Pelican HRA 1000

BCBS

Administered by Blue Cross Blue Shield of LA and CVS Caremark

The Office of Group Benefits (OGB) offers multiple health plans, including the Pelican HRA1000. The claims administrator is Blue Cross and Blue Shield of Louisiana, while the pharmacy benefit manager is CVS Caremark. It features lower premiums than Magnolia plans in exchange for higher deductibles. The Pelican HRA 1000 utilizes the Blue Cross and Blue Shield of Louisiana Preferred Care Providers and Blue Cross National Providers.

The Pelican HRA 1000 includes $1,000 in annual employer contributions for employee-only plans and $2,000 for family plans in a health reimbursement arrangement that can be used to offset deductibles and other out-of-pocket medical, not pharmacy, costs throughout the year.

A Health Reimbursement Arrangement, or HRA, is an account used to reimburse employees' medical expenses and other medical costs. These funds are available as long as you remain employed by an OGB-participating employer. Any unused funds roll up to the in-network, out-of-pocket maximum (see following chart), allowing members to build up balances that cover eligible medical expenses.

Members do not have direct access to the funds. The out-of-pocket portion of a claim will be paid directly by Blue Cross Blue Shield of Louisiana from the member's account. Funds can only be used to cover eligible medical expenses, such as coinsurance, co-pays, deductibles, and services. Pharmacy, dental, and vision claims are not considered eligible medical expenses and therefore will not be paid for out of the HRA funds.

Medical Coverage	Employee Only	Employee + Spouse	Employee + Child(ren)	Family
State Funding	$1,000	$2,000	$2,000	$2,000
Deductible (In-Network)	$2,000	$4,000	$4,000	$4,000
Deductible (Out-of-Network)	$4,000	$8,000	$8,000	$8,000
MOOP (In-Network)	$5,000	$10,000	$10,000	$10,000
MOOP (Out-of-Network)	$10,000	$20,000	$20,000	$20,000
Coinsurance (In-Network)	20%	20%	20%	20%
Coinsurance (Out-of-Network)	40%*	40%*	40%*	40%*

*Once a member's deductible for allowable charges is met, he or she will pay 40% of the allowable charge, plus 100% of the difference between the allowable charge and billed amount.

The Pelican HRA 1000 uses the CVS Caremark formulary. Members will continue to pay a portion of the cost of their prescriptions in the form of a co-pay or coinsurance. The amount members pay toward their prescription depends on whether or not they receive a generic, preferred brand, non-preferred brand or specialty drug.

Tier	Member Responsibility	Once you pay $1,500
Generic	50% up to $30	$0 co-pay
Preferred	50% up to $55	$20 co-pay
Non-Preferred	65% up to $80	$40 co-pay
Specialty	50% up to $80	$40 co-pay

As an member participating in one of the Magnolia Open Access health plan, you are automatically enrolled in the Access2Day Health program. When you arrive at an Access2day Health clinic, simply present your Access2day Health membership card and your BCBSLA insurance card. You will placed at the head of the line. Review more information here.

The Live Better Louisiana 2023 program year runs from Oct. 1, 2022 - Sept. 30, 2023. Save money on your health insurance premium through Live Better Louisiana, an OGB program that gives Blue Cross plan members resources to help you better monitor your health, understand your risk factors and make educated choices that keep you healthier.

To participate in the Live Better Louisiana program and get a Catapult check-up, you must be the primary member on an OGB Blue Cross plan at the time of the check-up. In order to receive the credit, you must be enrolled in an OGB Blue Cross plan as the primary member in 2024.

Visit the Catapult scheduler at www.timeconfirm.com/OGB or call (877) 841-3058 to schedule your appointment.

Enrollment forms can be submitted via email to nohrmbenefits@lsuhsc.edu. For secure transmission, employees should send these from their LSUHSC email. Forms can also be mailed or dropped off to our office at 433 Bolivar Street, Room 626.