Unless you experience a life-changing qualifying event,youcannotmakechangestoyourbenefitsuntil the next open enrollment period. Qualifying events includethingslike:
• Marriage, divorce or legal separation
• Birth or adoption of a child
• Change in child’s dependent status
• Death of a spouse, child or other qualified dependent
• Change in residence
• Change in employment status or a change in coverage under another employer-sponsored plan
In-NetworkMember’sCostShownBelow (Out-of-Network coverage is subject to additional charges)
Individual:$500, Family:$1,000
Individual:$6,350, Family:$12,700
Individual:$2,000, Family:$4,000
Medical Coinsurance N/A 20% 0%
Individual:$1,500, Family:$3,000
$30copay $30copay
$50copay $50copay
Telemedicine Covered100% Covered100%
Diagnostic X-Rays
$30copay 20%,subjecttodeductible
Individual:$5,000, Family:$10,000
$20copay,subjectto deductible
$20copay,subjectto deductible
Covered100%,subjectto deductible
$20copay,subjectto deductible
Preventative Care Covered100% Covered100% Covered100%
Diagnostic Tests and Labs
Inpatient Hospital Care
Urgent Care Visit
Emergency Room Visit
Outpatient Surgery
Physical Therapy
Mental Health Treatment –Inpatient
$30copay 20%,subjecttodeductible
$250copay
$50copay
$150copay
20%,subjecttodeductible
$75copay
$150,subjecttodeductible
$100copay 20%,subjecttodeductible
Maternity Care Covered100% Covered100%
$50copayforspecialist, $30copayforphysician
$250copay
20%,subjecttodeductible
20%,subjecttodeductible
Mental Health TreatmentOutpatient $30copay Covered100%
Substance Abuse TreatmentInpatient
Substance Abuse Treatment – Outpatient
RX Plan (30-day supply)
$250copay
In-NetworkOutlineAbove–Out-of-Networkcoverageissubjectto benefits/additionalcharges Co-pay High (PPO-800)
20%,subjecttodeductible
$30copay Covered100%
Retail:$10/$30/$50copay
MailOrder:$10/$20/$25 copay
Retail:$10/$30/$50copay
MailOrder:$10/$20/$25 copay
$20copay,subjectto deductible
$500,subjecttodeductible
$35,subjecttodeductible
$150,subjecttodeductible
$75,subjecttodeductible
$20copay,subjectto deductible
$20copay,subjectto deductible
$500copay,subjectto deductible
$20copay,subjectto deductible
$500copay,subjectto deductible
$20copay,subjectto deductible
Retail:$10/$30/$50, subjecttodeductible
MailOrder:$10/$20/$25 copay
Dental Insurance
In addition to protecting your smile, dental insurance helps pay for dental care and usually includes regular checkups,cleanings,andX-rays.Severalstudiessuggestthatoraldiseases,suchasperiodontitis(gumdisease),can affectotherareasofyourbody,includingyourheart.Receivingregulardentalcarecanprotectyouandyourfamily fromthehighcostofdentaldiseaseandsurgery.
AccidentInsuranceprovidesfinancialprotectionbypayingasetbenefitamountbasedonthetypeofinjuryyou experienceandthetreatmentyoureceive.Itcoversawiderangeofincidents—fromeverydayinjuriestomore seriousaccidents—andapplieswhethertheaccidenthappens off thejob.
Payingforhealthcarecanbestressful.That'swhySt.BonaventureUniversityoffersanemployer-sponsored flexiblespendingaccount(FSA). AhealthcareFSAletsyouusepre-taxdollarsforcertainIRS-approvedmedical careexpensesnotcoveredbyyourinsuranceplan.Forexample,cashthatyounowspendondeductibles, copaymentsorotherout-of-pocketmedicalexpensescaninsteadbeplacedinthehealthcareFSAonapre-tax basis. For 2025, the FSA maximum contribution limit is $3,300.
What Are the Benefits of a Health Care FSA?
ThereareavarietyofdifferentbenefitsofusingahealthcareFSA. It saves you money. Allowsyoutoputaside moneytax-freethatcanbeusedforqualifiedmedicalexpenses. It is flexible. YoucanuseyourFSAfundsatany time,evenifit’sthebeginningoftheplanyear.
HSAmoniescanbeusedforqualifiedmedicalexpensesnotcoveredbyhealthinsurance.TheHSAisanEmployeeownedbankaccountinwhichyoucandepositpre-taxmoneytosaveforfuturemedicalexpensesorpayfor servicespriortomeetingyourdeductible. You can only contribute to an HSA account if you elect one of St. Bonaventure’s High Deductible Health Plans.
$1,000 Catch-Up is only for those 55 years and older.
Making the most of your plan shouldn’t be complicated. When you sign up for a Highmark online member account, you get instant access to a variety of tools and other resources to make living healthy a little easier.
• Access your virtual member ID card
• Review Claims & EOBs, Manage costs with Highmark’s Care Cost Estimator
• Find a Doctor, Urgent Care, Hospital, Pharmacy, or More
• Receive personalized recommendations for health programs
• Find virtual health tools and activities to help you reach your goals
Download the My Highmark app or visit MyHighmark.com today
Already have an online account?
You can log in using your existing Highmark username and password
Telemedicine – Virtual Care
What is Virtual Care?
With Virtual Care, you can access a doctor from your home, office or on the go – 24 / 7 / 365. Through Highmark’s virtual care benefit, doctors can visit with you either by phone or secure video to help treat many non-emergency medical conditions. Highmark’s virtual care provides access to 24/7 urgent care, mental health care, virtual physical care to help you overcome back, joint, or muscle pain at home, and more.
When should you use telemedicine?
• Instead of going to urgent care or the emergency room for minor and non-life threatening conditions
• Whenever your primary care doctor is not available
• If you live in a rural area and don’t have access to nearby care
• When you’re traveling for work or on vacation
Make Preventive Care A Priority
Preventive Care Services are fully covered, even with a high-deductible health plan. Take advantage of preventive care available to you and your family to ensure you identify concerns that can be treated early.
Please review your preventative schedule which can be found in the HMBCBS benefit guide.
BRIWEB is your secure participant login for managing your accounts with BRI. BRIWEB allows you to view balance and transaction information, submit claims, downloadplandocumentsandmore.Togetstarted,goto BenefitResource.com.
For additional resourcesandto learn more aboutyour accounts,pleasevisittheEmployeeResourcespageonour website.
SUBMIT A CLAIM
If you are not using the Beniversal card or if you have Dependent Care expenses, you can submit a claim with your itemized receipt or supporting documentation. Claimscanbesubmittedthreeways:
