In Collaboration with Sanford
BluePartner is a narrow network health insurance plan that provides employees in-network care from a single provider network with the goal of better managing costs. Like many other options, this product offers several plans with different coinsurance and deductible levels.
- Employees get care within a single provider network, with the goal of better managing care to help control costs over time
- This network is provided by Sanford, and is initially available to employers who are based in Cass, Richland and Traill counties
- This product includes the ability to choose traditional copay plans, or high deductible plans that can be paired with a health savings account (HSA)
Covers the 10 essential benefits required by the Affordable Care Act:
- Preventive and wellness services as well as chronic disease management
- Prescription drugs
- Maternity and newborn care
- Laboratory services
- Outpatient services
- Emergency services
- Pediatric services, including dental and vision care
- Mental health and substance use disorder services
- Rehabilitative and habilitative services and devices
How it Works
With this health insurance plan from Blue Cross Blue Shield of North Dakota (BCBSND), employers can choose from a traditional copay plan where employees:
- Pay the same copayment (copay) each time they visit the in-network or Sanford doctor
- Share costs with BCBSND for other services, depending on the BluePartner plan selected for employees
A high deductible BluePartner health plan option may be available for large group employers, where employees:
- Have decision-making power over health care expenses
- Receive lower premium than traditional copay insurance
- Set aside money in an HSA for medical expenses
Doctor or specialist visits
For traditional plans, employees pay a copay for the in-network visit and may have to pay additional for extra tests, lab work or other medical services resulting from that visit. For out-of-network visits and high deductible plans, employees will pay up to the deductible and then share in the cost (coinsurance) up to the maximum out-of-pocket.
The exception is preventive care, which is covered at 100% for in-network visits. There are no copays and no requirement to meet a deductible. Out-of-network preventive visits are not covered.
Prescription drug benefits
Employees are responsible for in-network copays and/or coinsurance on both generic and name-brand prescription drugs. Refer to the product brochure for further details, as benefits change between plan designs.
Employees pay toward the in-network hospital costs until the deductible is met. After that, BCBSND shares the medical costs (coinsurance) until employees' out-of-pocket maximums are met, then BCBSND pays all other covered expenses.