Medical Plan options for PC(USA)-affiliated employers
The Medical Plan reflects our ongoing shared commitment to supporting the holistic well-being of your employees, promoting healthier lives, and enabling them to thrive both at work and in their communities.
If you are a PC(USA) congregation or employer, read about the Medical Plan for PC(USA) congregations and employers.
Six options to support your needs
We understand the importance of offering medical options that are both comprehensive and cost-effective — for your organization and your employees. That’s why we are pleased to introduce three new medical options for 2027, for a total of six medical options, to support holistic well-being. These include the existing PPO, EPO, and HDHP options — now renamed Premier — along with three new Select options that offer the same Blue Cross Blue Shield (BlueCard PPO) national provider network and similar features with different out-of-pocket costs for care.
You have the flexibility to offer any one or a combination of the six medical options that best supports your organization’s needs.
- preferred provider organization (PPO)
- existing option: renamed PPO Premier
- new option: PPO Select
- exclusive provider organization (EPO)
- existing option: renamed EPO Premier
- new option: EPO Select
- high deductible health plan (HDHP)
- existing option: renamed HDHP Premier
- new option: HDHP Select
You can compare features and out-of-pocket costs under each option using the Medical Plan Comparison Tool, with the option to print details as needed.
Employees enrolled in the Medical Plan have access to the Blue Cross Blue Shield (BlueCard PPO) national provider network,* giving members greater choice in providers and care options, along with seamless continuity of care — whether for routine services, ongoing conditions, or care while traveling.
*All PPO, EPO, and HDHP medical options use the BlueCard PPO program, allowing members to access participating Blue Cross Blue Shield doctors, hospitals, and other providers across the country.
Outstanding features to support holistic well-being
Each medical option includes features that support members’ well-being and help them navigate care with confidence, including preventive care benefits, prescription drug benefits, and more.
Preventive care benefits support overall health, including yearly well visits, health screenings, and immunizations.
Care navigation, offered through Quantum Health, gives members a primary point of contact when they need help navigating their healthcare needs. Care Coordinators are available to provide personalized guidance, simplify access to care, and support better-informed health decisions.
Prescription drug benefits, offered through Express Scripts, give members access to an extensive list of preventive drugs available at reduced costs, and savings when choosing generic medications or using the plan’s home delivery service.
Call to Health, our online well-being program, available on the WebMD ONE platform, allows members to reduce their annual medical deductible(s) for the following year by up to one-third, depending on the medical option, while helping them create and maintain healthy habits habits.
Telemedicine through Teladoc Health gives members 24/7 access to U.S. board-certified doctors via phone, video, or mobile app for less than the cost of an office visit to help with acute needs.
Mental Well-Being and Employee Assistance Plan (EAP), available through Spring Health and fully integrated with medical benefits, supports members’ mental well-being, including 24/7 crisis assistance, unlimited virtual coaching sessions, and up to six therapy sessions per year with a Spring Health provider. Plus, employers can access management consultations and critical incident support for a variety of workplace issues, ranging from employee performance to natural disasters.
Centers of Excellence are designated facilities that deliver superior results and, if used for complex, costly surgical procedures — including bariatric surgery, transplants, knee and hip replacements, and spinal surgery — members can qualify for enhanced benefits, reducing their out-of-pocket costs.
A diabetes management program offered through Teladoc Health helps members living with diabetes manage their condition. Members receive personalized 24/7 support, a connected glucose monitor, and unlimited test strips.
A virtual physical therapy program offered through Hinge Health provides one-on-one support from a physical therapist or health coach for relief of back, joint, and muscle pain.
International medical care for members traveling outside of the United States provides coverage that includes access to Global Care telemedicine services through Teladoc Health, and Blue Cross Blue Shield Global Core and/or International SOS for medically necessary services, so they can travel with peace of mind.
A vision exam benefit offered through VSP allows members to get an annual routine vision exam and certain health-related screenings for a flat-dollar copay (no deductible) when using VSP providers. Plus, covered members receive discounts of 15-20% from network providers on eyewear like eyeglass frames and lenses.
A shared approach to healthcare costs
The Medical Plan is designed to promote shared responsibility for healthcare costs — gains and losses are distributed across the total population of employers participating in the Medical Plan in the form of standard rates, adjusted for age and regional cost factors.
Learn more about:
-
Medical Plan pricing
-
Understanding medical trend and why it matters
- Balancing risk, rising costs, and member care in a fragmented system
Questions about the Medical Plan?
Employers who currently offer benefits through the Board of Pensions can call 800-PRESPLAN (800-773-7752) (TTY: 711) to speak with an Employer Services representative. They can answer questions about benefits and offer support on administering benefits through Benefits Connect.