Benefits

Welcome to Sandia National Laboratories

open enrollment for active employees.

January through December Plan Year 2025.

So why should you choose

Blue Cross and Blue Shield?

Blue Cross and Blue

Shield of New Mexico offers

the largest PPO networks of providers

in the nation.

We contract with more doctors

and hospitals than any other carriers.

We provide health and wellness programs

that help

you stay healthy and manage

ongoing conditions.

You have access to digital and mobile

technology and programs

that help you manage your health

and wellness information.

We have unrivaled customer service.

You can get personalized assistance

with your questions, benefit and claim

inquiries, and help finding a provider

or navigating digital tools.

We make accessing doctors and hospitals

a top priority,

so our members have access

to the best care possible anytime,

anywhere, and our national discounts

are second to none.

So you save money.

Blue Cross and Blue Shield offers

you the largest

directly contracted

PPO network in the nation

with more than 2 million providers,

which includes Blue Distinction centers

such as MD Anderson, Heart Hospital,

and The University of New Mexico

Cancer Center, to name a few.

As a New Mexico resident,

the Total Health PPO and Health Savings Plan

includes access to three tiers of providers.

When enrolled, you automatically

have access to all three tiers.

Tier one includes our Blue Preferred

Plus network of providers.

You can benefit

from this select network of providers

and pay less out of pocket,

but still have flexibility to get care

from providers within our larger

PPO network in tier two.

Here's how it works

and how it can help you save money.

To get the highest level of benefits,

you and your covered dependents

should select a New Mexico provider within

the Blue Preferred Network or tier one.

You will pay the least out-of-pocket cost

by using providers

within the Blue

Preferred Network in New Mexico.

You still have the choice to get care

from providers within the larger national

PPO network in tier two, but you will pay

slightly higher out-of-pocket cost.

You will

pay the highest out-of-pocket costs

if you choose an out-of-network

provider in tier three.

You may also have to pay

those fees upfront.

You will find that there are a wide

variety of providers

throughout the state of New Mexico

within our tier

one Blue Preferred Provider network.

Included in over the 12,000 contracted

providers are UNM

Health System, Christus Saint

Vincent Health System,

Optum and Loveless Health System.

Later, we will discuss how to determine

which additional providers

are in the blue preferred network.

Blue Cross and Blue Shield of New Mexico

offers a national PPO program

that allows coverage

regardless of where you live.

This robust national network

is the largest in the industry.

This network also encompasses

a full range of ancillary services

such as home health care, hospice,

private duty nursing, surgery centers,

and skilled nursing facilities.

However, provider participation

may vary on a network

specific basis.

Outside of the United States

members have access

to participating doctors and hospitals

in more than 190 countries.

With BlueCard, you can enjoy the peace of mind

knowing you have access

to network providers

when traveling out of state.

Through the BlueCard PPO program,

Blue Cross and Blue Shield

plans work together to help

ensure our members receive reliable,

affordable health care.

Blue Cross Blue Shield plans

throughout the country have established

PPO networks of doctors, hospitals,

and other health care providers.

All members have to do is show their Blue

Cross and Blue Shield ID

card with the suitcase logo at the network

provider's office, just like at home.

Blue Distinction Specialty Care

focuses on hospitals

and other health care

facilities that excel in delivering

safe, effective treatment

for specialty procedures,

such as, knee and hip replacement,

cardiac care, bariatric

or weight loss surgery, and transplants.

The choices you make matter, especially

when it comes to your health care.

The hospital you select

can have a direct impact on the care

you receive and your procedure results.

But finding the right hospital

can sometimes be a challenge.

Uses patient safety and outcomes measures,

plus hospital specific costs data

to identify

expertise and efficient specialty care.

Launched in 2006,

Blue Distinction is a national designation

awarded by Blue Cross and Blue Shield

companies

to hospitals and medical facilities

that have demonstrated expertise

in delivering quality health

care in the areas of bariatric surgery,

cardiac care,

knee and hip replacement, maternity care,

spine surgery, and transplants.

The designation is based on objective,

evidence based selection

criteria established in collaboration

with expert physicians

and medical organizations.

The Blues focused

first on high variability,

high volume and or complex procedures.

Blue Distinction Center designations

are for Blue Cross Blue Shield

participating medical facilities

and hospitals

only at this point. Not for physicians

or other individual providers.

We are thrilled to announce the launch

of a new provider option

effective July 1st, 2024,

for your employees

covered through Blue Cross and Blue

Shield New Mexico.

As you know, providing our members

with the best health

care options is top priority.

We understand

the importance of convenience,

accessibility, and quality of care.

Our new virtual primary care services

provided by Galileo

offer a range of benefits,

convenience, and accessibility.

Member can consult with the primary care

physician

from the comfort of their own homes

or work, reducing the need for travel

and wait times for an in-person

appointment.

Comprehensive care.

Virtual primary care

includes routine checkups,

chronic condition management,

prescription refills, and more.

24/7 availability.

Access to healthcare

professionals around the clock

ensures your clients receive

timely medical advice and support.

We believe this new provider option

will be a powerful addition

to the services provided to our members.

By promoting virtual primary care.

You are giving them an opportunity to

access additional providers for services.

Employer groups

and their eligible members can learn

more about Galileo

and create their account

to get started at: galileo.health/bcbsnm

How virtual visits work.

Visit the website mdlive.com/bcbsnm

Choose a doctor.

Video chat with the doctor.

You can also access through Blue Access

for Members.

On the mobile app.

Download the app from the Apple Store,

Google Play or Windows Store.

Open the app and choose a doctor.

Video chat with the doctor

from your mobile device.

Via telephone.

Call MDLIVE at: (888) 676-4204

Speak with a health service specialist.

Speak with a doctor.

In the event of an emergency,

this service should not take the place of

an emergency room or urgent care center.

MDLIVE doctors

do not take the place of your primary care

doctor.

Proper

diagnosis should come from your doctor

and medical advice

is always between you and your doctor.

Before contacting MDLIVE, call your doctor's office.

They may also offer

telehealth consultations

by phone or online video.

Members can take advantage

to make online video

and FaceTime calls with MDLIVE virtual visits.

They can share

complete medical history, send

and receive secure messages, and upload

and share symptoms with their provider.

All MDLIVE doctors are U.S board

certified.

MDLIVE is designed to handle

non-emergency medical conditions.

Doctors can prescribe medication

as part of an MDLIVE appointment.

The MDLIVE app takes advantage

of mobile technology members already

use and allows them to access a doctor

at home, at work or on the go,

24 hours a day, seven days a week.

The MDLIVE app is available for download

on Apple and Android devices.

It is highly recommended

to register immediately.

That way, when you need assistance

through an MDLIVE doctor,

you will be good to go.

Provider Finder Platform

is available to members when logging in

through Blue Access for Members

as shown above.

So, let's get started with Provider Finder.

First, go to bcbsnm.com

Next, log in to Blue Access for Members

with your username and password.

If you are not yet a registered user,

follow the prompts to complete

registration.

You'll need some information

from your member ID card,

so be sure to have it handy.

With the Blue Preferred Plus plan,

you can save even more money

by using a doctor or hospital

that participates in the Blue

Preferred Network.

Now that you know it's cost

effective to use a provider in tier one

or tier two, let us help you find one

through our Provider Finder tool.

It's easy to find a doctor, hospital,

or other health care

provider that participates in the Blue

Preferred Network.

You can select this network name

within your search,

and if a provider is within the Blue

Preferred Network,

it will be indicated on the right hand

side of the screen.

Remember,

you need to determine which network

your provider is in

to know your coverage level.

We're going to start off by

talking about your plan options

through Blue Cross and Blue Shield.

You have the choice of two plan options.

The Total Health PPO plan

or the High Deductible Health Plan.

Let's look at the Total Health PPO plan.

Total Health PPO offers direct

open access

to our nationwide network of providers.

You have the flexibility

and choice to utilize

and then network or out of network provider.

In-network, contracted, or preferred providers

have a signed contract

with Blue Cross Blue Shield,

and are responsible

for filing claims on your behalf,

and will not balance bill you.

If you choose to go out of network,

you will be able to see a licensed

non contracted provider.

Please note that you may pay

more for services received,

will need to file your own claims,

and could be balance

billed for charges over the allowable fee.

Most importantly,

the Total Health PPO plan

allows you the flexibility

to choose your own providers.

The Blue Preferred

tier one network offers similar benefits,

quality and services as a PPO tier two network

but at a more affordable cost

through an exclusive New Mexico

narrow network of providers.

Both tier one and tier two networks

offer a wide range of benefits,

including home health care, hospice,

private duty nursing, surgery,

and skilled nursing centers.

Health and wellness

programs are available,

including telemedicine

and virtual visits through MDLIVE.

Inspira Financial will be your HRA

administrator effective January 1st, 2024.

You will be able to use your debit card

for many expenses, which will give you

more control and flexibility over how

and when your funds are or

access to pay for services.

Your HRA pays your eligible expenses

as long as there's funds in it.

If you have an FSA,

these funds will be used

first to pay for any eligible expenses.

Then your HRA pays any remaining expenses.

After your FSA

and or your HRA funds have been used,

you're responsible for all costs until you

reach your out-of-pocket maximum.

Once you have met

your individual deductible or your family

members have met the family deductible,

you and the medical plan share expenses.

This is called co-insurance.

Your share is 10% of eligible

expenses for the Blue Preferred Network,

20% of eligible expenses

for In-Network PPO,

and 40% of eligible

expenses for Out-of-Network.

For your protection

there is a limit on how much you need

to pay out of your own pocket.

Once you reach the amount shown above,

you are covered

at 100% of eligible expenses

for the rest of the year.

Please remember

only your costs for health services

go towards your deductible

and out a pocket maximum.

Pharmacy costs

do not count towards your deductible

or out-of-pocket

maximum on the Total Health PPO plan.

Please note that monies

paid towards your in-network deductible

and out-of-pocket maximum do not cross

over to the out-of-network benefits.

Like the Total Health PPO

and the Health Savings Plan.

Like Total Health PPO,

the Health Savings

Plan offers direct open access

to our nationwide network of providers.

You have the flexibility and choice

to utilize an in-network or out-of-network

provider.

The Health Savings Plan is a qualified,

high deductible health plan.

Same quality and services

as a Total Health PPO plan.

Offers direct open access

to our nationwide network of providers.

All costs go towards a higher annual

deductible.

Both tier one and tier two networks provide

preventive care benefits

without having to meet the deductible.

You have the flexibility and choice

to utilize a in-network or

out-of-network provider.

This plan offers a health savings account

referred to as an HSA.

In place of the FSA, HRA

offered on the Total Health PPO plan.

Optum Bank will be your Health

Savings Account administrator

With the Health Savings Plan

you will have higher deductibles,

which must be met

before any cost-sharing begins.

Once the entire deductible has been met,

you will be responsible

for the coinsurance

until your out-of-pocket maximum

has been met for the year.

With this plan,

all your medical and pharmacy

costs go towards the deductible.

Please note that monies paid

towards your in-network

deductible and out-of-pocket maximum,

do not cross over to the out-of-network

benefits.

Now I'll discuss

some of the online tools

that you will have access to.

As a Blue Cross Blue Shield member,

you can utilize the Blue Access

for Members website.

You will need to register

for this password protected website

where you can: print

temporary ID cards or request new ones,

review your explanation of benefits,

email customer service,

search for contracted providers,

have access to our cost estimator tool

for the PPO plan,

which we will talk about in a moment

and access

your enhanced health and wellness tools.

Members also have access to our Blue Cross

Blue Shield New Mexico mobile app.

Please note that members must register

through our website

before they will have access to the app.

Through the app, you can view an I.D.

card and download a digital copy,

view benefits and eligibility,

including deductibles,

coinsurance, copays, out-of-pocket

maximums, and covered dependents,

view claim status,

access health and wellness tools.

Our cost estimator tool can be found

within the Provider Finder,

and it allows members to search

for estimated out-of-pocket cost

for a variety of services to see where

you and your employer can save money.

This slide shows

the expected cost range for the procedure,

followed by facilities in your search area

that perform

this procedure

along with your expected cost.

As you can see in this example,

for an artificial joint repair revision,

hip or knee,

there are differences

in cost between facilities.

These cost estimates

are based on actual benefit

plan and Blue Cross Blue Shield New Mexico

contracted amounts

and show how much deductible

and out-of-pocket amounts remain.

Now let's discuss

your health and wellness benefits.

Your health benefits

include tools that help you get healthier,

how and when it works for you.

Through Blue Access for Members,

you can access resources

to help you manage your health conditions,

get answers to health questions

and reach your wellness goals.

For quick access

to all your health and wellness resources

go to bcbsnm.com

sign up for or log into Blue Access

for Members.

If you have a serious injury or illness,

you may get a call from a Blue Cross

Blue Shield New Mexico Health advisor.

Your health advisor is a health

professional who can help

you understand your conditions and care,

plan and address your health concerns.

They work with your doctors

and your own team of specialists

to make sure you're getting appropriate

care and support

until you reach your optimum health.

When your health advisor calls,

they may ask you some personal details

to make sure they are talking

to the right person.

This is to keep your health information

private.

Your health

advisor will not try to sell you anything,

and what you discuss with your health

advisor will not be shared

with your employer.

Introducing Hinge Health

effective January 1st, 2025.

Hinge Health provides

a digital, 12-week coach led

musculoskeletal program based on proven

non-surgical care guidelines.

The program is delivered to you using

mobile and computer guided technology.

You will have access to a personal health

coach,

convenient

exercise therapy in your own home,

education articles to help you understand

your condition and treatment options,

and there is no cost to eligible members

and dependents.

Hinge Health will contact you

about how to sign up for this program.

With Sandia National Laboratories,

you also have support from our 24/7

nurse line,

which is available at no cost to you.

They provide around the clock

health and wellness advice

from licensed professionals.

I also want to highlight

our digital mental health partner,

Learn to Live.

Their motto is, Change your mind. Change your life.

So many New Mexicans are struggling

with their mental and emotional health.

Learn to Live

makes it easy for our members

to get the help they need

in the privacy of their own home.

Learn to Live

is a leader in tackling

behavioral health challenges

through a digital platform

which delivers assessments,

online cognitive behavioral

therapy programs and services.

There are five condition specific programs:

depression, stress, anxiety and worry,

social anxiety, insomnia,

substance use.

Each of which is delivered in a user paced

multimedia experience.

Available on-demand with the options

for 1 to 1 coaching services.

All of this is delivered at no cost

to members.

It's easy to access via internet,

any device,

tablet, smartphone, desktop.

Available 24 hours a day, seven days a week.

Ages 13

and over are eligible to participate.

Our wellness portal,

Well onTarget, automatically customizes

to your preferences

Well onTarget features

many tools to help you become healthier.

Begin by taking a health assessment.

Take one of the 20 Self-Management

programs.

Utilize the trackers and monitoring tools.

What we can measure. What we can manage.

Earn Blue Points

for everything you do

on the Well onTarget portal,

which can be redeemed on our online

shopping mall.

Utilize the mobile app, AlwaysOn

for easier access.

Well onTarget also has a library full

of wellness information

for you to explore, along with interactive

digital self-management programs

on a range of wellbeing topics such as:

embracing your physical activity,

managing your stress,

improving your sleep,

managing your metabolic syndrome,

preventing diabetes, healthy bone

and joints.

It's easy, flexible

and allows you to choose

how you wish to move by picking the plan

that is best for you.

If you prefer to work out at home

and on demand,

a digital only option is also available.

For those who prefer boutique style

classes or martial arts.

The Studio Class

Network is your best choice.

This is a pay-as-you-go option

and you receive 30% off your 10th class.

Blue365 member discount program.

Simply for being a Blue Cross and Blue

Shield of New Mexico member,

you will be able to receive exclusive

health and wellness

deals from national and local retailers

to help keep you healthy.

Save money on health care products

and services that are not always covered

by your benefit plan,

such as gym memberships,

vision exams and services, hearing aids,

fitness devices and diet related services.

Log on to the Blue Access for Members

and under the Member Services tab,

you'll find updates

on the discount program. From your blue

access from member's homepage,

you can access the Blue365 member discount program

from the Wellness menu under My Health.

Prepare for your life changing journey.

Whether you are pregnant

or planning to get pregnant.

Blue Cross Blue

Shield New Mexico has tools

to help you at no extra cost.

Ovia Health apps

are for tracking your cycle,

pregnancy and baby's growth.

Each app

has videos, tips, coaching and more.

Ovia fertility helps you track your cycle

and predict

when you are more likely to get pregnant.

Ovia pregnancy helps you

track your pregnancy

and baby's growth week by week

leading up to your baby's due date.

Ovia parenting helps track your child's

growth from birth through three years old.

Well onTarget has self-guided

courses about pregnancy that you can take

online covering healthy foods,

body changes, labor and more.

Plus, if your pregnancy is high risk.

Blue Cross Blue Shield New Mexico

will provide support for maternity

specialists to help you care for yourself

and your baby.

Stay engaged in your health care.

How to be a smart consumer.

Utilize in-network providers

whenever possible

to help you potentially reduce

your health care spending.

Use a provider finder to research cost

at different hospitals.

Review your explanation of benefits

and bills sent by your providers.

Make sure that you and the plan

are being charged

only for services that you received.

Take care of yourself.

Use wellness benefits and get appropriate

preventive medical care as needed.

Don't wait until

you have to go to the emergency room.

See your physician regularly

for preventive care or illness.

Call your doctor

to pre-qualify your symptoms.

Improve communications with your doctor.

Ask questions about prescribed medications

and treatment,

and follow the recommendation

of your health care provider.

Let your physician guide you

to the appropriate drug therapy.

Use generic and over-the-counter drugs

whenever they are available

for your condition.

Talk to your doctor about lower cost

drug options and visit: bcbsnm.com/sandia

for more health and wellness information.

Our service goal is to resolve

your inquiry and one call if we need to.

We'll even call your doctor's office.

This concludes the Blue cross and Blue

Shield of New Mexico presentation.

Our purpose is to do everything

in our power

to stand with our members,

in sickness and in health.

Thank you.

Welcome to Sandia National Labs

open enrollment for pre Medicare retirees

January through December Plan Year 2025.

So why should you choose

Blue Cross and Blue Shield?

Blue Cross and Blue

Shield of New Mexico offers

the largest PPO networks of providers

in the nation.

We contract with more doctors

and hospitals than any other carriers.

We provide health and wellness programs

that help

you stay healthy and manage

ongoing conditions.

You have access to digital and mobile

technology and programs

that help you manage your health

and wellness information.

We have unrivaled customer service.

You can get personalized assistance

with your questions, benefit and claim

inquiries, and help finding a provider

or navigating digital tools.

We make accessing doctors and hospitals

a top priority,

so our members have access

to the best care possible anytime,

anywhere, and our national discounts

are second to none.

So you save money.

Blue Cross and Blue Shield offers

you the largest

directly contracted

PPO network in the nation

with more than 2 million providers,

which includes Blue Distinction centers

such as MD Anderson, Heart Hospital,

and The University of New Mexico

Cancer Center, to name a few.

As a New Mexico resident,

the Total Health PPO and Health Savings Plan

includes access to three tiers of providers.

When enrolled, you automatically

have access to all three tiers.

Tier one includes our Blue Preferred

Plus network of providers.

You can benefit

from this select network of providers

and pay less out of pocket,

but still have flexibility to get care

from providers within our larger

PPO network in tier two.

Here's how it works

and how it can help you save money.

To get the highest level of benefits,

you and your covered dependents

should select a New Mexico provider within

the Blue Preferred Network or tier one.

You will pay the least out-of-pocket cost

by using providers

within the Blue

Preferred Network in New Mexico.

You still have the choice to get care

from providers within the larger national

PPO network in tier two, but you will pay

slightly higher out-of-pocket cost.

You will

pay the highest out-of-pocket costs

if you choose an out-of-network

provider in tier three.

You may also have to pay

those fees upfront.

You will find that there are a wide

variety of providers

throughout the state of New Mexico

within our tier

one Blue Preferred Provider network.

Included in over the 12,000 contracted

providers are UNM

Health System, Christus Saint

Vincent Health System,

Optum and Loveless Health System.

Later, we will discuss how to determine

which additional providers

are in the blue preferred network.

Blue Cross and Blue Shield of New Mexico

offers a national PPO program

that allows coverage

regardless of where you live.

This robust national network

is the largest in the industry.

This network also encompasses

a full range of ancillary services

such as home health care, hospice,

private duty nursing, surgery centers,

and skilled nursing facilities.

However, provider participation

may vary on a network

specific basis.

Outside of the United States

members have access

to participating doctors and hospitals

in more than 190 countries.

With BlueCard, you can enjoy the peace of mind

knowing you have access

to network providers

when traveling out of state.

Through the BlueCard PPO program,

Blue Cross and Blue Shield

plans work together to help

ensure our members receive reliable,

affordable health care.

Blue Cross Blue Shield plans

throughout the country have established

PPO networks of doctors, hospitals,

and other health care providers.

All members have to do is show their Blue

Cross and Blue Shield ID

card with the suitcase logo at the network

provider's office, just like at home.

Blue Distinction Specialty Care

focuses on hospitals

and other health care

facilities that excel in delivering

safe, effective treatment

for specialty procedures,

such as, knee and hip replacement,

cardiac care, bariatric

or weight loss surgery, and transplants.

The choices you make matter, especially

when it comes to your health care.

The hospital you select

can have a direct impact on the care

you receive and your procedure results.

But finding the right hospital

can sometimes be a challenge.

Uses patient safety and outcomes measures,

plus hospital specific costs data

to identify

expertise and efficient specialty care.

Launched in 2006,

Blue Distinction is a national designation

awarded by Blue Cross and Blue Shield

companies

to hospitals and medical facilities

that have demonstrated expertise

in delivering quality health

care in the areas of bariatric surgery,

cardiac care,

knee and hip replacement, maternity care,

spine surgery, and transplants.

The designation is based on objective,

evidence based selection

criteria established in collaboration

with expert physicians

and medical organizations.

The Blues focused

first on high variability,

high volume and or complex procedures.

Blue Distinction Center designations

are for Blue Cross Blue Shield

participating medical facilities

and hospitals

only at this point. Not for physicians

or other individual providers.

We are thrilled to announce the launch

of a new provider option

effective July 1st, 2024,

for your employees

covered through Blue Cross and Blue

Shield New Mexico.

As you know, providing our members

with the best health

care options is top priority.

We understand

the importance of convenience,

accessibility, and quality of care.

Our new virtual primary care services

provided by Galileo

offer a range of benefits,

convenience, and accessibility.

Member can consult with the primary care

physician

from the comfort of their own homes

or work, reducing the need for travel

and wait times for an in-person

appointment.

Comprehensive care.

Virtual primary care

includes routine checkups,

chronic condition management,

prescription refills, and more.

24/7 availability.

Access to healthcare

professionals around the clock

ensures your clients receive

timely medical advice and support.

We believe this new provider option

will be a powerful addition

to the services provided to our members.

By promoting virtual primary care.

You are giving them an opportunity to

access additional providers for services.

Employer groups

and their eligible members can learn

more about Galileo

and create their account

to get started at: galileo.health/bcbsnm

How virtual visits work.

Visit the website mdlive.com/bcbsnm

Choose a doctor.

Video chat with the doctor.

You can also access their blue access

for members on the mobile app.

Download the app from the Apple Store,

Google Play or Windows Store.

Open the app and choose a doctor.

Video chat with the doctor

from your mobile device via telephone.

Call MD live at

(888) 676-4204.

Speak with the health service specialist.

Speak with a doctor

in the event of an emergency.

This service should not take the place of

an emergency room or urgent care center.

MD live doctors

do not take the place of your primary care

doctor.

Proper

diagnosis should come from your doctor

and medical advice

is always between you and your doctor.

Before contacting MD

live, call your doctor's office.

They may also offer

telehealth consultations by phone

or online video.

Members can take advantage

to make online video

and FaceTime calls with MDLIVE virtual visits.

They can share

complete medical history, send

and receive secure messages, and upload

and share symptoms with their provider.

All MDLIVE doctors are U.S board

certified.

MDLIVE is designed to handle

non-emergency medical conditions.

Doctors can prescribe medication

as part of an MDLIVE appointment.

The MDLIVE app takes advantage

of mobile technology members already

use and allows them to access a doctor

at home, at work or on the go,

24 hours a day, seven days a week.

The MDLIVE app is available for download

on Apple and Android devices.

It is highly recommended

to register immediately.

That way, when you need assistance

through an MDLIVE doctor,

you will be good to go.

Provider Finder Platform

is available to members when logging in

through Blue Access for Members

as shown above.

So, let's get started with Provider Finder.

First, go to bcbsnm.com

Next, log in to Blue Access for Members

with your username and password.

If you are not yet a registered user,

follow the prompts to complete

registration.

You'll need some information

from your member ID card,

so be sure to have it handy.

With the Blue Preferred Plus plan,

you can save even more money

by using a doctor or hospital

that participates in the Blue

Preferred Network.

Now that you know it's cost

effective to use a provider in tier one

or tier two, let us help you find one

through our Provider Finder tool.

It's easy to find a doctor, hospital,

or other health care

provider that participates in the Blue

Preferred Network.

You can select this network name

within your search,

and if a provider is within the Blue

Preferred Network,

it will be indicated on the right hand

side of the screen.

Remember,

you need to determine which network

your provider is in

to know your coverage level.

We're going to start off by

talking about your plan options

through Blue Cross and Blue Shield.

You have the choice of two plan options.

The Total Health PPO plan

or the High Deductible Health Plan.

Let's look at the Total Health PPO plan.

Total Health PPO offers direct

open access

to our nationwide network of providers.

You have the flexibility

and choice to utilize

and then network or out of network provider.

In-network, contracted, or preferred providers

have a signed contract

with Blue Cross Blue Shield,

and are responsible

for filing claims on your behalf,

and will not balance bill you.

If you choose to go out of network,

you will be able to see a licensed

non contracted provider.

Please note that you may pay

more for services received,

will need to file your own claims,

and could be balance

billed for charges over the allowable fee.

Most importantly,

the Total Health PPO plan

allows you the flexibility

to choose your own providers.

The Blue Preferred

tier one network offers similar benefits,

quality and services as a PPO tier two network

but at a more affordable cost

through an exclusive New Mexico

narrow network of providers.

Both tier one and tier two networks

offer a wide range of benefits,

including home health care, hospice,

private duty nursing, surgery,

and skilled nursing centers.

Health and wellness

programs are available,

including telemedicine

and virtual visits through MDLIVE.

Inspira Financial will be your HRA

administrator effective January 1st, 2024.

You will be able to use your debit card

for many expenses, which will give you

more control and flexibility over how

and when your funds are or

access to pay for services.

Your HRA pays your eligible expenses

as long as there are funds in it.

After your HRA funds have been used,

you are responsible for all cost until you

reach your out-of-pocket maximum.

Once you have met

your individual deductible or your family

members have met the family deductible,

you and the medical plan share expenses.

This is called co-insurance.

Your share is 10% of eligible

expenses for the Blue Preferred Network,

20% of eligible expenses

for in-network PPO,

and 40% of eligible expenses

for out-of-network.

For your protection,

there is a limit on how much you need

to pay out of your own pocket.

Once you reach the amounts shown above,

you are covered at 100% of eligible

expenses for the rest of the year.

Please remember only your cost

for health services,

go towards your deductible

and out-of-pocket maximum.

Pharmacy costs

do not count towards your deductible

or out-of-pocket

maximum on the Total Health PPO plan.

Please note that monies paid towards

your in-network

deductible and out-of-pocket maximum

do not cross over to the out-of-network

benefits.

Like Total Health PPO,

the high deductible Health plan offers

direct

open access

to our nationwide network of providers.

You have the flexibility and choice

to utilize

in-network or out-of-network provider.

Same quality and services

as a Total Health PPO plan.

Offers direct open access

to our nationwide network of providers.

All costs go towards a higher annual

deductible.

Both tier one and tier two networks

provide

preventive care benefits

without having to meet the deductible.

You have the flexibility and choice

to utilize an in-network

or out-of-network provider.

With the High Deductible health plan

you will have higher deductibles,

which must be met before

any cost-sharing begins.

Once the entire deductible

has been met,

you will be responsible

for the co-insurance

until your out-of-pocket

maximum has been met for the year.

With this plan, all your medical

and pharmacy costs

go towards the deductible.

Please note that monies paid towards

your in-network deductible

and the out-of-pocket maximum

do not cross over to

the out-of-network benefits.

Now I'll discuss some of the

online tools that you will have access to.

As a Blue Cross Blue Shield member,

you can utilize the Blue Access

for Members website.

You will need to register

for this password protected website

where you can: print

temporary ID cards or request new ones,

review your explanation of benefits,

email customer service,

search for contracted providers,

have access to our cost estimator tool

for the PPO plan,

which we will talk about in a moment

and access

your enhanced health and wellness tools.

Members also have access to our Blue Cross

Blue Shield New Mexico mobile app.

Please note that members must register

through our website

before they will have access to the app.

Through the app, you can view an ID

card and download a digital copy.

View benefits and eligibility,

including deductibles,

coinsurance, copays, out-of-pocket

maximums, and covered dependents.

View claims status,

access health and wellness tools.

Our cost estimator tool can be found

within the provider finder,

and it allows members to search

for estimated out-of-pocket cost

for a variety of services to see where

you and your employer can save money.

This slide shows

the expected cost range for the procedure,

followed by facilities in your search area

that perform

this procedure

along with your expected cost.

As you can see in this example

for an artificial joint repair revision,

hip or knee,

there are differences

in cost between facilities.

These cost estimates

are based on actual benefit plan

and BlueCross BlueShield,

New Mexico contracted amounts

and show how much deductible

and out-of-pocket

amounts remain.

Now let's discuss your health and wellness

benefits.

Your health benefits

include tools that help

you get healthier, how

and when it works for you.

Through Blue Access for Members,

you can access resources

to help you manage your health conditions.

Get answers to health questions

and reach your wellness goals.

For quick access

to all your health and wellness resources,

go to bcbsnm.com

Sign up for or log into Blue Access

for Members.

If you have a serious injury or illness,

you may get a call from a Blue Cross

Blue Shield New Mexico Health advisor.

Your health advisor is a health

professional who can help

you understand your conditions and care,

plan and address your health concerns.

They work with your doctors

and your own team of specialists

to make sure you're getting appropriate

care and support

until you reach your optimum health.

When your health advisor calls,

they may ask you some personal details

to make sure they are talking

to the right person.

This is to keep your health information private.

Your health

advisor will not try to sell you anything,

and what you discuss with your health

advisor will not be shared

with your employer.

Introducing Hinge Health

effective January 1st, 2025.

Hinge Health provides

a digital, 12-week coach led

musculoskeletal program based on proven

non-surgical care guidelines.

The program is delivered to you using

mobile and computer guided technology.

You will have access to a personal health

coach,

convenient

exercise therapy in your own home,

education articles to help you understand

your condition and treatment options,

and there is no cost to eligible members

and dependents.

Hinge Health will contact you

about how to sign up for this program.

With Sandia National Laboratories,

you also have support from our

24/7 Nurseline,

which is available at no cost to you.

They provide around the clock

health and wellness advice

from licensed professionals.

I also want to highlight

our digital mental health partner,

Learn to Live.

Their motto is, Change your mind. Change your life.

So many New Mexicans are struggling

with their mental and emotional health.

Learn to Live

makes it easy for our members

to get the help they need

in the privacy of their own home.

Learn to Live

is a leader in tackling

behavioral health challenges

through a digital platform

which delivers assessments,

online cognitive behavioral

therapy programs and services.

There are five condition specific programs:

depression, stress, anxiety and worry,

social anxiety, insomnia,

substance use.

Each of which is delivered in a user paced

multimedia experience.

Available on-demand with the options

for 1 to 1 coaching services.

All of this is delivered at no cost

to members.

It's easy to access via internet,

any device,

tablet, smartphone, desktop.

Available 24 hours a day, seven days a week.

Ages 13

and over are eligible to participate.

Our wellness portal,

Well onTarget, automatically customizes

to your preferences

Well onTarget features

many tools to help you become healthier.

Begin by taking a health assessment.

Take one of the 20 Self-Management

programs.

Utilize the trackers and monitoring tools.

What we can measure. What we can manage.

Earn Blue Points

for everything you do

on the Well onTarget portal,

which can be redeemed on our online

shopping mall.

Utilize the mobile app, AlwaysOn

for easier access.

Well onTarget also has a library full

of wellness information

for you to explore, along with interactive

digital self-management programs

on a range of wellbeing topics such as:

embracing your physical activity,

managing your stress,

improving your sleep,

managing your metabolic syndrome,

preventing diabetes, healthy bone

and joints.

It's easy, flexible

and allows you to choose

how you wish to move by picking the plan

that is best for you.

If you prefer to work out at home

and on demand,

a digital only option is also available.

For those who prefer boutique style

classes or martial arts.

The Studio Class

Network is your best choice.

This is a pay-as-you-go option

and you receive 30% off your 10th class.

Blue365 member discount program.

Simply for being a Blue Cross and Blue

Shield of New Mexico member,

you will be able to receive exclusive

health and wellness

deals from national and local retailers

to help keep you healthy.

Save money on health care products

and services that are not always covered

by your benefit plan,

such as gym memberships,

vision exams and services, hearing aids,

fitness devices and diet related services.

Log on to the Blue Access for Members

and under the Member Services tab,

you'll find updates

on the discount program. From your blue

access from member's homepage,

you can access the Blue365 member discount program

from the Wellness menu under My Health.

Stay engaged in your health care.

How to be a smart consumer.

Utilize in-network providers

whenever possible

to help you potentially reduce

your health care spending.

Use a provider finder to research cost

at different hospitals.

Review your explanation of benefits

and bills sent by your providers.

Make sure that you and the plan

are being charged

only for services that you received.

Take care of yourself.

Use wellness benefits and get appropriate

preventive medical care as needed.

Don't wait until

you have to go to the emergency room.

See your physician regularly

for preventive care or illness.

Call your doctor

to pre-qualify your symptoms.

Improve communications with your doctor.

Ask questions about prescribed medications

and treatment,

and follow the recommendation

of your health care provider.

Let your physician guide you

to the appropriate drug therapy.

Use generic and over-the-counter drugs

whenever they are available

for your condition.

Talk to your doctor about lower cost

drug options and visit: bcbsnm.com/sandia

for more health and wellness information.

Our service goal is to resolve

your inquiry and one call if we need to.

We'll even call your doctor's office.

This concludes the Blue cross and Blue

Shield of New Mexico presentation.

Our purpose is to do everything

in our power

to stand with our members,

in sickness and in health.

Thank you.