MAGNOLIA LOCAL PLUS

The Magnolia Local Plus plan offers the same coverage as the Magnolia Local plan. This plan offers $25 primary care co-pays and $50 specialty care co-pays.

The Local Plus plan is ideal for members who prefer the predictability of co-payments rather than using employer funding to offset out-of-pocket costs.

This plan provides care in the Blue Cross nationwide network. Out-of-network care is provided in emergencies only.

MEDICAL COVERAGE

Single

Employee
+ Spouse

Employee
+ Children

Family

Deductible – Active Employee/Non-Medicare Retiree (on or after 3/1/2015)

$400

$800

$1,200

$1,200

Deductible Retiree (with or without Medicare before 3/1/15)

$0

$0

$0

$0

Co-pay(In-Network)

$25/$50

$25/$50

$25/$50

$25/$50

Out-of-Pocket Maximum – Active Employee/Non-Medicare Retiree (on or after 3/1/15)

$3,500

$6,000

$8,500

$8,500

Out-of-Pocket Maximum – Retiree (with or without Medicare before 3/1/15)

$2,000

$3,000

$4,000

$4,000

PHARMACY BENEFITS – Liviniti

OGB uses the Liviniti formulary to help Active Employees and Non-Medicare Retirees select the most appropriate, lowest-cost options. Medicare Retirees will continue to use the SilverScript 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

*Member responsibility is for a prescription drug benefit of up to a 31-day supply.

MAGNOLIA LOCAL PLUS 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

Liviniti Customer Service

1-833-925-2770

Microsite.liviniti.com

24/7 Member Service Support

SilverScript

1-877-996-0104

24 Hours a day

Seven Days a Week

2026 Benefit Plan

Louisiana Provider Directory

National Provider Directory

Schedule of Benefits

Plan A

Plan B

Statement of Benefits and Coverage

Medicare Retiree Plan A

Medicare Retiree Plan B

Medicare Primary Active Employees-Retirees (on or after 3-1-15)

Active Employees- Retirees (on or after 3-1-15)

Retirees (prior to 3-1-15)

Benefit Comparison

Premium Rates

OGB Health Plan Speed Guide