PELICAN HRA1000
OGB offers the Pelican HRA1000 option to active employee’s 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.
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Health Reimbursement Arrangement
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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.
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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.
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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.
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MEDICAL COVERAGE
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Single
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Employee
+ Spouse
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Employee
+ Children
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Family
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Employer Contribution to HRA
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$1,000
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$2,000
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$2,000
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$2,000
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Deductible (In-Network)
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$2,000
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$4,000
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$4,000
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$4,000
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Deductible (Out-of-Network)
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$4,000
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$8,000
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$8,000
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$8,000
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Coinsurance (In-Network)
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20%
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20%
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20%
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20%
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Coinsurance (Out-of-Network)
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40%
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40%
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40%
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40%
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Out-of-Pocket Maximum (In-Network)
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$5,000
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$10,000
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$10,000
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$10,000
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Out-of-Pocket Maximum (Out-of-Network)
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$10,000
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$20,000
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$20,000
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$20,000
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PHARMACY BENEFITS – CVS Caremark
The Pelican HRA1000 uses the CVS Caremark 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.
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Tier
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Member Co-Pay
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Generic
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50% up to $30
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Preferred
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50% up to $55
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Non-Preferred
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65% up to $80
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Specialty
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50% up to $80
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Once you pay $1,500:
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Generic
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$0
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Preferred
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$20
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Non-Preferred
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$40
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Specialty
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$40
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*Member responsibility is for a prescription drug benefit of up to a 31-day supply.
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