HMO 2000 Health Plan

Effective Date: 1/1/2023 – 12/31/2023

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 Chex Finer Foods, administered 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 covered for services rendered by In-Network health care provider only. You must designate a PCP (Primary Care Physician) and obtain referrals to see specialists.

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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.

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Prescription Drugs

BCBS covers 100% of approved In-Network prescription drugs at participating retail or mail order pharmacies, subject to the following copays, for which you are responsible:

• Tier 1 drugs: $25 retail (up to a 30-day supply), $50 mail order (up to a 90-day supply)
• Tier 2 drugs: $45 retail (up to a 30-day supply), $90 mail order (up to a 90-day supply)
• Tier 3 drugs: $65 retail (up to a 30 day supply), $130 mail order (up to a 90-day supply)
• Tier 4 drugs: $125 retail (up to a 30 day supply), $375 mail order (up to a 90-day supply)

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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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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 benemax.service@onedigital.com.