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Benefits

Benefits Menu

  • Introduction
  • Eligibility
  • Enroll Now
  • Employee Premium Costs
  • Medical Benefits
    • Medical Plans
    • Health Savings Account
    • Prescription Drugs
      • Prescription Drug Coverage
      • Weight-Loss Medications
    • HDHP Plan
    • Surcharges
  • Dental
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  • Life Insurance
  • Short & Long Term Disability
    • Short & Long Term Disability Coverage
    • Newly Eligible Short-Term Disability
  • Retirement Savings
  • Employee Assistance Program
  • Behavioral Health Benefits
  • Claim Forms
  • Paid Time Off (PTO)
  • Leave of Absence
  • Income Protection Program
  • Benefit Plan Descriptions

Medical Plans

About The Core Medical Plan

The Core Plan provides coverage competitive with other plans in the market at affordable rates. The McLeod Core Plan is a traditional preferred provider organization (PPO) insurance plan that covers most types of medical care, including physician office visits, inpatient hospital stays, outpatient services, psychiatric and substance abuse. The Core Plan lets you receive care from the network provider of your choice. The highest level of coverage is available when you use services provided through the McLeod Network.

About The Enhanced Medical Plan

The Enhanced Plan provides several coverage enhancements compared to the Core Plan, including lower annual deductibles, coinsurance and out-of-pocket maximums. However, you will pay a higher per-pay-period premium. When choosing a plan, be sure to estimate the anticipated benefits you receive to ensure it is worth the additional premium cost.

About the High Deductible Health Plan

The High Deductible Health Plan (HDHP) is like the Core and Enhanced medical plans because you pay less from your pocket when you choose services from a McLeod provider or a BCBS in-network provider. It provides comprehensive medical and prescription drug coverage plus a way to save for health care expenses today and in the future—tax-free—with a Health Savings Account (HSA).

The per-pay-period premiums are lower than the Core Medical Plan, but the deductible and out-of-pocket maximums are higher with the High Deductible Health Plan. The trade-off is that you can save money in the HSA to pay for eligible medical expenses such as your deductible and out-of-pocket expenses.

For a list of 2025 McLeod Benefits Premium Rates, click here.

Plan ProvisionsCore PlanEnhanced PlanHDHP Plan
BCBS Network
(TIER 2)
McLeod
Network
(TIER 1)
BCBS Network (TIER 2)McLeod
Network
(TIER 1)
BCBS Network (TIER 2)McLeod
Network
(TIER 1)
Annual deductibleIndividual $1,500
Family $4,150
Individual $850
Family $2,550
Individual $1,400
Family $3,900
Individual $700
Family $2,100
Employee Only Coverage: $2,000

Employee + Dependant Coverage:
$3,200 per person
$5,600 per family
Employee Only Coverage: $2,000

Employee + Dependant Coverage:
$3,200 per person
$4,000 per family
Medical annual deducible is separate from the pharmacy planDeductibles are combinedMedical annual deducible is separate from the pharmacy planDeductibles are combinedMedical and pharmacy annual deductibles are combined
Annual Out-of-pocket maximiumIndividual $6,500
Family $13,000
Individual $4,600
Family $9,200
Individual $6,300
Family $12,600
Individual $3,600
Family $7,200
Employee Only Coverage: $6,550

Employees + Dependent(s) Coverage $6,550/person $13,100 per family
Medical and pharmacy annual out-of-pocket maximum are combinedMedical and pharmacy annual out-of-pocket maximum are combinedMedical and pharmacy annual out-of-pocket maximum are combined
McLeod HSA maximum contribution(1)N/AN/AEmployee only: $250
Family(2) $500
MD office visit
• Primary care
$50 copay 70% coinsurance after deductible may apply for other services100% of allowable charges after $35 per visit copay –No deductible$50 copay 70% coinsurance after deductible may apply for other services100% of allowable charges after $35 per visit copay –No deductible100% of allowable charges after $35 per visit copay and deductible
MD office visit
• Specialist
70% of allowable charges after deductible100% of allowable charges after $50 per visit copay –No deductible75% of allowable charges after deductible100% of allowable charges after $50 per visit copay –No deductible70% of allowable charges after deductible80% of allowable charges after deductible
McLeod TeleHealth100% of allowable charges after $35 per visit copay and deductible100% of allowable charges after $35 per visit copay and deductible100% of allowable charges after $35 per visit copay and deductible
Plan ProvisionsCore PlanEnhanced PlanHDHP Plan
BCBS Network
(TIER 2)
McLeod
Network
(TIER 1)
BCBS Network (TIER 2)McLeod
Network
(TIER 1)
BCBS Network (TIER 2)McLeod
Network
(TIER 1)
Annual deductibleIndividual $1,500
Family $4,150
Individual $850
Family $2,550
Individual $1,400
Family $3,900
Individual $700
Family $2,100
Employee Only Coverage: $2,000

Employee + Dependant Coverage:
$3,200 per person
$5,600 per family
Employee Only Coverage: $2,000

Employee + Dependant Coverage:
$3,200 per person
$4,000 per family
Medical annual deducible is separate from the pharmacy planDeductibles are combinedMedical annual deducible is separate from the pharmacy planDeductibles are combinedMedical and pharmacy annual deductibles are combined
Annual Out-of-pocket maximiumIndividual $6,500
Family $13,000
Individual $4,600
Family $9,200
Individual $6,300
Family $12,600
Individual $3,600
Family $7,200
Employee Only Coverage: $6,550

Employees + Dependent(s) Coverage $6,550/person $13,100 per family
Medical and pharmacy annual out-of-pocket maximum are combinedMedical and pharmacy annual out-of-pocket maximum are combinedMedical and pharmacy annual out-of-pocket maximum are combined
McLeod HSA maximum contribution(1)N/AN/AEmployee only: $250
Family(2) $500
MD office visit
• Primary care
$50 copay 70% coinsurance after deductible may apply for other services100% of allowable charges after $35 per visit copay –No deductible$50 copay 70% coinsurance after deductible may apply for other services100% of allowable charges after $35 per visit copay –No deductible100% of allowable charges after $35 per visit copay and deductible
MD office visit
• Specialist
70% of allowable charges after deductible100% of allowable charges after $50 per visit copay –No deductible75% of allowable charges after deductible100% of allowable charges after $50 per visit copay –No deductible70% of allowable charges after deductible80% of allowable charges after deductible
McLeod TeleHealth100% of allowable charges after $35 per visit copay and deductible100% of allowable charges after $35 per visit copay and deductible100% of allowable charges after $35 per visit copay and deductible

(1) McLeod contributes up to the maximum contribution based on your coverage tier.
(2) Family coverage tier includes Employee + Spouse and Employee + Child(ren) coverage tiers.
(3) For more information refer to www.healthcare.gov.

Keeping You Well With Preventive Care

Preventive care coverage is included in McLeod’s medical plan options. To reinforce our focus on wellness, and in accordance with the Health Care Reform Act, preventive care services provided to eligible employees and their eligible dependents at a McLeod Network Facility and by a McLeod Network Provider are covered at 100% with no copays or deductibles. There is no cost to you if the primary reason for the visit is to receive preventive services.

Eligible preventive services provided at and by other BCBS Network Providers will be covered at 70% with no deductible.

  • Visit www.healthcare.gov for a complete listing of these preventive care services.

Choice Of Network Providers

If you choose a McLeod Medical Plan, you will have a choice of two provider networks:

  • McLeod Provider Network. When you use a McLeod provider for your health care needs, you receive excellent quality care at the lowest cost to you. The McLeod Network Provider list is located in the Businessolver reference center on McLeodOracle.org.
  • Blue Cross Blue Shield Provider Network.

All benefit-year deductibles and copayments must be met before any covered and allowable expenses can be paid. Physician office visits for primary care require a $35 copay at both the BCBS Network and McLeod Network. Coinsurance amounts (items stated as a %) indicate what McLeod pays after annual deductibles and copays are met. Allowable charges are paid at 100% after the out-of-pocket maximum is met. There are no lifetime limits under the plan. However, all services are subject to the provisions of the Summary Plan Descriptions.

To find a network provider, go to www.southcarolinablues.com or contact your provider to confirm their acceptance of BCBS insurance.

  • For additional information, contact Blue Cross Blue Shield customer service at 800-760-9290.

     

    To download a medical claim form, click here.

Download And Use These Apps When You Enroll In A Medical Plan

  • Blue Cross Blue Shield – My Health Toolkit®

    My Health Toolkit® is the Blue Cross Blue Shield app that provides you with a convenient way to access your health coverage. With My Health Toolkit®, you’ll be able to check your claims status, view and share your digital ID card, confirm your coverage, and more.

     

    SEARCH: My Health Toolkit for BCBS

    • App Store
    • Google Play
  • McLeod Telehealth

    The McLeod Telehealth app lets you visit a doctor anytime from anywhere. With the McLeod Telehealth app, get quickly diagnosed by a board-certified physician for recurring conditions, minor or common illnesses.

     

    SEARCH: McLeod Telehealth

    • App Store
    • Google Play
  • Businessolver

    MyChoice app allows you to sign up for your McLeod Health benefits or view your current benefits. Other benefits of MyChoice are that you can store pictures of your ID Cards, upload dependent verification documents and more.

     

    SEARCH: MyChoice Mobile

    • App Store
    • Google Play
  • Quick Links
    • Important Notices

IMPORTANT NOTICE: This site serves as a summary of material modification to the Summary Plan Descriptions.

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