Funded by the employer, a HRA sets aside a specific amount of pre-tax dollars for employees to pay for health care expenses and must be established for each covered employee.

Funds available are applied toward any deductible or coinsurance the employee may owe for covered medical services.

Office visit and prescription drug copays are not reimbursable from the HRA.

Available only in the Preferred-Care network.

HRA Plan

HRA PCA-$1000 PCB Gold
Preferred-Care Blue with BlueCard
(Available for purchase directly from Blue KC)1
Network IN OUT
DEDUCTIBLE
SINGLE $3,000 $3,000
FAMILY $6,000 $6,000
OUT OF POCKET MAX
SINGLE $6,000 $12,000
FAMILY $12,000 $24,000
COST SHARING
COINSURANCE 20% 50%
PCP2 Visits $20 copay in-network / $40 copay out-of-network
URGENT CARE Deductible then 20%
SPECIALIST VISITS Deductible then 20%
Emergency Room Deductible then 20%
Prescription drugs at a retail pharmacy3 Tier 1: $10
Tier 2: $55
Tier 3: 20% (Max $250)
Tier 44: Ded then 30%
DEDUCTIBLE TYPE5 EMBEDDED

Summary of Benefits and Coverage

View a complete list of Summary of Benefits and Coverage Documents.

  • 1 Blue KC is a Qualified Health Plan issuer on the Small Business Health Options (SHOP) Marketplace Exchange. All Blue KC products qualify as Minimum Essential Coverage under the Affordable Care Act (ACA), meaning your covered employees and their family members will not be subject to the individual mandate penalty for any months they are enrolled in the product.
  • 2 Primary Care Physicians include General Practice, Family Practice, Internal Medicine, and Pediatrics.
  • 3 Maintenance medications must be filled through the mail-order pharmacy to receive the lowest copay. Individuals will be charged two times the applicable copay for a maintenance medication at retail pharmacies after the second prescription is filled.
  • 4 Tier 4 specialty medications should be filled through the mail-order pharmacy to receive the lowest copay. Members will be charged up to two times the applicable copay for a specialty medication at retail pharmacies. Some specialty medications are only available through the mail order pharmacy. A list of those medications for Missouri members is available in the 2017 Missouri Prescription Drug List and for Kansas members in the 2017 Kansas Prescription Drug List.
  • 5 Embedded—An individual deductible you must satisfy each calendar year before benefits will be paid. Aggregate—The entire family deductible must be satisfied each calendar year before benefits for any covered person will be paid.

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When life calls for more than health insurance, Blue KC answers. With dental plans, vision plans, short-term security plans and even travel medical insurance. That's how you cover all of life's plans.

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Blue KC Member Health Programs

Good health starts with good support. That's why every Blue KC member has access to the resources they need to live healthy. From Health Risk Assessments to health and wellness programs. From prenatal programs to preventive care. We're committed to improving the health of our members and our community.

Member Health Programs

Health Insurance Matters

We'll help you, and your employees, understand the lay of the healthcare landscape. Navigate through all the twists and turns. And make decisions that benefit the bottomline. After all, the smarter we are, the healthier we can be.

Learn More About Employer Insurance