Your Choices
Ocean Spray gives you three great options for quality health care through Blue Cross Blue Shield of Massachusetts:
- PPO 80
- PPO 70
- HDHP
- High Performance Network (HPN) available for Lehigh Valley, PA and Henderson, NV only
Which plan should you choose?
PPOs offer benefits for both in-network and out-of-network benefits. You pay a copay when you go to the doctor’s office or ER. Use the Health Care FSA to pay for out-of-pocket expenses with tax-free dollars.
You pay the full cost of medical care with the High Deductible Health Plan (HDHP) until you meet the annual deductible. Then, the plan pays the majority of the cost of medical care. Take advantage of the Health Savings Account to pay for eligible expenses with tax-free dollars.
Spousal and Tobacco Surcharges
Spousal Surcharge – $150/month (pre-tax)
This surcharge applies if your spouse or domestic partner has access to other employer-sponsored medical coverage but chooses to enroll in Ocean Spray’s plan instead.
Tobacco Surcharge – $50/month (pre-tax)
This surcharge applies to team members who attest to using tobacco products.
Benefit Spotlight
Whether you have a chronic condition like high blood pressure or diabetes or your child comes down with strep throat, your medical benefits have you covered.These plans offer everything you and your family need to reach your health goals:
- Free in-network preventive care
- Free Telehealth visits for PPO 80 and PPO 70 plans
- Free in-network lab work and X-rays for PPO 80 and PPO 70 plans
- Affordable premiums for great health care coverage
- $0 copay for in-network mental health services
Primary Care vs Urgent Care vs ER
| Employee Contribution | ||||
| Monthly Cost | ||||
| PPO 80 | PPO 70 | HDHP | HPN | |
| Team Member | $295.26 | $148.55 | $152.55 | $136.30 |
| Team Member + Spouse | $749.26 | $410.98 | $422.04 | $377.07 |
| Team Member + Child(ren) | $708.66 | $386.23 | $396.61 | $354.36 |
| Family | $1,129.40 | $606.23 | $621.06 | $550.86 |
| Semi-Monthly Cost | ||||
| Team Member | $147.63 | $74.27 | $76.27 | $68.15 |
| Team Member + Spouse | $374.63 | $205.49 | $211.02 | $188.54 |
| Team Member + Child(ren) | $354.33 | $193.11 | $198.31 | $177.18 |
| Family | $564.70 | $303.18 | $310.53 | $275.43 |
| Bi-Weekly Cost | ||||
| Team Member | $136.27 | $68.56 | $70.41 | $62.91 |
| Team Member + Spouse | $345.81 | $189.68 | $194.79 | $174.03 |
| Team Member + Child(ren) | $327.07 | $178.26 | $183.05 | $163.55 |
| Family | $521.26 | $279.86 | $286.64 | $254.24 |
| Weekly Cost | ||||
| Team Member | $68.14 | $34.28 | $35.20 | $31.45 |
| Team Member + Spouse | $172.91 | $94.84 | $97.39 | $87.02 |
| Team Member + Child(ren) | $163.54 | $89.13 | $91.53 | $81.77 |
| Family | $260.63 | $139.93 | $143.32 | $127.12 |
Don’t Forget
Stay in-network for medical care for the best value. If you need to use out-of-network providers, your cost will be much higher.The following coverage is available through our BCBSMA medical plans:
- Fertility services, such as reciprocal IVF, egg freezing, artificial insemination, sperm and egg and/or inseminated egg procurement and processing, banking of sperm or inseminated eggs (only when they are not covered by the donor’s health plan); and infertility technologies, such as: in vitro fertilization and embryo placement; gamete intrafallopian transfer; zygote intrafallopian transfer; natural oocyte retrieval intravaginal fertilization; and intracytoplasmic sperm injection. Read the Summary Plan Description on the portal for a full summary of benefits.
- Transgender services, such as mastectomy, breast augmentation, Gender Confirmation Surgery (GCS), facial feminization, electrolysis, and Oocyte, embryo, or sperm retrieval, freezing and storage for up to 24 months. Click here for the full policy.
Transparency In Coverage Rule
In compliance with the Transparency in Coverage Rule (TCR), through Blue Cross Blue Shield of MA, BCBSMA creates and publishes Machine-Readable Files on behalf of Ocean Spray Cranberries. The Transparency in Coverage Rule requires that group health plans post publicly available machine-readable files that include in-network negotiated payment rates and historical out-of-network charges for covered items and services. While these files are accessible to all, the file itself is large and written in JSON, which is a machine-readable language, and not easily interpreted or searchable. To review the Machine-Readable Files, visit https://transparency-in-coverage.bluecrossma.com/. The site will be searchable by Health Insurance Oversight System (HIOS) and employer tax ID number (EIN). To support our national and regional networks, we will provide links to other BCBSMA plans data within the table of contents directing you to the information needed for a complete In-network File.
Health Reimbursements
Over the Counter COVID Test Reimbursement Form
Eligible plan members may get reimbursed for the cost of FDA-authorized, at-home COVID-19 tests. Members can request reimbursement for up to eight tests per calendar month, for purchases made on or after January 15, 2022. You must submit a separate form for each covered member, including dependents. Click here to download the Non-BCBS fitness reimbursement.
Weight Loss Reimbursement
- Employees and their spouse/domestic partner who are enrolled in a BCBS medical plan can receive $150 each, up to $300/family for eligible weight loss programs.
- Log into your MyBlue account to apply for reimbursement.
- Non-plan members are not eligible.
Eligible programs include
- E.A.T. Noom
- iDiet Engage Well & Simple
- Jenny Craig (if using coaching)
- Weight Watchers In-Person and Online (if online is Meetings, Workshops, or Coaching Program)
- Mayo Clinic YMCA Weight Loss Programs
Fitness Reimbursement
- Employees and their spouse/domestic partner who are enrolled in a BCBS medical plan can receive $150 each, up to $300/family for eligible fitness expenses.
- If you are enrolled in OSC medical, you may apply for this reimbursement by logging into your MyBlue account.
- If you are not enrolled in OSC medical, you are still eligible for a $150 reimbursement. Download the Non-BCBS fitness reimbursement form to submit your claim.
Eligible expenses include:
- Gym Memberships (online memberships included such as Beachbody On Demand)
- Specialty Fitness Classes (i.e. Pilates, Yoga, Kickboxing, Spin, etc.)
- Fitness Trackers (i.e. FitBit, Apple Watch, Garmin, etc.)
- Home Fitness Equipment (i.e. Treadmill, Elliptical, Dumbbells, etc.)
Mind and Body Reimbursement*
- Employees and their spouse/domestic partner who are enrolled in a BCBS medical plan can receive up to $300/family for eligible mind and body services and apps.
- Non-plan members are not eligible.
Eligible Expenses Include:
- Massage Therapy
- Hypnosis Therapy
- Meditation Therapy
- Tai Chi
- Qi (Chi) Gong
- Breathing and Meditation Apps
BCBS Fitness and Weight Loss Reimbursement Instructions
Mind and Body Reimbursement Request Form
Non-BCBS Fitness Reimbursement Form
*The Mind and Body Reimbursement is only available to BCBS members. BCBS members may qualify for both the Mind and Body Reimbursement and the fitness and weight loss reimbursement in the same year.
Traveling Outside the U.S.?
As a BCBSMA member you are covered by your healthcare benefits even when you’re traveling abroad thanks to the Blue Cross Blue Shield Global Core program. Read the program guide for more information.
Medical Plan Comparison
Your medical plans offer coverage both in- and out-of-network to give you flexibility when choosing care. Here is a summary of some of the in-network benefits your medical plans offer.
| PPO 80 | PPO 70 | HDHP (High Deductible Plan with HSA option) | HPN (High Performance Network) for Leigh Valley, PA and Henderson, NV only |
| Higher Paycheck deductions | Lower paycheck deductions | Lower paycheck deductions | Lower paycheck deductions |
| Lower Deductible | Higher Deductible | Higher Deductible | Higher Deductible |
| In and Out of Network Coverage | In and Out of Network Coverage | In and Out of Network Coverage | In-Network Coverage only (no Out-of Network Coverage) |
| Copays for nonpreventive office services and 20% coinsurance (after deductible) where a flat copay does not apply | Copays for nonpreventive office services and 30% coinsurance (after deductible) where a flat copay does not apply | Copays do not apply. 20% coinsurance after deductible | Copays for nonpreventive office services and 30% coinsurance (after deductible) where a flat copay does not apply |
| Access to a Flexible Spending Account (FSA). You fund this account through pre-tax payroll contributions up to the annual IRS limit. This is a use-it or lose-it account, your expenses must be incurred before December 31 of the Plan year and you have until March 31st of the following year to submit your claims for eligible expenses. | Access to a Flexible Spending Account (FSA). You fund this account through pre-tax payroll contributions up to the annual IRS limit. This is a use-it or lose-it account, your expenses must be incurred before December 31 of the Plan year and you have until March 31st of the following year to submit your claims for eligible expenses. | Access to a health savings account (HSA) to fund pretax, plus a one-time contribution from Ocean Spray: $500 for team member only coverage and $1,000 for all other coverage levels. You do NOT have access to the Flexible Spending Account (FSA). | Access to a Flexible Spending Account (FSA). You fund this account through pre-tax payroll contributions up to the annual IRS limit. This is a use-it or lose-it account, your expenses must be incurred before December 31 of the Plan year and you have until March 31st of the following year to submit your claims for eligible expenses. |
| Medical Plan Summary | PPO 80 | PPO 70 | HDHP* | HPN (HEN and LHV only) | |||
| In-Network | Out-of-Network | In-Network | Out-of-Network | In-Network | Out-of-Network | In-Network (No Out-of-Network Coverage) | |
| Annual Deductible Individual/Family | $1,500/$3,000 | $2,000/$4,000 | $2,500/$5,000 | $2,000/$4,000 | |||
| Out-of-Pocket Maximum* Individual/Family | Medical: $4,500/$9,000 Rx: $1,600/$3,200 | Medical: $5,500/$11,000 Rx: $1,600/$3,200 | Combined medical and Rx: $6,650/$13,300 | Medical: $5,500/$10,000 Rx: $1,600/$3,200 | |||
| Coinsurance (your share) | 20% | 40% | 30% | 50% | 20% | 40% | 30% |
| Maximum Benefit | Unlimited | ||||||
| Copays Office visits Specialist visits | $25 $40 | 40% after deductible | $25 $50 | 50% after deductible | 80% after deductible | 80% after deductible | $25 $40 |
| Preventive Care | $0 | 40% after deductible | $0 | 50% after deductible | $0 | 40% after deductible | $0 |
| Telehealth | $0 copay | $0 copay | subject to deductible | $0 copay | |||
| Hospital Care Including pre- admission testing | 20% after deductible | 40% after deductible | 30% after deductible | 50% after deductible | 20% after deductible | 40% after deductible | 30% after deductible |
| Emergency Room | $250 | $250 | $250 | $250 | 20% after deductible | 40% after deductible | $250 |
| Hi Tech Radiology (MRI/CT/PET) | Deductible (no coinsurance) | 40% after deductible | Deductible (no coinsurance) | 50% after deductible | 20% after deductible | 40% after deductible | Deductible (no coinsurance) |
| *Lab Work and X-Rays | $0 | 40% after deductible | $0 | 50% after deductible | 20% after deductible | 40% after deductible | $0 |
| Mental Health Treatment | $0 copay | subject to deductible | $0 copay | subject to deductible | $0 copay | subject to deductible | $0 copay |
| Substance Abuse Treatment | Please refer to the benefits summary provided by BCBSMA. | ||||||
| Acupuncture | Up to 12 visits, subject to specialist copayment | ||||||
| Prescription Drugs | You are automatically enrolled in the Prescription Drug Program, administered by Express Scripts®, when you elect medical coverage. | ||||||
*Out-of-Pocket Maximum is the total of your coinsurance, deductible and all copays (excluding prescription drug copays for the PPO 80 and PPO 70 plans).
Contacts
| Benefits | Contact | Phone | Website |
| Medical | Blue Cross Blue Shield of Massachusetts | 1-800-872-5298 | Visit Website |
