Health coverage is one of the most important benefits for you and your family. Health benefits provide significant value through support for and protection against potentially large financial expenses, as well as covering preventive care. We are committed to the health and wellness of our team members by offering comprehensive health care plans. The health plan you choose will be in place until the new year, unless you have a qualifying family status change. Our health insurance plans are administered by Blue Cross Blue Shield.
There are three health plan options available to team members:
- The EPO Plan
- The PPO Plan
- HDHSA Plan
Each of these plans are designed to provide you with coverage options that best suit you and your family’s healthcare needs. To learn more about each plan, including premium pricing and coverage details, please reference the Team Member Guide to Benefits.
Network Navigation Resources – Finding an In-Network Provider:
- Network Guides - We understand the importance of finding a healthcare provider that best meets the needs of you and your family. Our Network Guides are available to help you navigate our FMOLHS customized network. Whether it be our narrow EPO network or our PPO Tier 1 or Tier 2 network, our Network Guides can help you find a provider, assist with scheduling an appointment with network Primary Care Physicians, and check availability of a specialty service within our network.
- Call (855) 875-6265 to access our Network Guides. You will then be prompted to select a Network Guide for either our Louisiana or Mississippi network. Our Network Guides are available in most locations 7 days a week, 24 hours a day.
- Customized Provider Directory - Current plan members can see the most current list of the customized FMOLHS EPO network or the PPO Tier 1 and Tier 2 network online by visiting myhealthtoolkitLa.com/links/fmolhs.
- NEW RESOURCE: BCBS Shopping for Care Search Tool - Blue Cross Blue Shield, our health insurance administrator, launched new upgrades to the Blue Cross Blue Shield (BCBS) Find a Provider Tool that will make finding a provider and estimating health costs easier for those enrolled in an FMOLHS Health Plan. The updated tool will allow you to not only find providers in your network but also shop for care and preview costs based on your plan, deductible and coinsurance information. For a guide on how to use the new tool, please click here. To start using the Shopping for Care Tool, click here. For a guide on how to use the Shopping for Care Search Tool, click here.
- Important Reminders:
- Before receiving care, team members should confirm the location of where services are received and that the location of the provider is in network, as providers may have multiple affiliations, not all of which may be in our network. The best way to ensure this is to make sure you are receiving care from the provider in the location that matches the address listed on the Shopping for Care Tool.
- The cost tool is based on claims data and because of this the actual provider group names or facility names may not appear. This is due to the way providers file claims after reading tests. For example:
- If you search for ABC Radiology Group, the name may not come up if there are not enough claims filed under the provider.
- If Dr. Brown works for ABC Radiology Group and you search for his name, it will likely show more results due to the way claims are filed.
Through a program called “Just Premium”, we offer team members who apply and qualify for financial assistance based on total household income the opportunity to reduce their health plan premiums. Based on the team members total household income (adjusted gross income) and the number of dependents you claim on your Federal Individual Income Tax Return, team members may be eligible to receive a higher subsidy to improve affordability and access to coverage. Details about the just premium application process are communicated each open enrollment period. To apply for Just Premium, download and complete the application and submit it to justpremium@fmolhs.org.
New Health Resource for those enrolled in a FMOLHS Health Plan: Meru Health provides mental health resources that provide you with access to several care options, including chat-based services, that are built to fit your schedule. Learn more at meruhealth.com.