Group Health Plans
for Businesses

Plans and Programs Designed to
Fit Your Employees' Needs

Local Group: Companies with 50 or fewer full-time employees

Request a quote or browse the topics below to learn more.

Local Group Plan Type & Network

The larger the network, the more doctors and drugstores there are in that network. Larger networks tend to have fewer limits when you need to find a doctor or prescription drugs. But, it also means the health plan may cost more.

Keep in mind that even though we offer out-of-network coverage on most plans, you'll save the most money when you see a doctor or visit a pharmacy in your plan’s network.

Blue High Performance Network^℠ (BlueHPN^℠)

Significant savings over our industry-leading PPO¹
Carefully selected network of doctors & hospitals consistently delivering higher-quality care at lower costs
Engagement tools and decision support for employees

Available to residents of the Charlotte-Concord-Gastonia-York, Hickory-Statesville, Raleigh-Durham-Chapel Hill and Winston-Salem-Greensboro-High Point regions of North Carolina:*

network map for Blue Options

Plus seamless in-network only access across 65+ major U.S. markets:*

network map for BlueHPN

* Anticipated market footprint for 1/1/2022. Urgent and emergent care benefits in non-BlueHPN markets. Market footprint subject to change. In the North Carolina market, BlueHPN available as of 1/1/22 to employees who live in one of these counties: Alexander; Anson; Cabarrus; Caswell; Catawba; Chatham; Cleveland; Davidson; Davie; Durham; Forsyth; Gaston; Granville; Guilford; Iredell; Lincoln; Mecklenburg; Orange; Person; Randolph; Rowan; Stanly; Stokes; Union; Wake; Wilkes; Yadkin; York County, SC.

Blue Options^®

Largest provider network
Integrated Rx drug benefit
Available in all 100 counties

network map for Blue Options

Blue Local & My Blue

System-centered for more coordinated care
Coverage across the country and around the world through BlueCard^®2
Customer service that’s based in North Carolina
Tailored formulary that encourages lower-cost options

Blue Local^℠ with Atrium Health

Overall savings up to 18.3%³

network map for Blue Local with Atrium Health

Blue Local^℠ with Wake Forest Baptist Health

Overall savings up to 17.3%⁴

network map for Blue Local Wake Forest

My Blue with Duke Health

Overall savings up to 18.3%⁵

network map for My Blue with Duke Health

Local Group Plan Options

Dual-Option Plans

No matter the size of your group, you may offer your employees the ability to choose between two health plans⁶ for the benefits that best suit their needs. All you have to do is establish your base plan and choose another plan from our many options. Often employers choose a buy-up option for their employees who need or want more benefits.

Employer contribution - Set your contribution to your premium as a fixed dollar amount or fixed percentage for the base plan. Employees who want the richer benefit plan option can choose to buy up to that plan. Your cost stays the same.
Broad choice of plan designs - As your business needs change, you'll be able to adjust your plan choices year-to-year and keep your coverage with Blue Cross and Blue Shield of North Carolina (Blue Cross NC).

Health Savings Accounts (HSAs)

Our unique relationship with HealthEquity^® allows us to offer tax-favorable HSAs that are fully integrated with a member’s health plan.

Benefits:

Pair with any eligible high-deductible health plan on any network
Employer or employee funds with pre-tax dollars up to limits set by the IRS
May be used for qualified medical expenses
Unused amounts roll over to the next year without penalty

Balanced Funding

The balanced funding⁷ option offers groups with at least 20 eligible employees the advantages of a self-funding plan with the financial protection and predictable monthly payments of a fully insured plan.

Benefits:

Potential savings that can come from self-funding
Predictable monthly rates, similar to a fully insured plan
Integrated stop-loss coverage for protection against high-dollar claims
Money-back opportunity – with balanced funding, Blue Cross NC will refund a portion of your claims surplus if you renew your coverage

Total Health Bundling

Make the most of your health care budget with Total Health Bundling from Blue Cross NC. When you combine your Blue Cross NC medical plan with our dental, vision or select ancillary coverage through Mosaic Group℠, we’ll give you a credit on your monthly bill.⁸

Don’t Forget Dental and Vision

Employees get a simplified experience with a single ID card and portal – helping them create a total health connection.

Dental makes a difference.

Proper oral health affects our overall health and well-being. That’s why Blue Cross NC takes an integrated approach to dental and medical coverage. From taking care of your total health to lower costs, integrating with us is a clear win-win for you and your employees. With each of our flexible plans, you get:

One bill and one ID card
A dedicated account management support team
Broad local and national network
One portal with access to all Blue Cross NC medical, dental and vision plans through Blue Connect^SM
Dental care gap reminders for medical members with certain health conditions
Options for rollover benefits, preventive not applying to the annual maximum, orthodontia with no age limit and more

Along with easy administration and access, our plans include the following covered services as standard benefits:

Composite (white) filling covered on all teeth
No missing tooth exclusion or limitation
Phone or virtual visits
Sustained release therapeutic injections to minimize the need for opioid prescriptions

Dental Blue^® Preferred^SM (PPO)

Saves money for you and your employees with lower premiums and higher benefits for going in-network*
Three cleanings and exams come standard – unique to Dental Blue Preferred
Preventive Only and Preventive & Basic Only plans available
Options available with no annual maximum on preventive services

Dental Blue^®

Indemnity-like plan with same benefit level at any provider
Your employees can save on out-of-pocket expenses by using participating providers*
Preventive Only and Preventive & Basic Only plans available
Options available with no annual maximum on preventive services

Dental Blue^® Select^SM (shelf-rated)

Indemnity-like plan with reliable, steady rates because it’s community (shelf) rated
Three plans from standard to enhanced, including options with implants and orthodontia
Lifetime deductible your members only need to meet once

* Non-participating providers may bill members the balance for amounts higher than what is allowed for out-of-network.

Dental Care Resource Center

The Dental Care Resource Center has the information and tools you need to get a healthy smile. Read helpful articles, get tips for good dental health, check symptoms or find answers to frequently asked questions.

Visit Our Dental Care Resource Center

Vision Plans

Blue 20/20^℠ Vision Plans to Meet Your Employees’ Needs

Our Blue 20/20 plans offer your employees a wide network of vision providers. They can choose from independent eye doctors or retail chains and online vision products. Each of our plans has unique features along with great coverage for both in- and out-of-network benefits.

You can choose between employer-paid or voluntary coverage. And, if you purchase with a medical plan, you’ll get one bill and one enrollment to save you time!

Choose from Four Flexible Plan Options:

Blue 20/20 Exam Only	Blue 20/20 Exam Plus	Blue 20/20 Lens & Frame Plus	Blue 20/20 Lens & Frame Only
Coverage for routine comprehensive eye exams	Coverage for routine comprehensive eye exams	Coverage for routine comprehensive eye exams	No coverage for routine comprehensive eye exams
	An allowance for frames — and — a choice of a copayment for lenses OR an allowance for contact lenses	An allowance for prescription eyeglasses or contact lenses	An allowance for prescription eyeglasses or contact lenses
	20% off any remaining balance above your frame allowance and/or 15% off any remaining balance above your in-network conventional contact lens allowance	20% off any remaining balance above your allowance and/or 15% off any remaining balance above your in-network conventional contact lens allowance	20% off any remaining balance above your allowance and/or 15% off any remaining balance above your in-network conventional contact lens allowance
Additional In-Network Savings
An average of 35% off complete pairs of prescription eyeglasses and prescription sunglasses on initial purchase, and additional pair discount of 40% off	40% off additional complete sets of prescription eyeglasses	40% off additional complete sets of prescription eyeglasses	40% off additional complete sets of prescription eyeglasses
15% off conventional contact lenses	15% off conventional contact lenses	15% off conventional contact lenses	15% off conventional contact lenses
Discounts of 15% off retail or 5% off promo price for LASIK or PRK	Discounts of 15% off retail or 5% off promo price for LASIK or PRK	Discounts of 15% off retail or 5% off promo price for LASIK or PRK	Discounts of 15% off retail or 5% off promo price for LASIK or PRK
20% off select non-covered items, including non-prescription sunglasses	20% off select non-covered items, including non-prescription sunglasses	20% off select non-covered items, including non-prescription sunglasses	20% off select non-covered items, including non-prescription sunglasses
Special offers on Blue Connect for discounts on frames and lenses, contacts and other vision services and items	Special offers on Blue Connect for discounts on frames and lenses, contacts and other vision services and items	Special offers on Blue Connect for discounts on frames and lenses, contacts and other vision services and items	Special offers on Blue Connect for discounts on frames and lenses, contacts and other vision services and items

Local Group Health & Wellness

Blue Connect
Member Site

Blue Connect is your personal guide to the tools you need to manage your health plan and health care. You can:

View your deductible, claims and benefits in an instant
Access important documents like your digital ID card no matter where you are
Get health tips, articles and videos on everything from weight loss to prescription costs to dental health

Blue Rewards^℠
Program

Our Blue Rewards program encourages participation in activities that can improve your employee’s health and well-being. Rewards come in the form of gift cards for activities like registering for Blue Connect, sharing contact preferences or participating in a condition care or care management program.

Blue365^® Health & Wellness Discounts

Blue365 gives you access to savings across all aspects of your life – including 20% off on Fitbit^® devices; over $800 off LASIK, discounts on healthy, organic meal delivery services like Sunbasket; and much more!⁹

Blue365

Preventive Care
Covered Services

In-network preventive care is covered at 100%. Our Preventive Care Services List shows you which services and prescriptions are considered preventive and covered at 100%.

Preventive Care Services

Health Line Blue^℠
Nurse Line

Health Line Blue connects you to a trained nurse, 24/7, to get your health questions answered.10

Health Line Blue

Prime Therapeutics^® Prescriptions by Mail

Prime Therapeutics Prescriptions by Mail delivers a 90-day supply of medications by mail. No driving. No waiting.

Prime Overview

Local Group ACA Requirements

Based on your company size, you may be subject to a penalty if you choose not to offer your employees health insurance.¹¹But you may be eligible for Small Business Health Care Tax credits if you have fewer than 25 full-time employees.¹²

More information is available through the Health Insurance Marketplace at healthcare.gov.

Request a Quote

We'd like to help you make the right choice for your business.

Please fill out the following form if you have 1-50 Full-Time Employees.

First Name *

Last Name *

Company Name *

Email Address *

Phone Number *

Number of Full-Time Employees *

Use this form for more than 50 full-time employees.

County *

Zip Code *

Effective Date *

Leave this field blank

This is a partial list of services not covered by your dental benefits plan. Refer to the member booklet for a full list of exclusions: Not clinically necessary services, Hospitalization for any dental procedure, Dental procedure solely for cosmetic or aesthetic reasons, Dental procedures not directly associated with dental disease, Procedures not performed in a dental setting, Procedures that are considered experimental, Drugs or medications obtainable with or without a prescription, unless they’re dispensed and utilized in the dental office during the patient visit, Services related to temporomandibular joint (TMJ), Services received prior to member’s effective date, Oral orthotic devices, palatal expanders and orthodontics, except as specifically covered by your dental benefit plan

This is a partial list of services not covered by your vision benefits plan. Refer to the member booklet for a full list of exclusions: Orthoptic or vision training, subnormal vision aids and any associated supplemental testing, Aniseikonic lenses, Medical and/or surgical treatment of the eye, eyes or supporting structures, Any eye or vision examination, or any corrective eyewear required by a policyholder as a condition of employment, Safety eyewear, Services provided as a result of any workers’ compensation law, or similar legislation, or required by any governmental agency or program whether federal, state or subdivisions thereof, Plano (non-prescription) lenses and/or contact lenses, Non-prescription sunglasses, Two pairs of glasses in lieu of bifocals, Services rendered after the date an insured person ceases to be covered under the policy, except when vision materials ordered before coverage ended are delivered, and the services rendered to the insured person are within 31 days from the date of such order, Services or materials provided by any other group benefit plan providing vision care, Lost or broken lenses, frames, glasses or contact lenses will not be replaced except in the next benefit frequency when vision materials would next become available

Blue Cross NC has collaborated with Atrium Health to bring you Blue Local with Atrium Health. It is a health insurance plan offered by Blue Cross NC that provides access to a limited network of providers. Atrium Health is an independent company that is solely responsible for the physicians and medical facilities it owns and operates. Atrium Health does not offer Blue Cross or Blue Shield products or services.

Blue Cross NC has collaborated with Wake Forest Baptist Health to bring you Blue Local with Wake Forest Baptist Health. Blue Local with Wake Forest Baptist Health is a health insurance plan offered by Blue Cross NC that provides access to a limited network of providers. Wake Forest Baptist Health is an independent company that is solely responsible for the physicians and medical facilities it owns and operates. Wake Forest Baptist Health does not offer Blue Cross or Blue Shield products or services.

Blue Cross NC has collaborated with Duke Health to bring you My Blue with Duke Health. My Blue with Duke Health is a health insurance plan offered by Blue Cross NC that provides access to Duke Health’s comprehensive network of providers. Blue Cross NC is not responsible for Duke Health’s physicians and medical facilities owned or operated by Duke Health. Duke Health does not offer Blue Cross or Blue Shield products or services.

Blue365 offers access to savings on items that members may purchase directly from independent vendors, which are different from items that are covered under the policies with Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Blue Cross and Blue Shield Association (BCBSA) may receive payments from Blue365 vendors. Neither Blue Cross NC nor BCBSA recommends, endorses, warrants or guarantees any specific Blue365 vendor or item. This program may be modified or discontinued at any time without prior notice.

HealthEquity, Mosaic Group, Fitbit, Sunbasket and Prime Therapeutics are independent companies that are solely responsible for the services they provide. They do not offer Blue Cross or Blue Shield products or services.

All other trade names are the property of their respective owners.

1 Total cost of care savings based on Consortium Health Plans analysis, 2020. Savings are on average and assume 100% enrollment. Results will vary based on employer locations and implementation. Fully Insured savings based on Blue Cross and Blue Shield of North Carolina analysis, February 2020. Fully Insured savings are premium savings which include medical, Rx, administration, premium taxes and more. Results will vary based on employer location, plan selection and implementation.

2 BlueCard coverage varies for each BCBS Plan. For more complete details, including benefits, limitations and exclusions, please refer to your certificate of coverage. Blue Cross Blue Shield Association (BCBSA), www.bcbs.com/learn/glossary#B (Accessed April 2022)

3 Blue Cross NC Internal Data, 2021. Savings figures for Blue Local with Atrium Health compared to a comparable Blue Options^® PPO plan. Actual savings will depend on geography and plan design(s) selected by group.

4 Blue Cross NC Internal Data, 2021. Savings figures for Blue Local with Wake Forest Baptist Health compared to a comparable Blue Options^®PPO plan. Actual savings will depend on geography and plan design(s) selected by group.

5 Blue Cross NC Internal Data, 2021. Savings figures for My Blue with Duke Health compared to a comparable Blue Options^® PPO plan. Actual savings will depend on geography and plan design(s) selected by group.

6 No restriction on dual-option plans based on group size, but some restrictions may apply based on health plan options. Talk to your Blue Cross NC representative for full details.

7 Special conditions apply. Please contact us at small.business@bcbsnc.com for more details.

8 Groups and agents may contact their Blue Cross NC sales representative for program eligibility details. Total Health Bundling is generally available to new and qualified renewing fully insured 1-50 ACA medical groups that add new ancillary lines of coverage. The medical and ancillary plans must have the same group number and the same effective date. Not all groups may qualify. Blue Cross NC has the sole discretion to offer this program and it may be subject to change or termination at any time.
9

Blue365 offers access to savings on items that members may purchase directly from independent vendors, which are different from items that are covered under the policies with Blue Cross NC. The Blue Cross and Blue Shield Association (BCBSA) may receive payments from Blue365 vendors. Neither Blue Cross NC nor the Blue Cross Blue Shield Association recommends, endorses, warrants or guarantees any specific Blue365 vendor or item. This program may be modified or discontinued at any time without prior notice. This program is provided by BCBSA and not Blue Cross NC.
10

Blue Cross NC offers wellness programs as a convenience to aid members in improving their health; results are not guaranteed. Blue Cross NC may contract with independent third-party vendors for the provision of certain aspects of our wellness programs and is not liable in any way for goods or services received from them. These vendors do not offer Blue Cross or Blue Shield products or services. Blue Cross NC reserves the right to discontinue or change our wellness programs at any time. These programs are educational in nature. They are intended to help members make informed decisions about their health and comply with their doctor’s plan of care. Decisions regarding care should be made with the advice of a doctor.
11

Consult your legal or tax advisor for guidance.
12

Final determination of eligibility and/or amount of Small Business Health Care Tax credits can only be obtained through the Health Insurance Marketplace.

DentalB, 6/21; DentalB Select, 6/21; DentalB PPO, 6/21; VIS-EO, 6/21; VIS-EP, 6/21; VIS-LFO, 6/21 U40244, 4/22

Group Health Plansfor Businesses