Employees Retirement System of Texas

05/01/2024 | News release | Distributed by Public on 05/01/2024 16:16

Consumer Directed HealthSelect medical plan: the basics

Consumer Directed HealthSelect medical plan: the basics

May 01, 2024

4-minute read

Know your benefits

Learn about your options in preparation for Summer Enrollment.

For the next few months, News About Your Benefits will feature overviews of the plans you can elect, change or drop during Summer Enrollment. For May, we highlight the Consumer Directed HealthSelectSM and HealthSelect of Texas® health plans.

Consumer Directed HealthSelect is a high-deductible health plan administered by Blue Cross and Blue Shield of Texas (BCBCTX). The plan is paired with a tax-free health savings account (HSA). An HSA lets you use pre-tax dollars to pay for a wide range of qualified health care costs, including covered dental and vision services.

If you cover eligible dependents on your medical plan, you will pay lower monthly premiums in Consumer Directed HealthSelect. If you don't need to visit the doctor often, Consumer Directed HealthSelect may save you money and provide flexibility in how you spend and save for your health care. But if you get sick or injured and need significant medical care, you will spend more out of pocket on health services before the plan begins to pay.

Consumer Directed HealthSelect has an annual deductible for both medical and prescription drug costs. When you enroll in Consumer Directed HealthSelect, you are responsible for paying the full cost of health care (except preventive care) and prescriptions until you reach your annual deductible for in-network services. You can get care from out-of-network providers, but you will have higher out-of-pocket costs.

Get the most from your Consumer Directed HealthSelect benefits:

  • Open an HSA that allows you to set aside pre-tax funds to pay for eligible out-of-pocket health care expenses, including copays and deductibles. The funds in your HSA earn non-taxable interest and roll over year-to-year. (There's no use-it-or-lose-it rule like with a flexible spending account.) If you change to a different health plan or even change employers, the money in your HSA stays with you.
  • The State of Texas contributes funds to your HSA. The state contributes pre-tax $45 per individual or $90 per family each month. You can also make tax-free contributions to your HSA up to a certain amount determined each year by the IRS.
  • Stay in the HealthSelectSM network. To find in-network providers or check network status, go to the Find a Doctor/Hospital page.
  • Your plan covers the cost of most preventive screenings and services when you visit an in-network provider and your provider bills those screenings and services as preventive care. You don't have to meet your deductible before benefits are paid for eligible preventive care services like annual checkups and vaccinations.
  • BCBSTX must approve certain covered health services before you get them. This is called a prior authorization. In general, your in-network health care providers are responsible for obtaining prior authorization before they provide these services to you.
  • You have access to the same wellness and other value-added benefits as HealthSelect of Texas. Consumer Directed HealthSelect members can participate in Blue Points, enroll in the Real Appeal or Wondr weight management programs, the Fitness Program and take advantage of other value-added benefits offered by BCBSTX.
  • Earn rewards with HealthSelectShoppERS to save money when shopping for certain medical services and procedures. Rewards are deposited into a TexFlexSM limited-purpose flexible spending account (FSA) that can be used for eligible vision and dental expenses. If you're not already enrolled in a limited-purpose FSA, ERS will set one up for you.
  • Use Virtual Visits to get care where and when you need it. Connect with a medical doctor online or by telephone 24 hours a day, seven days a week through Doctor On Demand® and MDLIVE®. You must meet your annual deductible before medical and mental health Virtual Visits are covered. After you meet your deductible, you're responsible for your 20% coinsurance.
  • BCBSTX Personal Health Assistants can answer questions about your health plan benefits, help you find in-network providers, assist with prior authorizations and more. Call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039 (TTY: 711) Monday - Friday, 7 a.m. - 7 p.m. and Saturday, 7 a.m. - 3 p.m. CT.

Cost for Plan Year 2024

Participant(s) Cost
You $0
You + Spouse $322.20
You + children $215.72
You+ family $537.92

Please keep in mind that costs could change for Plan Year 2025 (starting Sept. 1, 2024). Plan Year 2025 rates will be available in late May, after the Employees Retirement System of Texas (ERS) Board of Trustees votes on them.

How to enroll

You may enroll yourself and dependents:

  • during Summer Enrollment,
  • within 31 of a qualifying life event (QLE) such as marriage or a new child or
  • within 31 days of starting work at an agency or higher education institution that participates in the Group Benefits Program (GBP) or 60 days if you have a health coverage waiting period as a new employee.

During your Summer Enrollment phase or after a QLE, you can enroll through your ERS OnLine account, by filling out a Summer Enrollment form and returning it to you HR department, or by calling ERS.

Learn more

Go to the HealthSelect of Texas website to find more information about Consumer Directed HealthSelect and HSAs. The Optum Bank website also has information on HSAs.