Gold HMO Plan

Effective Date: 1/1/2020 – 12/31/2020

Your Health Plan

Your health benefit plan consists of a fully insured “base” plan, underwritten by Blue Cross Blue Shield of Massachusetts (BCBS), plus a “supplemental” plan, funded by Benemax, and known as the Benemax Wrap®. To see how your base plan and supplemental plan work together, click on Learn How Your Health Plan Works. Your BCBS plan is a HMO (Health Maintenance Organization). You are required to designate a Primary Care Physician (PCP), referrals are required to see a specialist.

You are covered for services rendered by In-Network providers only.

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Your Benefits

Please review Your Summary of Benefits.

Your plan Summary of Benefits and Coverage is also available by clicking here. This is a regulatory document that helps to compare plans, however the Summary of Benefits above best describes your plan and how it works.

As a Blue Cross Blue Shield member, you have access to many reimbursement and discount programs. Please visit your BCBSMA E-Kit (available shortly) for additional details.

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Prescription Drugs

Benemax provides you with a Benemax Debit Card™. Use your Benemax Debit Card to pay for covered prescription drugs at participating pharmacies or through your mail order provider. Note: your Benemax Debit Card can only be used to pay for prescription drugs that are covered by your BCBS plan. For more information about the card, please refer to the RX Drug Tab.

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Selecting a Health Care Provider

You may use any in-network doctor or hospital of your choice, anywhere, anytime. Look up an In-Network Provider.

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Partners Healthcare Online Second Opinions

As a Benemax member, you are entitled to a second opinion consultation from a Harvard Medical School faculty member through Partners Healthcare Online Specialty Consultations. To take advantage of the program visit our Benemax Wellness® site. Once you and your doctor have submitted all necessary information to Partners, you should expect to receive a second opinion in about five business days.

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Benemax Wellness®

As a Benemax member, you have access to everything Benemax Wellness® has to offer to get fit, stay healthy and use health care wisely. Check your symptoms, find the right physician or hospital, learn about Complementary Alternative Medicine, obtain a second opinion, keep a personal fitness journal, learn how to make informed healthcare decisions and much more. Whatever you health mission may be, Benemax Wellness® can help you accomplish it.

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BCBS Healthy Actions

Take action on maintaining your health by enrolling in BCBS Healthy Actions program, where employees can earn up to $300 for participation. For more information about this program, please click here.

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Curelator

You have access to Curelator, a company that is pioneering new, non-invasive, non-pharmaceutical therapies that target chronic diseases. Through Benemax, you have the opportunity to participate in Curelator’s clinical trials and in their post-trial programs, free of charge. Initially, Curelator is offering a program designed to reduce the incidence of Migraine headache. To learn more about Curelator, click www.curelator.com. To enroll in Curelator’s upcoming clinical trials, click www.curelator.com/trial.

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Please refer to your policy or plan document for more specific information about your coverage, or contact a Benemax Independent Member Advocate at 800-528-1530, prompt 3 or at service@benemax.com.