Blue Cross - Pelican HRA

Medical

Southeastern will contribute $1,000 to the HRA for employee only coverage, and $2,000 for all other levels of coverage. This employer funded contribution to your HRA can help offset the deductible you a responsible for. The HRA Plan has a $2,000 deductible for employee only and $4,000 deductible for all other levels of coverage.  After deductible is met, the member pays 20% of contracted rate.  The maximum out-of-pocket expense in-network is $5000 for employee only and $10,000 for all other levels of coverage, including deductibles. Effective July 1, 2011 there is an unlimited lifetime medical maximum.    Note: Individual plan documents should be consulted for more details. More information, including a list of Blue Cross providers is available on Group Benefits website: groupbenefits.org or https://www.bcbsla.com/ogb 

 

 

Pharmacy

Administered by Express Scripts, Inc. (ESI) | Member Drug Questions - 1-866-781-7533
Blue Cross and Blue Shield of Louisiana works with Express Scripts, Inc. (ESI) to administer our
prescription drug program. For ESI’s list of generic, preferred brand, non-preferred brand, specialty and
maintenance/preventive drugs, go to www.bcbsla.com/ogb.

ESI has a robust pharmacy network that consists of a large group of conveniently located participating
retail pharmacies as well as an optional mail-service program. You may use any pharmacy you wish, but
there are advantages to selecting a participating network pharmacy:
• Lower costs
• No claims to file
• No waiting for reimbursement