Medical Plans

2019 Medical Plan Options

For 2019, you will have four high-deductible health plan options that all offer access to a Health Savings Account (HSA) for tax-free health care spending. If you are not eligible to open an HSA, or choose not to, you may enroll in a Health Care Flexible Spending Account (FSA) instead.

HSA company contribution! Windstream will contribute to your HSA for 2019 – you will receive up to $600 deposited in prorated, tax-free amounts each pay period. If you are unable to enroll in an HSA, you will receive a $500 tax-free contribution to a Health Care FSA account.

What is included?

  1. Your choice of carriers. Blue Cross Blue Shield (BCBS) or UMR. In each state, one carrier will have a lower cost than the other. This represents the larger discount that doctors and facilities have with one carrier over the other in a given state. Plan features and benefits provided with each carrier are the same.
  2. Prescription drug coverage. Coverage for prescription medications comes with each plan and is provided by Express Scripts.
  3. Free in-network preventive care. Services, such as annual physicals, immunizations and routine screenings, are fully covered at 100%. That means you pay nothing.
  4. Annual deductible. You pay for initial medical and prescription drug costs until you meet your annual deductible.
  5. Coinsurance. After meeting your deductible, you pay a percentage of eligible costs through coinsurance, then the plan pays the rest. Keep in mind: With the $1,850 Deductible Plan — per IRS regulations — coinsurance for any person covered under an employee plus dependent plan begins only after the entire family deductible has been met.
  6. Tax-saving opportunity. If eligible, you can contribute to an HSA on a before-tax basis to help pay for your eligible out-of-pocket health care costs – in 2019 or in the future. Your HSA funds roll over year after year; they are always yours to keep! In 2019, Windstream will contribute up to $600 tax-free to your HSA, deposited over the course of the year (per pay period). If you enroll in a medical plan but do not meet HSA eligibility requirements, Windstream will contribute up to $500 tax-free (IRS limit) to a Health Care Flexible Spending Account on your behalf if you enroll in one and make a minimum annual contribution of $1.
  7. Out-of-pocket maximum. Each plan protects you by capping the total amount you will pay each year for in-network medical care. Once you meet your out-of-pocket maximum, the plan pays 100% of your eligible
    expenses for the rest of the year. Medical premiums are not included in the out-of-pocket maximum.
  8. Health Advocate. With Health Advocate, get personalized assistance to help you navigate the health care system, from understanding claims to choosing providers to negotiating fees. This service is available at no extra cost to you and your family members.
  9. Advance Medical. The expert medical opinion program through Advance Medical ensures that the medical treatment you get is the medical treatment you need. You work directly with a doctor whenever you’re concerned about a treatment or diagnosis, feel that you’re not clear on what to do next or wonder if you have all the information you need to make a decision. This service is available 24/7 at no extra cost to you and your enrolled family members.

Compare the plans

All plans are offered through your choice of Blue Cross Blue Shield or UMR. In each state, one carrier has a lower cost than the other, referred to as Carrier 1. This represents the larger discount that doctors and facilities have with one carrier over the other in a state. No matter which Windstream medical plan you choose, the benefits covered by each option are the same. All plans cover in-network preventive care such as blood pressure and cholesterol tests, mammograms, colonoscopies, screenings for osteoporosis, vaccines and well-woman visits — all at no cost to you! Be sure to follow the recommended age guidelines outlined in the medical summary plan description when scheduling your preventive care.

Compare Your Costs

Spousal Surcharge

When reviewing the costs for medical coverage, keep in mind that Windstream has a spousal surcharge of $100 per month. The spousal surcharge is applied if your spouse has coverage available through his/her employer but chooses to be on a Windstream medical plan. If your spouse is not offered coverage through his/her employer or is not employed, the surcharge does not apply. If your spouse is employed by Windstream, the surcharge also does not apply.

Tobacco use surcharge

In addition, a $50 monthly surcharge will be applied to employees and spouses who use tobacco products. During Annual Enrollment, you will be asked to attest to your and your enrolled spouse’s tobacco status. By completing the tobacco cessation program, the surcharge can be stopped and removed prospectively during the year by calling 866.553.9409.

Medical surcharge

Employees and spouses who enroll in a Windstream medical plan must complete both the confidential biometric
screening and well-being 5 assessment (WB5) by May 31 to avoid a $500 annual surcharge.

What to expect when you go to the doctor

Your doctor will ask to see your new card on your first visit. The office will bill your insurance for your visit, and you will get a statement showing the cost of the visit that will be applied toward your deductible and the discount applied. Your doctor will send you a bill for the balance. You will be responsible for the full-cost until your deductible is met. Your doctor may bill you up-front if your deductible hasn’t been satisfied. Here’s how it works.

Be prepared. Not all hospitals and surgeons charge the same price for the same services. If you anticipate extensive medical care or are planning an elective surgery, you can review the average cost of most services, and the quality of the facilities before you make an appointment. Take advantage of Health Advocate services by calling 866.553.9409.

No matter which medical plan you choose, the benefits covered by each option are the same, and each offers the same large network of providers. Through these plans you are eligible for preventive care such as blood pressure and cholesterol tests, mammograms, colonoscopies, screenings for osteoporosis, vaccines and well-woman visits – all at no cost to you! Be sure you use an in-network provider and follow the recommended age guidelines outlined in the medical summary plan description when scheduling your preventive care.

Enroll in a Health Savings Account (HSA) for additional financial protection

While getting preventive care and doing your best to stay healthy are important first steps toward keeping medical costs down, anyone can face unavoidable health conditions and expenses. That’s why it’s important to plan ahead. A Health Savings Account (HSA) offers an opportunity to save tax-free today so you’ll be prepared in the future. An HSA is a unique account type permitted by the IRS that can be used with Windstream’s medical plans. In addition to having pre-tax contributions, earnings are also tax-free, and the use of funds for qualified medical expenses is not taxable income. It’s a triple win from a tax standpoint! See the My Wealth section for more detail.

Medical Plan Terms You Need to Know 

Coinsurance – Your share of the costs after the deductible is met. You may receive an added coinsurance benefit for preventive prescriptions. See description below.

Deductible – The amount you owe before your health insurance plan begins to pay. The deductible may not apply to all services.

Embedded Deductible – For all plans except the $1,850 Deductible Plan, this is equal to the employee only plan deductible for any covered person on an employee + family member plan. This means a single member of your family can meet the embedded deductible and enter the coinsurance phase without all covered members reaching the full plan deductible.

In-Network – A provider who has a contract with your health insurer or plan to provide services or prescriptions to you at a discount. You will likely pay extra for out-of-network usage and can be billed the balance by
the provider.

Out-of-Pocket Maximum – The most you pay during the year before Windstream begins to pay 100% of the allowed amount.

Preventive Medical Care – Windstream health plans cover a set of preventive services at no cost to you even if you haven’t met your deductible. Covered preventive care services include biometric screenings, mammograms, colonoscopies, vaccines, well-woman and well-child visits. Be sure to follow the recommended age guidelines outlined in the medical summary plan description when scheduling your preventive care. For a complete list, visit healthcare.gov/coverage/preventive-care-benefits.

Preventive Prescription Drugs – Certain medications are defined by the IRS as preventive. A complete preventive medication list is available on the Prescription Drug Program page. Preventive prescription medications are available at a coinsurance rate whether or not you have met the deductible on all plans.