To find an in-network provider go to Doctors & Hospitals – Blue Cross and Blue Shield of Kansas City

CHANGE IN STATUS
Under the IRS guidance, Conception Abbey has adopted the following new types of change in status for employees to drop their group health coverage through a cafeteria plan (Section 125):
1. An employee qualifies for and enrolls in coverage through the federal Exchange or a state Exchange (either during its open enrollment period or because the employee qualifies for special enrollment); or
2. An employee’s hours are reduced below 30 but he/she doesn’t lose eligibility for employer coverage; and the employee enrolls in another plan that offers minimum essential coverage (whether through an Exchange or not).
* Note that doing so allows the employee to drop coverage but not to change their FSA elections.

	In-Network
Deductible
Individual	$1,000
Family	$2,000
Member Coinsurance	20%
Out-of-Pocket Max
Individual	$2,500
Family	$5,000
Physician Visits
Primary Care Visit	$25 Copay
Specialist Visit	$25 Copay
Urgent Care	$25 Copay
Emergency Room	$100 Copay + Ded. + 20%
Prescriptions
Retail	$15 / 70 / 110 / 200
Mail Order	$37.50 / 175 / 275

	Monthly Rates
Employee Only	$212.00
Employee + Spouse	$1,743.88
Employee + Child(ren)	$1,149.23
Employee + Family	$2,087.60

Downloads

Summary of Benefits

To find an in-network provider go to Doctors & Hospitals – Blue Cross and Blue Shield of Kansas City

CHANGE IN STATUS
Under the IRS guidance, Conception Abbey has adopted the following new types of change in status for employees to drop their group health coverage through a cafeteria plan (Section 125):
1. An employee qualifies for and enrolls in coverage through the federal Exchange or a state Exchange (either during its open enrollment period or because the employee qualifies for special enrollment); or
2. An employee’s hours are reduced below 30 but he/she doesn’t lose eligibility for employer coverage; and the employee enrolls in another plan that offers minimum essential coverage (whether through an Exchange or not).
* Note that doing so allows the employee to drop coverage but not to change their FSA elections.

	In-Network
Deductible
Individual	$2,000
Family	$6,000
Member Coinsurance	20%
Out-of-Pocket Max
Individual	$5,000
Family	$10,000
Physician Visits
Primary Care Visit	$40 Copay
Specialist Visit	$40 Copay
Urgent Care	$40 Copay
Emergency Room	$100 Copay + Ded. + 20%
Prescriptions
Retail	$15 / 70 / 110 / 200
Mail Order	$37.50 / 175 / 275

	Monthly Rates
Employee Only	$138.00
Employee + Spouse	$1,548.43
Employee + Child(ren)	$1,000.76
Employee + Family	$1,864.66

Downloads

Summary of Benefits

To find an in-network provider go to Doctors & Hospitals – Blue Cross and Blue Shield of Kansas City

CHANGE IN STATUS
Under the IRS guidance, Conception Abbey has adopted the following new types of change in status for employees to drop their group health coverage through a cafeteria plan (Section 125):
1. An employee qualifies for and enrolls in coverage through the federal Exchange or a state Exchange (either during its open enrollment period or because the employee qualifies for special enrollment); or
2. An employee’s hours are reduced below 30 but he/she doesn’t lose eligibility for employer coverage; and the employee enrolls in another plan that offers minimum essential coverage (whether through an Exchange or not).
* Note that doing so allows the employee to drop coverage but not to change their FSA elections.

	In-Network
Deductible
Individual	$5,000
Family	$10,000
Member Coinsurance	10%
Out-of-Pocket Max
Individual	$6,450
Family	$12,900
Physician Visits
Primary Care Visit	Ded. + 10%
Specialist Visit	Ded. + 10%
Urgent Care	Ded. + 10%
Emergency Room	$100 Copay + Ded. + 10%
Prescriptions
Retail	Ded. + 10%
Mail Order	Ded. + 10%

	Monthly Rates
Employee Only	$102.00
Employee + Spouse	$1,338.27
Employee + Child(ren)	$858.20
Employee + Family	$1,615.54

Downloads

Summary of Benefits

Medical Benefits