savings account is owned by you and is portable. If you decide to terminate the HDHP, you will no longer be able to deposit new funds into the H.S.A. account, but funds already in the H.S.A. will remain available for your use.

2014 HDHP PLAN INFORMATION


2015 HDHP PLAN INFORMATION

 

HEALTH SAVINGS ACCOUNT (HSA)

A Health Saving Account (HSA) is available only to employees who participate in the Blue Shield High Deductible Health Plan (HDHP). A HSA is like a IRA for healthcare. It is a tax-advantaged personal savings or investment account that you can use to save and pay for qualified health expenses, now or in the future. Paired with a qualified high deductible health plan (HDHP), an HSA is a powerful financial tool that empowers you to be more actively involved in your healthcare decisions.

An HSA allows you to:

  • Save toward medical expenses (including dental and vision), up to IRS maximums (see Table)
  • Have your contributions deducted on a pre-tax basis
  • Change your contribution amount at any time
  •  Roll the funds to the following year (this is not a “use it or lose it” plan)
  • Keep the account; it is portable; it goes with you if you leave employment
  • Use a debit card to pay for qualified medical expenses
  • Use the funds to pay for IRS tax dependents even if they are not enrolled in the HDHP

 

TABLE 1- HSA Contribution Limits for 2015

Annual Single Contribution Maximum

$3,350*

Annual Family Contribution Maximum

$6,650*

Annual Catch-Up Contribution Maximum
(For HSA participants that are 55 years or older)

$1,000

*These amounts are the maximum the IRS allows you to contribute to your HSA. If the Court contributes $900 into this account you have to deduct that amount from this limit   As an example; $3,350 - $900 =$2,450 would be the annual single contribution maximum you can make on a pre-tax basis.

IMPORTANT INFORMATION:

  • If you have a Healthcare Flex Spending Account (FSA) for 2014, you cannot open an HSA until the available funds in your 2014 FSA Healthcare account has been used, and the balance in your Healthcare FSA account is $0.
  •  You cannot have an HSA and be a dependent on another person’s health insurance plan, unless that plan is also a High Deductible Health Plan.
  • The Court will contribute $900 annually over 24 pay periods into your Sterling HAS account. 

 

You must open your HSA with Sterling HSA. If you do not open your account you will not be able to receive any of the Court’s contributions

 

Health Savings Accounts are administered by Sterling

 

PHARMACY / PRESCRIPTIONS

Express Scripts is your pharmacy carrier if you are on the Blue Shield Low Option EPO, High Option EPO or PPO plan. You have a separate pharmacy ID card for your prescription coverage. You must use this ID card to obtain your prescriptions from your local pharmacy. Your Blue Shield ID card will not be valid.

If you are enrolled in the Blue Shield HDHP, you must use your Blue Shield ID card to obtain prescriptions (Express Scripts will not be your pharmacy carrier).

  • 2014 Express Scripts National Preferred Formulary List: This list also includes a list of the non formulary drug exclusions and the covered alternatives that took effect 01/01/2014.

  • 2015 Express Scripts
    Your preferred drug list is a list of brand-name and generic medications that are preferred by your plan.  These medications are selected because they can safely and effectively treat most medical conditions while helping to contain costs for you and your plan.  See Guide: 2015 Guide to your Preferred Drug List

    The following is a list of the most commonly prescribed drugs.  The list is not all-inclusive and does not guarantee coverage.  You are encouraged t ask your doctor to prescribe generic drugs whenever appropriate.  See more info below:
    2015 Express Scripts National Preferred Formulary List


    The excluded medications are not covered by the Express Scripts drug list.  In most cases, if you fill a prescription for one of these drugs, you will pay the full retail price. If you are currently using one of the excluded medications, please ask your doctor to consider writing a new prescription for one of the preferred alternatives.  See list:
    2015 Preferred Drug List Exclusions


CONTACT HUMAN RESOURCES:

Superior Court Figueroa Division 
Human Resources 
118 East Figueroa Street 
Santa Barbara, CA 93101 

Superior Court Cook Division 
Human Resources 
Santa Maria Office
312 E. Cook St. Bldg. E.
2nd Floor Rm. 242
Santa Maria, CA 93454

Phone: (805) 882-4739 
Emailhr@sbcourts.org

 
© 2014 Superior Court of the County of Santa Barbara