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Health Benefits

Medical, prescription, dental and vision

Medical

You have three medical plans to choose from: SEQA or EQA, PPO and HSA. Our medical plans are administered by Scott and White Health Plan (SWHP) and include prescription coverage. 

  • Select Exclusive Quality Alliance (SEQA) Plan
  • Exclusive Quality Alliance (EQA) Plan
  • Preferred Provider Organization (PPO) Plan
  • Health Savings Account (HSA) Plan

Select Exclusive Quality Alliance (SEQA) Plan

For employees making $25 or less per hour
  • Only includes providers in the Tier 1 BSWQA Network
  • 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
  • $0 deductible, preventive visits, video visits and eVisits
  • $0 for select diabetic medicine and supplies
  • Low copays and NEW! $400 bundled maternity copay*
  • Pairs with a general-purpose FSA for eligible healthcare expenses

*Copay applies to the facility claim. All other services billed with a maternity/delivery diagnosis code will be paid at 100%, including well-baby charges and prenatal services.

Exclusive Quality Alliance (EQA) Plan

For employees making $25.01 or more per hour
  • Only includes providers in the Tier 1 BSWQA Network
  • 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
  • Low deductible
  • $0 preventive visits, video visits and eVisits
  • Low copays, including NEW! $400 bundled maternity copay*
  • Pairs with a general-purpose FSA for eligible healthcare expenses

*Copay applies to the facility claim. All other services billed with a maternity/delivery diagnosis code will be paid at 100%, including well-baby charges and prenatal services

Preferred Provider Organization (PPO) Plan

Available to all benefits-eligible employees
  • Includes providers in Tier 1, 2 and 3 networks—providers in the Tier 1 BSWQA Network are always your best bet!
  • $0 preventive visits, video visits and eVisits
  • NEW! $1,200 bundled maternity copay for Tier 1 BSWQA providers*
  • Pairs with a general-purpose FSA for eligible healthcare expenses

*Copay applies to the facility claim. All other services billed with a maternity/delivery diagnosis code will be paid at 100%, including well-baby charges and prenatal services

Health Savings Account (HSA) Plan

Available to all benefits-eligible employees
  • Includes providers in Tier 1, 2 and 3 networks—providers in the Tier 1 BSWQA Network are always your best bet!
  • High deductible
  • $0 preventive visits
  • Not eligible for new bundled maternity copay
  • Pairs with a health savings account (HSA) that lets you save tax-free dollars for current or future healthcare expenses, including in retirement
  • Pairs with a limited-purpose FSA for certain eligible healthcare expenses (dental and vision only until the deductible is met)

Smoker? Keep in mind the

Tobacco surcharge

Prescription

  • Prescription coverage is included in all of our medical plans
  • Choose from 30+ outpatient pharmacies, a dedicated specialty pharmacy, 24/7 kiosks or from our nationwide contracted network
  • You'll save money when you use a BSW pharmacy!
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Dental

Our two dental plan options are administered by MetLife.

  • MetLife Dental PPO Plan
  • MetLife Dental PPO Plus Plan

MetLife Dental PPO Plan

  • Plan pays 50% of the cost of basic and major care after deductible is met
  • Maximum benefit the plan will pay in a year is $1,250
  • No coverage for orthodontia or dental implants

MetLife Dental PPO Plus Plan

  • Plan pays 80% of the cost of basic care and 50% of the cost of major care after deductible is met
  • Maximum benefit the plan will pay in a year is $2,500
  • Orthodontia covered at 50% with separate lifetime maximum benefit of $2,000
  • Dental implants covered at 50% and will be subject to annual maximum of $2,500

Vision

Our vision plan is administered by EyeMed.

  • $10 copay for eye exam
  • $25 copay for contact lens fitting
  • Copay for lenses depending on selection
  • Up to $170 allowance for frames or contacts
  • Laser vision correction discounts
  • Diabetic care services
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STILL WONDERING WHAT PLAN IS RIGHT FOR YOU?

Ask ALEX!

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.

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