We’re proud to offer you the choice between two major medical plans, through Regence Group Administrators, designed to help you and your family get the care you need at an affordable price.
Note: If your spouse or domestic partner is employed and is eligible for a medical plan through their employer, they are expected to obtain medical coverage through their place of work and are not eligible to participate in CHPW medical plans.
The Consumer Driven Health Plan (CDHP) offers health coverage with the ability to choose to visit in-network or out-of-network providers. You must satisfy a higher deductible than the PPO before the carrier will begin paying toward your medical services; however, you may be eligible to enroll in a Health Savings Account (HSA) which allows you to contribute pre-tax dollars to pay for eligible medical expenses.
CHPW makes monthly tax-free contributions to your HSA for an annual total of $500 for individuals and $1,000 for families to help offset the CDHP’s higher deductible.
The Preferred Provider Organization Plan (PPO) offers the flexibility to choose an in-network or out-of-network provider each time you need care. It is a more traditional health plan and offers predictable copays for routine health care expenses. Keep in mind, you will save money when you visit in-network providers.
At CHPW, our goal is to help you reach your highest potential and be the best version of yourself. This starts with taking care of your overall health. Choosing the right plan to meet your needs is the first step to living your healthiest life.
While each medical plan covers in-network preventive screenings in full, the plans vary on annual deductibles, copays, and levels of coinsurance. This means you may pay higher out-of-pocket costs with one plan versus another. The ideal medical plan should cover most of your health needs with out-of-pocket costs that meet your budget.
| Benefit | CDHP | PPO |
|---|---|---|
| In-network preventive care covered in full | ✓ | ✓ |
| Annual deductible to satisfy | ✓ | ✓ |
| Plan pays before deductible is met | – | ✓ |
| Predictable copay for services | – | ✓ |
| Coinsurance for services | ✓ | ✓ |
| In-network coverage | ✓ | ✓ |
| Out-of-network coverage | ✓ | ✓ |
| Eligible to enroll in an HSA | ✓ | – |
| Eligible for CHPW HSA contribution | ✓ | – |
| Eligible to enroll in Health Care FSA | – | ✓ |
| Eligible to enroll in Limited Purpose FSA | ✓ | – |
| Eligible to enroll in Dependent Care FSA | ✓ | ✓ |
Review the cost of coverage page or go directly to CompareMyHSA. The information below will assist you in completing the information needed to complete the estimation.
To find a provider, visit accessrga.com, select the state your employer is headquartered and follow the prompts. You may also find a provider at one of our Community Health Centers, which can be found here.
Did you know that the cost you pay can vary wildly between providers for the same service? Rightway can help you save money by directing you to the highest value, lowest cost providers. Go to the Rightway website and click the sign in button to get your account set up online or download the Rightway Healthcare app on the app store.
For more details on how Rightway can help you, visit the Rightway page.
Did you know that annual medical and dental checkups help you stay healthy? Take care of yourself and your family by using your free in-network preventive care benefits each year!
All our CHPW medical plans (and our dental plan!) cover preventive care services at no cost to you when you visit in-network providers. Work as a team with your doctor to manage your overall health. Call today, to schedule your free annual checkups.
An annual physical exam or wellness visit can benefit you, your spouse, and your children. Annual physicals provide an opportunity to discuss health concerns, update your medications, and receive personalized health advice from your primary care doctor.
Adults can benefit from regular screenings for diabetes, blood pressure, cholesterol, cancer, depression, and obesity. Pediatric screenings support children’s health and development in various areas, including hearing, vision, autism, developmental disorders, depression, and obesity.
Immunizations and flu shots protect you from serious diseases, reduce your risk of infections, and help maintain your overall health.
Mammograms for women over 40 offer several benefits, including early detection of breast cancer, increased chances of successful treatment, and improved survival rates.
Insurance coverage can be complicated. A Benefit Advocate at Alliant is available to help you and your dependents navigate the healthcare system. Find doctors, get cost estimates, or solve billing problems with help. For more information, visit the Benefit Advocate page.
Through the Regence medical plans, you may receive a breast pump at no cost to you. Many breast pumps and lactation pumps are 100% covered when they’re purchased through an approved vendor. See your benefit summary for more information.
You can breathe easy knowing that you’ve got coverage when you can’t receive services near your home. CHPW’s Medical Travel Benefit will provide reimbursement for necessary travel and lodging expenses when covered medically necessary services are not available within 100 miles of your residence.
The benefit maximum is:
Note for CDHP Enrollees: This benefit is subject to your deductible, however coinsurance is waived.
Note for PPO Enrollees: Your deductible and coinsurance are waived for this benefit.
For more information, please refer to your medical SPD.
CHPW is committed to providing new and inclusive coverage, including coverage for transgender services for medically necessary care when prescribed as gender affirming treatment. See the Summary Plan Description for full details.
Services covered include:
| Plan Features | Regence CDHP | Regence PPO | ||||
|---|---|---|---|---|---|---|
| Tier I: In-Network (CHNW*) |
Tier II: In-Network (BCBS) |
Tier III: Out-of-Network |
Tier I: In-Network (CHNW*) |
Tier II: In-Network (BCBS) |
Tier III: Out-of-Network |
|
| Annual Deductible Individual/Family | $1,700 / $3,400 | $0 / $0 | $1,300 / $2,600 | $3,050 / $6,100 | ||
| Annual Out-of-Pocket Maximum Individual/Family | $4,000 / $8,000 | Covered in full | $5,000 / $15,000 | $5,500 / $16,500 | ||
| CHPW Annual HSA Contribution Individual/Family | $500 / $1,000 | Not available | ||||
| You pay: | You pay: | |||||
| Preventive Care Visit | Covered in full | 50% after deductible | Covered in full | 50% after deductible | ||
| Primary Care Visit | Covered in full after deductible | 20% after deductible | 50% after deductible | Covered in full | $20 copay | 50% after deductible |
| Specialist Visit | Covered in full after deductible | 20% after deductible | 50% after deductible | Covered in full | $30 copay | 50% after deductible |
| Lab & X-ray | Covered in full, if available | 20% after deductible | 50% after deductible | Covered in full, if available | 20% after deductible | 50% after deductible |
| Urgent Care | Covered in full after deductible, if available | 20% after deductible | 50% after deductible | Covered in full, if available | $50 copay, then 20% after deductible | 50% after deductible |
| Emergency Room (copay waived if admitted) | Not available | 20% after deductible | 50% after deductible | Not available | $150 copay, then 20% after deductible | $150 copay, then 20% after deductible |
| Inpatient/Outpatient Hospital Services | Not available | 20% after deductible | 50% after deductible | Not available | 20% after deductible | 50% after deductible |
| Outpatient Mental Health Services | No charge | 20% after deductible | 50% after deductible | No charge | $20/visit | 50% after deductible |
| Chiropractic (10 visits per calendar year) | Covered in full after deductible, if available | 20% after deductible | 50% after deductible | Covered in full, if available | $30 copay | 50% after deductible |
| Acupuncture (60 visits per calendar year, combined with other therapy visits) | Covered in full after deductible, if available | 20% after deductible | 50% after deductible | Covered in full, if available | $30 copay | 50% after deductible |
| Outpatient Rehabilitative Therapy (60 visits per year, combined with other therapy visits) |
Covered in full after deductible, if available | 20% after deductible | 50% after deductible | Covered in full, if available | $20 copay, then 20% after deductible | 50% after deductible |
| Prescription Drugs: Retail (up to a 30-day supply) | ||||||
| Generic | 20% after deductible | 20% after deductible | 50% after deductible | $10 copay | $10 copay | $10 copay, then 50% |
| Brand Formulary | 50% up to $250, then 100% of excess | 50% up to $250, then 100% of excess | 50% up to $250, then 100% of excess | |||
| Brand Non-Formulary | 50% | 50% | 50% | |||
| Prescription Drugs: Mail Order (up to a 90-day supply) | ||||||
| Generic | 20% after deductible | 20% after deductible | Not available | $20 copay | $20 copay | Not available |
| Brand Formulary | 50% up to $500, then 100% of excess | 50% up to $500, then 100% of excess | Not available | |||
| Brand Non-Formulary | 50% | 50% | Not available | |||
*Tier I benefit coverage applies to services that are provided and billed by a Community Health Network of Washington (CHNW) only. Any contracted services that are provided at a Community Health Center via a third party are subject to Tier II and Tier III coverage levels.