HDHP Plans

HDHP stands for High-Deductible Health Plan. What’s makes an HDHP a high-deductible plan is its hefty deductible. Once you reach the deductible, your insurer will begin to pay its share and you’ll pay your percentage of coinsurance. Your insurer will cover all costs once you’ve hit your out-of-pocket maximum. HDHP usually have lower premiums, so they can be a less costly plan option; as long as you don’t need a lot of medical care. HDHPs typically feature a Health Savings Account (HSA). An HSA allows you to save money pre-tax to pay for qualified medical expenses.

2024 Plan Offerings

The values below are for in-network benefits for the 2024 plan year.

Plan Name (Click for Highlights)	Annual Deductible (Individual/Family)	Out-of-Pocket Maximum Individual/Family (Includes all copays, deductibles, & coins)	Family Member Deductible	Family Member Out-of-Pocket Deductible	Office Visit Primary/Telemedicine/Specialist	Hospital Inpatient & Outpatient (Includes Maternity, Mental Health, & Substance Abuse)	Urgent Care/ER	Prescription Drug
HDHP 2700-100	$2,700/$5,450	$2,700/$5,450	N/A	N/A	100% after deductible	100% after deductible	100% after deductible	100% after deductible
HDHP 3500-100	$3,500/$7,000	$3,500/$7,000	$6,550	$6,550	100% after deductible	100% after deductible	100% after deductible	100% after deductible
HDHP 2700-80	$2,700/$5,450	$5,000/$10,000	$5,450	$6,550	80% after deductible	80% after deductible	80% after deductible	80% after deductible
HDHP 5000-100	$5,000/$10,000	$5,000/$10,000	$6,550	$6,550	100% after deductible	100% after deductible	100% after deductible	100% after deductible
HDHP 6350-100	$6,350/$12,700	$6,350/$12,700	$6,550	$6,550	100% after deductible	100% after deductible	100% after deductible	100% after deductible
HDHP 5500-70	$5,500/11,000	$7,000/$14,000	$5,500	$7,000	70% after deductible	70% after deductible	70% after deductible	70% after deductible
HDHP 7000-100	$7,000/$14,000	$7,000/$14,000	$7,000	$7,000	100% after deductible	100% after deductible	100% after deductible	100% after deductible
HDHP 7500-100	$7,500/$15,000	$7,500/$15,000	$7,500	$7,500	100% after deductible	100% after deductible	100% after deductible	100% after deductible
HDHP 8050-100	$8,050/$16.100	$8,050/$16.100	$8,050	$8,050	100% after deductible	100% after deductible	100% after deductible	100% after deductible

2023 Plan Offerings

The values below are for in-network benefits for the 2023 plan year.

Plan Name (Click for Highlights)	Annual Deductible (Individual/Family)	Out-of-Pocket Maximum Individual/Family (Includes all copays, deductibles, & coins)	Family Member Deductible	Family Member Out-of-Pocket Deductible	Office Visit Primary/Telemedicine/Specialist	Hospital Inpatient & Outpatient (Includes Maternity, Mental Health, & Substance Abuse)	Urgent Care/ER	Prescription Drug
HDHP 2700-100	$2,700/$5,450	$2,700/$5,450	N/A	N/A	100% after deductible	100% after deductible	100% after deductible	100% after deductible
HDHP 3500-100	$3,500/$7,000	$3,500/$7,000	$6,550	$6,550	100% after deductible	100% after deductible	100% after deductible	100% after deductible
HDHP 2700-80	$2,700/$5,450	$5,000/$10,000	$5,450	$6,550	80% after deductible	80% after deductible	80% after deductible	80% after deductible
HDHP 5000-100	$5,000/$10,000	$5,000/$10,000	$6,550	$6,550	100% after deductible	100% after deductible	100% after deductible	100% after deductible
HDHP 3500-70	$3,500/$7,000	$7,000/$14,000	$6,550	$6,550	70% after deductible	70% after deductible	70% after deductible	70% after deductible
HDHP 6350-100	$6,350/$12,700	$6,350/$12,700	$6,550	$6,550	100% after deductible	100% after deductible	100% after deductible	100% after deductible
HDHP 5500-70	$5,500/11,000	$7,000/$14,000	$5,500	$7,000	70% after deductible	70% after deductible	70% after deductible	70% after deductible
HDHP 7000-100	$7,000/$14,000	$7,000/$14,000	$7,000	$7,000	100% after deductible	100% after deductible	100% after deductible	100% after deductible
HDHP 7500-100	$7,500/$15,000	$7,500/$15,000	$7,500	$7,500	100% after deductible	100% after deductible	100% after deductible	100% after deductible

Vision

All Plans have coverage for a routine eye exam covered at 100% through an in-network provider. Lenses and Frames are subject to deductible and coinsurance

Telemedicine

Telemedicine services are provided through Teledoc. Click here for more information on Teledoc Telehealth coverage.

Pharmacy/Rx

All Plans offer the same prescription formulary, referred to as Essential C Formulary. For more information around Pharmacy benefit coverage click here.

PPO Plans have a drug co-payment, as shown above. Up to a 30-day supply is one drug copayment, and a 31-60 day supply is two drug copayments. A 61-90 day supply is three drug copayments at retail pharmacies or two and a half drug copayments using mail-order service.

All plans offer mail order subscription programs through Amazon MedsYourWay. Click here for more information.

Health Savings Account (HSA) / Health Equity

A Health Savings Account (HSA) is a tax-advantaged, member-owned account that lets your employees save pre-tax dollars for future qualified medical expenses.

Contributions are made into the account by the individual or their employer and are limited to a maximum amount each year. The contributions are invested over time and can be used to pay for qualified medical expenses, such as medical, dental, and vision care and prescription drugs.
Contributions made to an HSA do not have to be used or withdrawn during the tax year. Instead, they are vested, and any unused contributions can be rolled over to the following year. Also, an HSA is portable, meaning that if employees change jobs, they can still keep their HSAs.
One of the great benefits of the HSA is that it can be used to make payments that count toward your deductible.

The IRS establishes what is and what is not a qualified medical expense, detailed in IRS Publication 502, Medical and Dental Expenses.

The NCMS Plan partners with Health Equity (through BCBSNC) as the preferred partner for HSA account administration. NCMS Plan groups are not required to use Health Equity for HSA account administration and may use any vendor partner of their choosing. If Health Equity is elected as the vendor of choice, the NCMS Plan team will initiate the implementation of HSA services with Health Equity. Health Equity representatives will then coordinate with the designated Group Admin to coordinate implementation requirements such as Employer Funding, Member Communication, and Ongoing Administration procedures.

HSAs are paired with High-Deductible Health Plans (HDHPs) only. PPO Plans are not eligible for contributions towards an HSA.

Contribution Maximums
Type	2023	2024
Individual	$3,860	$4,150
Family	$7,750	$8,300
Catch Up (Age 55+)	$1,000	$1,000