BSWHP-FEHB-26Benefits

2026 BENEFITS

GR_FEHB_26BenefitsProgram

Zero in on the right plan.

Zero ($0) copay for:

Zero barriers to care:

▪ Preventive care coverage

▪ No referrals needed to see

▪ Virtual care ▪ First in-person sick visit for adults ▪ PCP visits (dependents ages 0-18) ▪ Nurse Line­—talk to a nurse 24/7

in-network providers —even specialists ▪ No requirement to select a Primary Care Physician (PCP)

Welcome to Baylor Scott & White Health Plan We’re a not-for-profit organization established in 1982. We’re based in Texas and are part of the Baylor Scott & White Health family of companies. Whether you’ve been with us for years or you’re thinking about joining our family of members, we’re here in Texas and here for you.

NEW this year: THREE plan options.

We’ve added a Value Plan to our Basic Plan and Standard Plan options. The Value Plan is a great choice for people who are generally healthy and looking for an option with a lower monthly premium cost.

With Baylor Scott & White Health Plan (BSWHP), all FEHB members enjoy the benefits of the BSW Premier HMO network—with in-network options for care available in 140 Texas counties—no matter which of our plans you choose.

What's so great about open access?

Unlike most other HMOs, our BSW Premier HMO is “open access.” That means as a BSWHP FEHB member, you: ▪ Are not required to get a referral to see in-network specialists. Just make an appointment with the network specialist of your choice.

▪ Are not required to select a Primary Care Provider (PCP). You are encouraged to establish a relationship with a primary care physician (PCP), but you are not required to designate one in your member record, and you are not obligated to visit the same PCP routinely.

Top tip for new and prospective members: Check out the Find a Doctor/Pharmacy tool at BSWHealthPlan.com/FEHB to see if your current providers are in your network before making an appointment. If they’re not, you can find options for care in the same search tool. You can look for providers by name, specialty, location, hospital affiliation and more.

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MyBSWHealth member portal Whether you need care now, need a prescription refilled or want to see test results, you can use MyBSWHealth to connect with the resources you need to stay well—24 hours a day, 7 days a week. Inside the portal, you can: ▪ Get help finding care ▪ View or print your ID card ▪ See benefit plan documents ▪ View lab results and past visit summaries ▪ Complete a telehealth visit, get a diagnosis and a prescription ▪ View deductible, out-of-pocket max, and claims information and more!

Your MyBSWHealth account is secure, and only you can access your private information.

Sign up for an account or sign in at MyBSWHealth.com.

BSWHealthPlan.com/FEHB Your hub for benefits information and more.

▪ Provider search tool ▪ Brochures, forms and guides ▪ Health & wellness programs ▪ Discount programs ▪ Pharmacy information ▪ Access to the MyBSWHealth member portal

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Extra help when you need it Case management If you or one of your dependents is diagnosed with complicated health problems, case managers are available to help. A nurse case manager will work with you, your family and the physician to create a plan to meet ongoing complex care needs. Case managers: ▪ Advocate for members.

▪ Help you set goals and make a personal plan to improve your health.

▪ Assist with arrangements for necessary services and community support.

▪ Answer questions and provide education to help you have a better understanding of your condition and plan of care.

Disease management Disease management empowers you, working with your healthcare providers, to manage chronic conditions and prevent complications. Programs are available for members with asthma, breathing trouble (such as bronchitis, emphysema), diabetes, heart problems and many other conditions.

Maternity Care Management Members who are expecting a baby can get helpful tips and assistance during pregnancy and for one year after birth. Benefits include: ▪ Access to a nurse 24/7 during pregnancy ▪ In-home support for high-risk conditions (such as diabetes, hypertension and severe nausea) ▪ Depression screening following delivery ▪ Parental education for newborn health during the first year ▪ Immunization reminders ▪ Planning for returning to work

Participation in Disease Management, Case Management or Maternity Care Management is voluntary.

There is no additional cost to members for these programs.

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Wellness Tips and information on how to

#WebinarWednesdays Join the BSW Be Well team at 11 AM CT on the first Wednesday of every month for a free online session. Each month brings a new topic to help you live healthier and happier.

get and stay well, delivered to your inbox every month. If you miss one, you can find the latest version on the Wellness page at BSWHealthPlan.com/FEHB.

WebMD: Wellness at Your Side Get personalized support to live well through our digital wellness platform. With Wellness at Your Side, WebMD’s standalone app, a healthier lifestyle is always at your fingertips.

Wondr Health TM

As a Baylor Scott & White Health Plan member, you have access to Wondr —a digital weight loss program that teaches the science of health and nutrition, so you can enjoy the foods you love. No counting calories. No restrictions.

No guilt.

Learn more about these benefits and more in the Health & Wellness section of BSWHealthPlan.com/FEHB.

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If you have Type 2 Diabetes, you should be aware of the risks and take it seriously.

Without proper management, diabetes can lead to other serious health issues. In fact, this “silent killer” is the eighth leading cause of death in adults in the United States.*

But, you can be well­­—even with diabetes.

That's what this program is all about. At Baylor Scott & White Health Plan, our goal is to keep our members healthier. BSW Be Well with Diabetes provides support to help improve your health, better manage your diabetes, and save you money.

What this program can do for you.

If you apply and complete the initial health activities: ▪ Your copays for covered diabetes medications and testing supplies will be waived ($0 copayments) up to a year.

▪ You will be eligible for a free blood glucose monitor and a free app to track your blood sugar.

▪ You will be referred to a BSW Be Well coach and meet with them for eight required virtual sessions.

▪ A clinical pharmacist will review your medications and will be available to meet with you virtually for any questions you may have.

Are you eligible?

FEHB members and their dependents, who are at least 18 years old with Type 2 diabetes, may apply for the program. Learn more at BSWHealthPlan.com/BeWell/Diabetes.

Apply today Fill out the application form online at BSWHealthPlan.com/BeWell/Diabetes OR download the form, then print, complete and email it to BSWHPDiabetesProgram@BSWHealth.org.

BSWHP reserves the right to terminate this Program at any time with a 30-day notice to all participants, at which time Rewards will also terminate as of the effective date of termination.

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Skip the waiting room.

Baylor Scott & White Health Plan members have two options for virtual care: BSWHealth and Teladoc.

Baylor Scott & White Health Plan members have options for care anytime. Even bedtime. You can access virtual urgent care 24/7/365, or make an appointment with a therapist or psychiatrist (7 AM to 9 PM)—all from the comfort of home or wherever you are.

Need care now?

If it’s an emergency, call 911 or go to the nearest Emergency Room.

If it’s not an emergency—something like seasonal allergies, cold and flu, bladder infection (UTI), stomach issues, mental health concerns, and so on—virtual care could be just what the doctor ordered. If you need a prescription, it will be sent to the pharmacy of your choice.

MyBSWHealth When in Texas, you can get care through your MyBSWHealth member portal.

Choose a face-to-face virtual visit (using a camera on your smartphone, tablet or computer) or a questionnaire-based eVisit, both available anytime, day or night.

▪ Online: MyBSWHealth.com ▪ App: Download at MyBSWHealth or text “BETTER” to 88408

Download the MyBSWHealth app today.

You can access urgent care and behavioral health services through Teladoc anywhere in the US (including Texas).

Feeling crummy?

With a same-day virtual visit you can talk to a licensed provider by phone or video for common conditions like sinus problems, allergies, flu symptoms and much more.

Overwhelmed? Anxious? Depressed?

Private therapy is available. You can choose a therapist or psychiatrist who fits your needs. You can also select a time that works best for you. Therapists and psychiatrists are available seven days a week from 7:00 AM to 9:00 PM.*

To register, call 1.800.TELADOC (1.800.835.2362).

Be sure to have your member ID card handy when you call.

After registration, you can access care: ▪ Phone: 1.800.TELADOC ▪ Online: TeladocHealth.com ▪ App: Download the Teladoc app

*Mental health care is available for members ages 13-plus.

Plans by county You can choose the Basic, Standard or Value Plan in any of the following counties.

North and West Texas counties Andrews, Armstrong, Bailey, Borden, Brewster, Briscoe, Brown, Callahan, Carson, Castro, Childress, Cochran, Collin, Collingsworth, Comanche, Cottle, Crane, Crosby, Dallam, Dallas, Dawson, Deaf Smith, Denton, Dickens, Donley, Eastland, Ector, Ellis, Erath, Fisher, Floyd, Gaines, Garza, Glasscock, Gray, Grayson, Hale, Hall, Hansford, Hartley, Haskell, Hemphill, Hockley, Hood, Howard, Hutchinson, Johnson, Jones, Kent, King, Knox, Lamb, Lipscomb, Loving, Lubbock, Lynn, Martin, Midland, Mitchell, Moore, Motley, Navarro, Nolan, Ochiltree, Oldham, Parmer, Pecos, Potter, Randall, Reeves, Roberts, Rockwall, Scurry, Shackelford, Sherman, Somervell, Stephens, Stonewall, Swisher, Tarrant, Taylor, Terry, Throckmorton, Upton, Ward, Wheeler, Winkler and Yoakum

Central Texas counties Austin, Bastrop, Bell, Bexar, Blanco, Bosque, Brazos, Burleson, Burnet, Caldwell, Coke, Coleman, Comal, Concho, Coryell, Crockett, Falls, Fayette, Freestone, Grimes, Guadalupe, Hamilton, Hays, Hill, Houston, Irion, Kimble, Lampasas, Lee, Leon, Limestone, Llano, Madison, Mason, McCulloch, McLennan, Menard, Milam, Mills, Reagan, Robertson, Runnels, San Saba, Schleicher, Sterling, Sutton, Tom Green, Travis, Walker, Waller, Washington and Williamson

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Dallam

Sherman

Hansford

Ochiltree

Lipscomb

Hartley

Moore

Hutchinson

Roberts

Hemphill

Oldham

Potter

Carson

Gray

Wheeler

Deaf Smith

Randall

Armstrong

Donley

Collingsworth

Hall

Childress

Castro

Parmer

Swisher

Briscoe

Hale

Floyd

Motley

Cottle

Lubbock

Crosby

Dickens

King

Hardeman Bailey

Lamb

Cochran

Hockley

Foard

Wilbarger

Wichita

Baylor

Archer

Clay Knox

Montague

Lamar

Grayson

Cooke

Bowie

Delta Yoakum

Terry

Garza

Lynn

Haskell

Stonewall

Kent

Gaines

Dawson

Borden

Scurry

Fisher

Jones

Andrews

Martin

Howard

Mitchell

Nolan

Taylor

Throckmorton

Jack

Young

El Paso

Hudspeth

Winkler

Ward

Culberson

Ector

Crane

Reeves

Midland

Upton

Glasscock

Sterling

Coke

Runnels

Stephens

Callahan

Parker

Palo Pinto

Eastland

Brown

Coleman

Johnson

Jeff Davis

Schleicher

Menard

Sutton

Kimble

Crockett

Robertson

Terrell Presidio

Kerr

Edwards

Val Verde

Real

Brewster

Blanco

Uvalde

Travis

Madison

Caldwell Gonzales

Walker

Austin

Atascosa

Chambers

Colorado

Fort Bend

Wharton

Jackson

Karnes

Victoria Goliad

Dimmit

La Salle

McMullen

Bee Live Oak

Orange Jefferson

Harris

Waller

De Witt Frio

Jasper

Hardin Liberty

Lavaca

Medina

Zavala

Tyler

SanJacinto

Grimes

Washington

Wilson Maverick

Newton Polk

Montgomery

Fayette

Sabine

Angelina Trinity

Bastrop

Guadalupe

Bexar Kinney

Lee

Hays Comal

Bandera

Houston

Brazos

Williamson

Kendall

SanAugustine

Milam

Burleson Gillespie

Shelby Nacogdoches

Leon

Falls

Llano

Panola

Anderson

Freestone

Burnet

Mason

Rusk

Limestone

McLennan

Lampasas

Harrison

Cherokee

Bell Pecos

Gregg Henderson

Hamilton

San Saba

VanZandt

Navarro

Hill

Bosque

Cass Marion

Upshur

Smith

Coryell McCulloch

Wood

Ellis

Somervel l

Erath

Franklin Titus Morris Camp

Rains

Dallas

Tarrant

Mills Concho

Irion

Hopkins

Hunt

Kaufman

Comanche

TomGreen

Reagan

Collin

Rockwall

Shackleford

Hood

Loving

Denton

Wise

Red River

Fannin

Galveston

Galveston

Brazoria

Matagorda

Calhoun Refugio Aransas

San Patricio JimWells

Webb

Nueces

Duval

Kleberg

Eligibility area

Zapata

Jim Hogg

Brooks

Starr

Kenedy

Willacy Hidalgo Cameron

North and West Texas Central Texas Out-of-Area

Find a BSW Premier HMO Provider 1. Go to BSWHealthPlan.com/FEHB. 2. Click on the “Find a Provider” button.

3. Choose your filters, and start your search.

Referrals are NOT required to see network specialists.

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2026 summary of benefits & services

Note: The deductible applies to all benefits below marked with an asterisk (*) Standard Individual Deductible Options Self only

$300

Self plus one

$600

Self and family

$600

Out-of-Pocket Maximum Self only

$5,500

Self plus one

$11,000

Self and family

$11,000

Doctor Office Visits Primary care visit to treat an injury or illness Adults first sick visit Dependents age 0-18

$25 copay/visit $0 copay $0 copay/visit

Specialist visit

$50 copay/visit

Other practitioner office visit

$50 copay/visit

Preventive care/screening/immunization

No charge

Emergency Medical Care Urgent care visit Emergency room services* Emergency medical transportation*

$50 copay/visit 10% $125 copay

Services Provided by a Hospital Inpatient*

10%

Outpatient surgery*

10%

Medical Testing Diagnostic test (X-ray, blood work) Imaging* (CT/PET scans, MRIs)

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No charge 10%

Basic

Value

$1,500

$2,000

$3,000

$4,000

$3,000

$4,000

$6,000

$9,000

$12,000

$18,000

$12,000

$18,000

$25 copay/visit $0 copay $0 copay/visit

$30 copay/visit $0 copay $0 copay/visit

$50 copay/visit

$75 copay/visit

$50 copay/visit

$75 copay/visit

No charge

No charge

$75 copay/visit

$75 copay/visit

20%

30%

20%

30%

20%

30%

20%

30%

No charge

No charge

20%

30%

2026 prescription drug coverage Drugs Coverage Tier

Standard 30-day / 90-day*

Tier 1

$5 / $12.50

Tier 2

$18 / $45

(Preferred Generic)

(Non-Preferred Generic)

Tier 3

30%, up to a maximum of a $75 / Lesser of $187.50 copay or 30%

Tier 4

50%, up to a maximum of a $200 / Lesser of $500 copay or 50%

(Preferred Brand)

(Non-Preferred Brand)

Tier 5

20%, up to a maximum of $400

Tier 6

$400

Tier 7

$600

(Preferred Generic Specialty)

(Preferred Brand Specialty)

(Non-Preferred Specialty)

Note: Some drugs do not have a generic equivalent, in this case, the brand name copay is required. * Maintenance drugs are allowed up to a 90-day supply if obtained through a participating pharmacy or when using the mail-order prescription service. Specialty drugs are limited to a 30-day supply.

Basic 30-day / 90-day*

Value 30-day / 90-day*

$8 / $20

$10 /$25

$20 / $50

$25 / $62.50

$60 / $150

$90 / $225

$120 / $300

$200 / $500

20%, up to a maximum of $400

20%, up to a maximum of $400

$400

$450

$600

$650

2026 premiums North and West Texas Premium Rate

Standard Plan

Biweekly

Monthly

Type of Enrollment

Enrollment Code

Gov’t Share

Your Share

Gov’t Share

Your Share

Self Only

P84

$324.76

$181.71

$703.65

$393.70

Self Plus One

P86

$711.17

$413.19

$1,540.87

$859.24

Self and Family

P85

$778.03

$412.18

$1,685.73

$893.06

Premium Rate

Basic Plan

Biweekly

Monthly

Type of Enrollment

Enrollment Code

Gov’t Share

Your Share

Gov’t Share

Your Share

Self Only

P81

$225.45

$75.15

$488.48

$162.82

Self Plus One

P83

$500.51

$166.89 $1,084.45 $361.48

Self and Family

P82

$529.82

$176.61

$1,147.95

$382.65

Premium Rate

Value Plan

Biweekly

Monthly

Type of Enrollment

Enrollment Code

Gov’t Share

Your Share

Gov’t Share

Your Share

Self Only

RE1

$209.26

$69.75

$453.39

$151.18

Self Plus One

RE3

$464.56

$154.85

$1,006.55

$335.51

Self and Family

RE2

$491.77

$163.92

$1,065.50

$355.16

Central Texas Premium Rate

Standard Plan

Biweekly

Monthly

Type of Enrollment

Enrollment Code

Gov’t Share

Your Share

Gov’t Share

Your Share

Self Only

A84

$324.76

$108.46

$703.65

$234.99

Self Plus One

A86

$711.17

$250.59

$1,540.87

$542.94

Self and Family

A85

$763.56

$254.52

$1,654.38

$551.46

Premium Rate

Basic Plan

Biweekly

Monthly

Type of Enrollment

Enrollment Code

Gov’t Share

Your Share

Gov’t Share

Your Share

Self Only

A81

$217.34

$72.44

$470.90

$156.96

Self Plus One

A83

$482.48

$160.82

$1,045.87

$348.45

Self and Family

A82

$510.73

$170.24

$1,106.58

$368.86

Premium Rate

Value Plan

Biweekly

Monthly

Type of Enrollment

Enrollment Code

Gov’t Share

Your Share

Gov’t Share

Your Share

Self Only

YZ1

$202.99

$67.66

$439.81

$146.60

Self Plus One

YZ3

$450.63

$150.21

$976.37

$325.45

Self and Family

YZ2

$477.02

$159.00

$1,033.53

$344.51

#1

in Member Satisfaction among Commercial Health Plans in Texas

The J.D. Power 2025 U.S. Commercial Member Health Plan Study measures satisfaction across key factors, including coverage and benefits, provider choice, cost, customer service, and trust.

Baylor Scott & White Health Plan ranks #1 in Texas across the following categories: Product/Coverage Offerings ▪ Ease of Doing Business ▪ Trust ▪ Helps Save Time or Money ▪ Ability to Get Health Services How/When I Want ▪ Digital Channels ▪ People ▪

Baylor Scott & White Health Plan, anchored by Baylor Scott & White Health, continues to innovate and evolve to meet the needs of members across Texas. From digital tools that simplify access to care to personalized wellness programs, Baylor Scott & White Health Plan is redefining what it means to be a health partner.

The health plan is also accredited by the National Committee for Quality Assurance (NCQA) and a recipient of a 2024 Human Experience of Excellence award by Press Ganey. It’s ranked among the top 5% of health plans nationwide, and its small and large group commercial HMO plans earned the highest physician care CAHPS ratings.

For J.D. Power 2025 award information, visit jdpower.com/awards.

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