Medical

Overview of Plans

Select Exclusive Quality Alliance (SEQA)

Employees making $27.00 or less an hour

Network:

Choose care from one of our Tier 1 BSWQA Network providers
No out-of-network coverage, except in cases of urgent/emergency care or rare situations when an in-network provider is not available and authorization is provided

Costs

$0 deductible and low premiums
Low copays, including $400 for bundled maternity costs
You pay copays or coinsurance for prescription drugs from day one
Pairs with a general-purpose FSA for eligible healthcare expenses

Pair with the general-purpose FSA*

View the SEQA Plan Overview

Exclusive Quality Alliance (EQA)

Employees making $27.01 or more an hour

Network:

Choose care from one of our Tier 1 BSWQA Network providers
No out-of-network coverage, except in cases of urgent/emergency care or rare situations when an in-network provider is not available and authorization is provided

Costs:

Low deductible and premiums
Low copays, including $400 for bundled maternity costs
You pay copays or coinsurance for prescription drugs from day one
Pairs with a general-purpose FSA for eligible healthcare expenses

Pair with the general-purpose FSA*

View the EQA Plan Overview

Preferred Provider Organization (PPO)

All benefits-eligible employees

Network:

Choose care from Tier 1, 2 or 3 providers – providers in our Tier 1 Network are always the best value

Costs:

Moderate deductible and premiums
Copays apply for select services, including $1,200 for bundled maternity costs (with a Tier 1 provider)
You pay copays or coinsurance for prescription drugs from day one

Pair with the general-purpose FSA*

View the PPO Plan Overview

Health Savings Account (HSA)

All benefits-eligible employees

Network:

Choose care from Tier 1, 2 or 3 providers – providers in our Tier 1 Network are always the best value

Costs:

High deductible, low premiums
Once you meet your deductible, you pay 10% for Tier 1 and 50% for Tier 2 services (including maternity)
Pharmacy costs count toward your deductible or coinsurance up until the out-of-pocket maximum, and are covered at 90% after your deductible is met

Pair with the HSA* OR the limited-purpose FSA*

View the HSA Plan Overview

Compare Medical Plans

As you consider your options, keep in mind the main difference is how you pay—either more up front (out-of-paycheck premium) and less when you get care (deductible and copays), or less up front and more when you get care. Review the chart for a high-level overview and expand each section to learn more.

Medical Plan Overview PDF

Check Premiums

The amount you pay for your medical plan per pay period depends on the plan you choose and the number of covered dependents. Premiums are deducted from your paycheck before taxes. If you change salary bands during the year, your premium will not be impacted.

Keep in mind the tobacco surcharge and Thrive wellness requirements may impact the amount you pay in premiums.

View Medical Premiums PDF

Tobacco surcharge

Wellness requirements

What You Pay for Care

Your cost for care depends on your medical plan, services received and where you go for care. With every plan, you get preventive care at no cost when you visit in-network providers.

View Medical Coverage Details PDF

Where to Go for Care

Understanding our Network Tiers

Depending on your medical plan, you have access to Tier 1, 2 or 3 network providers. The Tier 1 Baylor Scott & White Quality Alliance (BSWQA) network offers the best value across all plans.

Tier 1 Baylor Scott & White Quality Alliance (BSWQA)

The BSWQA is a complete network of 8,000+ primary care and specialty care physicians, 73 hospitals and ambulatory surgical centers, and 100+ urgent care clinics working together to manage your health and well-being at an affordable price. The Tier 1 network is included in all medical plans and the only network available for the SEQA and EQA plans (except in cases of urgent/emergency care or rare situations when an in-network provider is not available, and authorization is provided).

Tier 2 Cigna National Network

Only available with the PPO and HSA plans, the Cigna Network gives you access to a national network of providers.

If you or a covered dependent live 40 or more miles from the nearest Tier 1 acute-care hospital, contact Scott and White Health Plan (SWHP) at 844.843.3229 to activate out-of-area coverage (80% vs. 50% after Tier 2 deductible for inpatient and outpatient services).

Tier 3 Out-of-Network

Only available with the PPO and HSA plans. Tier 3 out-of-network providers will always be the most expensive option.

Medical Plan Networks PDF

Find a Provider
Full list of providers in Tier 1 and 2

Search by your medical plan

Call the HealthAccess Line for direct assistance

Plus: Tap into the MyBSWHealth app for a quick search of all Tier 1 providers within our System.
Find a Provider (SEQA and EQA) Find a Provider (PPO and HSA) Call HealthAccess Line

Virtual Visits

Virtual care is available through your MyBSWHealth account at no cost to you for all BSW medical plans*, when using Tier 1 providers. Make sure your MyBSWHealth and SWHP accounts are linked so your claim is processed accordingly.

Video visits let you complete a face-to-face visit with your doctor using a camera-enabled device.
eVisits let you complete a 5-10 minute questionnaire and receive a response in less than an hour.

Plus, when you download the app you can:

Get care where and when you need it

Track your test results

View your BSW medical plan, deductible and claims

Access a digital copy of your medical insurance card

Refill and manage prescriptions at BSW pharmacies

Message your care team

Complete your well-being assessment and track your goals

_{*Virtual care is currently available in all tiers as a result of COVID-19. Will revert to only being available under Tier 1 when COVID restrictions are listed.}

Tobacco Surcharge

We are committed to you and your family’s long-term health. If you and/or a dependent enroll in a medical plan, you will be asked about your tobacco usage within the last 12 months. If you confirm the use of tobacco products, you will pay a $30 tobacco surcharge for each member who uses tobacco, up to a maximum of $60 per pay period.

To remove the tobacco surcharge, you or your dependents must complete a tobacco cessation wellness coaching or have your physician provide a certification that you have quit using tobacco products. Please note that enrollment in the Tobacco Cessation Program will not prevent the tobacco surcharge from being applied. The surcharge will be applied until you or your dependents have completed the program and submitted the Tobacco Affidavit to PeoplePlace, which is provided once you complete the Tobacco Cessation Program.

Quit Tobacco

Helpful Resources

Need help choosing a medical plan?

ALEX can help. Answer a few questions and get a custom recommendation in minutes.

Ask ALEX

Have a medical plan question?

We’ve got answers.
Call Scott and White Health
Plan for assistance.

Call 844.843.3229

Need to enroll or submit a life event?

Visit PeoplePlace to select a plan or submit a qualifying life event.
Note: Log in required

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This site summarizes the programs and benefits available to employees and their eligible dependents. Official plan documents, policies and certificates of insurance that contain the details, conditions, maximum benefit levels and restrictions on benefits govern our benefits program and are available on this site. In case of a conflict between this site and the official documents, the official documents prevail. The information on this site isn't a guarantee of benefits. Baylor Scott & White reserves the right to modify or terminate its employee benefit plans and programs at any time for any reason.

Click here if you have feedback on the website or need to report an issue. All other questions and issues, please contact the corresponding resource on the Need Help page.