Medical
Medical Benefits
Nation’s Best Holdings, LLC. offers three medical plan options through BlueCross BlueShield
of Texas.
Medical Costs
Listed below are the biweekly and monthly costs for medical insurance. The amount you pay for coverage is deducted from your paycheck on a pre-tax basis, which means you don’t pay taxes on the amount you pay for coverage.
Tobacco Surcharge
A $100 tobacco surcharge will apply to a covered member on the plan (employee, spouse, or dependent) that uses tobacco. Tobacco is defined as any kind of nicotine, including snuff, chew, dip, cigars, pipes, cigarettes, e-cigarettes, or vapes. You will be required to fill out a tobacco-free affidavit every year during open enrollment. Your medical rate selection (tobacco or non-tobacco user) is based on the honor system. False indication of your rate is grounds for dismissal.
If you use tobacco and your personal physician finds that it would be medically inappropriate for you to attempt to quit using tobacco, Nation’s Best Holdings, LLC will accommodate the physician’s recommendation by waiving the tobacco-free requirement.
The BlueCross BlueShield of Texas (BCBSTX) plans offer in- and out-of-network benefits, providing you the freedom to choose any provider. However, you will pay less out of your pocket when you choose a BCBSTX provider.
The table below summarizes the benefits of each medical plan. The coinsurance amounts listed reflect the amount you pay. Please refer to the official plan documents for additional information on coverage and exclusions.
(1) Preauthorization required; $250 penalty. (2) Mail order is available for in-network preferred generic, non-preferred generic, and brand name prescription drugs only.
Note: As a reminder, CVS is considered an out-of-network pharmacy.
Are You Covering Your Spouse and/or Children?
If you elect employee + spouse, employee + child(ren), or family coverage, the individual deductible and out-of- pocket maximum apply to each covered member of the family (capped at family amount).
Preventive Care
In-network preventive care is 100% free for medical plan members.
You won’t have to pay anything out of your pocket when you receive in-network preventive care. Practice preventive care and reap the rewards of a healthier future.
Preventive care helps keep you healthier long-term.
An annual preventive exam can help IDENTIFY FUTURE HEALTH RISKS and treat issues early when care is more manageable and potentially more effective.
Preventive care helps keep your costs low.
With a preventive care exam each year, you can TARGET HEALTH ISSUES EARLY when they are less expensive to treat. You can also effectively manage chronic conditions for better long-term health.
Preventive care keeps your health up to date.
Yearly check-ins with your doctor keeps your health on track with AGE- AND GENDER-SPECIFIC EXAMS, VACCINATIONS, AND SCREENINGS that could save your life.
Some services are generally not considered preventive if you get them as part of a visit to diagnose, monitor, or treat an illness or injury. Please be aware that you will be responsible for the cost of any non-preventive care services you receive at your preventive care exam based on your plan design. Learn more about preventive care at bcbstx.com.
Prescription Drug Benefits
Administered by BlueCross BlueShield of Texas and Prime Therapeutics
Your pharmacy benefits are provided to you through BCBSTX and Prime Therapeutics. Below is information about the plan and resources that you can utilize to learn more about the pharmacy coverage available to you.
Mail order benefits available for in-network preferred and non-preferred generics and brand drugs only.
Preferred Pharmacies:
- Walgreens
- Walmart
- Albertsons
- HEB
- Brookshire’s
- Health Mart Atlas
REMINDER: CVS Pharmacy is NOT a participating pharmacy in the BCBS network. You will not have prescription drug coverage at CVS if it is your current pharmacy of choice for prescriptions. In order to have covered pharmacy benefits, you will need to have all future prescriptions filled at an in-network pharmacy.
Express Scripts Home Delivery:
Express Scripts Pharmacy delivers your long-term (or maintenance) medicines right where you need them. View your prescriptions online and/or send your refill order. To register or create a profile, visit express-scripts.com/rx. Or, log into myprime.com and follow the links to Express Scripts Pharmacy.
MyPrime.com:
Visit www.myprime.com to determine what tier your prescription is in, your prescription history, what preferred pharmacies are in your area, schedule home delivery, and more. You can access this website from your computer, tablet, or smartphone. Be sure to register on the website to get personalized information that is specific to you and the benefits plan in which you enrolled.
OPEN ENROLLMENT FOR 2024-2025 BENEFITS BEGINS ON 1/29 AND ENDS ON 2/15.
You have three ways to enroll!
- Call 866-430-3009 Monday - Friday from 7 a.m. to 7 p.m. CST during your enrollment eligibility period. Benefits counselors are ready to assist you.
- Schedule an appointment below with a benefits counselor during the enrollment period.
- Self-enroll by registering as a New User here: https://workforcenow.adp.com