PELICAN HRA1000

OGB offers the Pelican HRA1000 option to active employees and retirees — with or without Medicare. This plan is administered by Blue Cross and Blue Shield of Louisiana and features lower premiums than Magnolia plans in exchange for higher deductibles.

Health Reimbursement Arrangement

A Health Reimbursement Arrangement, or HRA, is an account used to reimburse employees’ medical expenses and other medical costs. These funds are available as long as you remain employed by an OGB-participating employer.

The Pelican HRA1000 includes $1,000 in employer contributions for the employee-only plan and $2,000 for employee plus dependent plan(s). Funds rollover up to the in-network out-of-pocket maximum, allowing members to build up a balance.

How does it work? – Members do not have direct access to the funds. The out-of-pocket portion of a claim will be paid directly by Blue Cross from the member’s account. Funds can only be used to cover eligible medical expenses, such as coinsurance, co-pays, deductibles, and services. Pharmacy, dental, and vision claims are not considered eligible medical expenses and therefore will not be paid for out of the HRA funds.

MEDICAL COVERAGE

 

Single

Employee
+ Spouse

Employee
+ Children

Family

Employer Contribution to HRA

$1,000

$2,000

$2,000

$2,000

Deductible (In-Network)

$2,000

$4,000

$4,000

$4,000

Deductible (Out-of-Network)

$4,000

$8,000

$8,000

$8,000

Coinsurance (In-Network)

20%

20%

20%

20%

Coinsurance (Out-of-Network)

40%

40%

40%

40%

Out-of-Pocket Maximum (In-Network)

$5,000

$10,000

$10,000

$10,000

Out-of-Pocket Maximum (Out-of-Network)

$10,000

$20,000

$20,000

$20,000

 

PHARMACY BENEFITS – MEDIMPACT

The Pelican HRA1000 uses the MedImpact formulary. The formulary is reviewed regularly to reassess drug tiers based on the current prescription drug market. Members will continue to pay a portion of the cost of their prescriptions in the form of a co-pay or coinsurance. The amount members pay toward their prescription depends on whether or not they receive a generic, preferred brand, non-preferred brand or specialty drug.

Tier

Member Co-Pay

Generic

50% up to $30

Preferred

50% up to $55

Non-Preferred

65% up to $80

Specialty

50% up to $80

Once you pay $1,500:

Generic

$0

Preferred

$20

Non-Preferred

$40

Specialty

$40

 

HRA RESOURCES

Blue Cross and Blue Shield of LA

www.bcbsla.com/ogb

1-800-392-4089

8:00 AM – 5:00 PM CT Monday-Friday

MedImpact

mp.medimpact.com/ogb

1-800-788-2949

24 Hours, Seven Days a Week

Provider Directory

2017 Schedule of Benefits

2017 Benefit Plan

HRA Benefit Plan

Benefit Comparison

Premium Rates

HRA vs HSA