Group Health Plans for Businesses

Plans and Programs Designed to Fit Your Employees' Needs

For companies with 51 or more full time employees

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

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, you'll save the most money when you see a doctor or visit a pharmacy in your plan's network.

Blue High Performance Network (Blue HPN)

Launching January 1, 2021

Carefully Selected Network of Doctors & Hospitals Consistently Delivering Higher-Quality Care at Lower Costs
Engagement Tools and Decision Support for Employees

Learn About the Blue HPN Difference

Available to residents of the Charlotte-Concord-Gastonia and Winston Salem-Greensboro-High Point regions of North Carolina:*

network map for Blue Options

Plus seamless in-network only access across 55+ major U.S. markets:*

network map for Blue Options

* Anticipated market footprint for 1/1/2021. Subject to change. In North Carolina, Blue HPN is available to employees who live in one of these counties in the Charlotte-Concord-Gastonia and Winston Salem-Greensboro-High Point metropolitan statistical areas (MSAs): Anson; Cabarrus; Cleveland; Davidson; Davie; Forsyth; Gaston; Guilford; Lincoln; Mecklenburg; Randolph; Rowan; Stanly; Stokes; Union; Wilkes; Yadkin; York (South Carolina). Not all products are available in all markets. Please discuss specific product options with your Blue Cross NC representative.

Blue Options

Largest Provider Network
Integrated Rx Drug Benefit
Available in All 100 Counties

Blue Select Plus

Tiered Benefits for Higher-Value Care
Broad Provider Network
Available in All 100 Counties

Blue Value

Limited Provider and Hospital Network
Lower Monthly Cost
Limited County Availability

Blue Local with Atrium Health

Smaller, Local Network
Includes Nationally Ranked Atrium Health
Lower Monthly Premiums for Employees

network map for Blue Local with Atrium Health

Blue Local with Wake Forest Baptist Health

Lower Monthly Premiums for Employees
Smaller, Local Network
Integrated Providers for Quality Care

network map for Blue Local Wake Forest

Multiple Options

Consumer-Driven Health Plans (CDHPs)

Our unique relationship with HealthEquity® allows us to offer our members consumer-driven solutions that are fully integrated with their health plan.^†These CDHPs deliver tax-favorable HSAs, HRAs and FSAs with these great benefits:

HSA (Health Savings Account)
- Can be paired with any eligible plan on any network^††
- Employer or employee funds with pretax dollars up to limits set by the IRS
- Unused amounts roll over to the next year without penalty
- May be used for qualified medical expenses and retirement income
HRA (Health Reimbursement Account)
- Employer funds and owns the account
- May only be used for qualified medical expenses
- Enrollee is not required to participate in a high-deductible plan^††
FSA (Flexible Spending Account)
- Employee funds with pre-tax dollars by voluntary salary reduction (employer may contribute)
- May be used for qualified medical expenses, equipment and services
- Employee forfeits any balance remaining at end of year (a “use-it-or-lose-it” account)
- Enrollee is not required to participate in a high-deductible plan^††

† Blue Cross NC is the plan administrator and contracts with HealthEquity, Inc., an independent entity, to perform certain HRA, HAS and FSA administrative services.

†† HSAs and HRAs can be paired with any high-deductible health plan with an eligible deductible. These benefits are commonly provided by employers to help reduce employees’ high out-of-pocket limits.

Funding Options

Fully Insured

Choose fully insured and we'll underwrite your group's medical expenses as well as provide full administrative services.

Benefits:

A simple monthly premium with predictable and stable health care costs
Peace of mind, ease and convenience - We handle the details
Health benefits without claims cost risks

Self-Funded⁵

Our self-funded option offers control and flexibility in plan design for large businesses (more than 100 FTEs). Self-funded arrangements (sometimes referred to as ASOs) allow the business to fund their own health benefits and claims while Blue Cross NC provides all or a portion of administrative services.

Benefits:

Stop-loss insurance to limit potential claims losses
Flexibility in plan design
More control over cash flow

Balanced Funding⁵

This funding 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 insurance plan.

Benefits:

Potential savings that can come from self-funding
Predictable montly rates similar to a fully insured plan
Integrated stop-loss coverage
Money-back opportunities

Dental Plans

Our Offering:

Dental Blue is our broad family of dental products. Within that family, we offer plans that have a more traditional structure with the same benefit levels in- and out-of-network, plans that have richer benefits for members who stay in-network for services, and plans that have steady, shelf-rates and a lifetime deductible.

Dental Blue®

Same benefit levels in- and out-of-network¹
Annual deductible
Broad national network
Visit any dentist¹
Traditional and Rollover plan designs
Up to two (2) cleanings & exams per benefit period
Single ID card with medical

Dental Blue® Preferred^SM (PPO)

Higher benefit levels in-network¹
Annual deductible
Broad national network
Visit any dentist¹
Traditional, Rollover and new Balanced plan designs
Up to three (3) cleanings & exams per benefit period²
Single ID card with medical

Dental Blue Select® (Shelf-rated)

Same benefit levels in- and out-of-network¹
Lifetime deductible
Broad national network
Visit any dentist¹
Standard, Complete and Enhanced plans
Up to two (2) cleanings & exams per benefit period³
Single ID card with medical

1 Non-participating providers may bill members the balance for amounts higher than what is allowed for out-of-network.
2 For plan effective dates of 1/1/20 and after.
3 The Standard plan includes one cleaning & exam per benefit period

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 options. 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. Plus, no ID card is needed for in-network vision care.

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 Three Flexible Plan Options:

Blue 20/20 Exam Only	Blue 20/20 Exam Plus	Blue 20/20 Lens and Frame Only
Coverage for routine comprehensive eye exams	Coverage for routine comprehensive eye exams	No coverage for routine comprehensive eye exams
	Coverage for lenses or contact lenses, and frames. No frame formularies*	Coverage for contact lenses or complete glasses (frames, standard lenses and lens options in one purchase.) No frame formularies
Additional In-network Savings
Discounts for glasses (up to 40% off)	40% off additional complete sets of glasses at any in-network location anytime during the benefit year	40% off additional complete sets of glasses at any in-network location anytime during the benefit year
Discounts for Lasik or PRK	Discounts for Lasik or PRK	Discounts for Lasik or PRK
	20% off non-covered items including non-prescription sunglasses	20% off non-covered items including non-prescription sunglasses
	20% off any remaining balance above your frame allowance	20% off any remaining balance above your frame allowance
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

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 wellbeing. 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.

Blue Rewards (PDF)

Blue365^®Health & Wellness Discounts

Blue365 gives you access to savings across all aspects of your life– including 20 percent off on Fitbit devices and over $800 off Lasik, discounts on healthy, organic meal delivery services like Sun Basket, and much more!⁵

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.⁶

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 (PDF)

ACA Requirements

Based on your size selection, you may be required to offer health insurance or pay an Employer Shared Responsibility Payment.⁸

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

Insurance Form

We'd like to help you make the right choice for your business. Please fill out the following form, and we'll get in touch with you.

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

Are your Headquarters in NC? (optional)

First Name *

Last Name *

Company Name *

Phone Number *

Email Address *

Number of Full-Time Employees *

Use this form for less than 51 full-time employees.

Street Address (optional)

City (optional)

County *

Zip Code *

Leave this field blank

U20826

1.

Certain preventive care services are covered at 100% before deductible when received in an in-network office or outpatient setting. Other covered services may be subject to deductible and coinsurance. When you receive preventive care out-of-network, you may pay more. Visit BlueCrossNC.com/preventive for a full list of preventive services.
2.

Covered in more than 200 countries and territories worldwide through BlueCard® program. Blue Cross and Blue Shield Association. Not all plans have statewide coverage and not all plans are available in all counties.
3.

Dual-option plans are available to employers with 10 or more participating on their health insurance plan.
4.

Special conditions apply. Please contact us at small.business@bcbsnc.com for more details.
5

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 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.
6

Blue Cross NC offers Healthy Outcomes programs as a convenience to aid you in improving your health; results are not guaranteed. Blue Cross NC contracts with Optum, an independent third party vendor, for the provision of certain aspects of Healthy Outcomes programs and is not liable in any way for goods or services received from Optum. Optum does not provide Blue Cross and Blue Shield products or services. Blue Cross NC reserves the right to discontinue or change Healthy Outcomes programs at any time. The programs are educational in nature, and are intended to help you make informed decisions about your health, and to help you comply with your doctor's plan of care. Decisions regarding your care should be made with the advice of your doctor.
7.

Consult your legal or tax advisor for guidance.
8.

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