Medical Plan Options
Option 1: Core PPO $3,000 w/HRA (BD-R9)
Option 2: Navigate HMO $2,000 w/ HRA (BF-C9)
Option 3: Charter HMO $1,000 (BF-DV)
Option 4: Core HSA (Health Savings Account) (DJ26)
Preferred Provider Organization (PPO)
Although you have the flexibility to see any doctor or visit any hospital of your choice, you will pay significantly less money out of your pocket if you use a doctor or hospital that is in the network. For most doctor visits and preventative care visits, you simply pay a copayment at the time of service. You have a great deal of flexibility and choice with a PPO and can manage your out-of-pocket costs by remaining in network.
The Health Reimbursement Arrangement or HRA
is automatic when you enroll in this plan. When you have claims that go toward your deductible, we reimburse you for part of your deductible. If you elect a plan with an HRA, You are responsible for the 1st 50% of the Deductible and then Core Pipe will cover the rest. The 2 plans that offer this option are the Core PPO w/HRA Plan (BD-R9) Network: Core, and the Navigate HMO w/HRA (BF-C9) Network: Navigate HMO.
HMO
With an HMO plan you will have lower out-of-pocket costs and a set copay for a range of
medical services. However, you must select a primary care physician (PCP) who will provide or
coordinate most of your care. For specialty care, you will need a referral from your PCP. If you do not receive care through a PCP, your medical costs will not be covered by the HMO.
High Deductible Health Plan (HDHP) with Health Savings Account (HSA)
Although you have the flexibility to see any doctor or visit any hospital of your choice, you will pay significantly less money out of your pocket if you use a doctor or hospital that is in the network. Preventative care services are covered at 100%. For other services, including prescription drugs, no benefits will be paid until you have met your annual deductible. The HSA is a bank account paired with your HDHP that allows you to save money on a tax-free basis to pay your deductible and other out-of-pocket medical expenses in the current year or in the future. Qualified medical expenses that can be paid using this account include doctor visits, prescription drugs, and even dental and vision expenses. You own the money in your HSA account, and it is yours to keep – even when you change plans or retire. The funds can roll over from year to year and you do not pay tax on withdrawals used for qualified medical expenses. The HDHP PPO Plan (BD-CZ) allows you to open an HSA account.
RX and Maintenance Medications
You may fill a 30-day supply at the preferred pharmacy of your choice or a 90-day supply at CVS. As new drugs become available to consumers or the prices of existing drugs increase or decrease, insurers may add, remove or move drugs between cost tiers. Drugs placed in a higher tier may cost you more money or may only be covered after you try lower-tiered drugs first. For questions about specific prescriptions (including ongoing prescriptions) or for additional information regarding your prescription coverage, please contact your prescription drug provider at 800-282-2881 to determine the costs and learn more about their restrictions prior to filling your prescriptions. The prescription drug list associated with both plans is called the Advantage PDL.
Virtual Visits $0 – Core PPO, Navigate HMO and Charter HMO
Virtual Visit $54 – Core HDHP HSA
| PPO | ||
| Plan Features | In-Network Only (What You Pay) | Out-of-Network Only (What You Pay) |
| Deductible* | $3,000 Single / $6,000 Family (Employee pays first half of deductible – Core Pipe pays remainder) | $5,000 Single / $10,000 Family |
| Out-of-Pocket Limit | $6,000 Single / $12,000 Family | $10,000 Single / $20,000 Family |
| Office Visit (Primary) | $30 Copay (this copay is waived for children under 19) | 40% after deductible |
| Office Visit (Specialist) | $60 Copay | 40% after deductible |
| Virtual Visit | $0 Copay | Not Available |
| Preventive Care | $0 | 40% after deductible |
| Outpatient Surgery Facility Fee | 20% after deductible | 40% after deductible |
| Emergency Room | $250 Copay + Coinsurance | |
| Urgent Care | $75 Copay | 40% after deductible |
| Inpatient Facility Fee | 20% after deductible | 40% after deductible |
| Prescription Drugs Retail Copay | $10 / $35 / $60 Mail Order: 2.5x Retail | |
IL Core PPO with HRA Benefit Summary
| Navigate HMO | ||
| Plan Features | In-Network Only (What You Pay) | |
| Deductible | $2,000 Single / $4,000 Family Employee pays first half of deductible – Core Pipe pays remainder | |
| Out-of-Pocket Limit (Includes Deductible) | $6,000 Single / $12,000 Family | |
| Office Visit (Primary) | $30 Copay Copay is waived for children under 19 | |
| Office Visit (Specialist) | $60 Copay | |
| Virtual Visit | $0 | |
| Preventive Care | $0 | |
| Urgent Care | $75 Copay | |
| Emergency Room | $250 Copay + 20% | |
| Inpatient Services | 20% after deductible | |
Prescription Drug Copay | $10 / $35 / $60 after deductible Mail Order: 2.5x Retail after deductible | |
| Charter HMO | ||
| Plan Features | In-Network Only (What You Pay) | |
| Deductible | $1,000 Single / $2,000 Family | |
| Out-of-Pocket Limit (Includes Deductible) | $2,500 Single / $5,000 Family | |
| Office Visit (Primary) | $20 Copay Copay is waived for children under 19 | |
| Office Visit (Specialist) | $40 Copay | |
| Virtual Visit | $0 | |
| Preventive Care | $0 | |
| Urgent Care | $75 Copay | |
| Emergency Room | $300 Copay | |
| Inpatient Services | 0% after deductible | |
Prescription Drug Copay | $10 / $35 / $60 after deductible Mail Order: 2.5x Retail after deductible | |
| Core HDHP PPO with HSA | ||
| Plan Features | In-Network Only (What You Pay) | Out-of-Network Only (What You Pay) |
| Deductible | $3,200 Single / $6,400 Family | $5,600 Single / $10,000 Family |
| Out-of-Pocket Limit | $4,000 Single / $8,000 Family | $10,000 Single / $20,000 Family |
| Office Visit (Primary) | 0% after deductible | 20% after deductible |
| Office Visit (Specialist) | 0% after deductible | 20% after deductible |
| Virtual Visit | $50 | Not Available |
| Preventive Care | $0 | 20% after deductible |
| Diagnostic Test (X-ray, blood work) | 0% after deductible | 20% after deductible |
| Outpatient Surgery Facility Fee | 0% after deductible | 20% after deductible |
Emergency Room | 0% after deductible | |
Ambulance | 0% after deductible | |
| Urgent Care | 0% after deductible | 20% after deductible |
| Inpatient Facility Fee | 0% after deductible | 20% after deductible |
Prescription Drug Copay | $10 / $35 / $60 after deductible Mail Order: 2.5x Retail after deductible | |
2025-2026
Core PPO w/HRA | Navigate HMO | Charter HMO | Core HDHP w/ HSA PPO | |
Employee | $32.00 | $26.00 | $16.00 | $30.00 |
Employee + Spouse | $74.00 | $55.00 | $51.50 | $66.00 |
Employee + Child(ren) | $58.00 | $46.00 | $37.00 | $54.00 |
Family | $122.00 | $86.50 | $70.00 | $115.00 |
2024-2025
Core PPO w/HRA | Navigate HMO | Charter HMO | Core HDHP w/ HSA PPO | |
Employee | $29.50 | $24.50 | $15.50 | $28.00 |
Employee + Spouse | $68.00 | $52.00 | $50.00 | $60.00 |
Employee + Child(ren) | $54.00 | $45.00 | $36.00 | $50.00 |
Family | $116.00 | $84.00 | $68.00 | $106.00 |
This plan year Core Pipe will be offering an Opt-Out Credit for any full-time employee that wishes to waive their medical coverage. For anyone currently not enrolled in our medical plan you will receive a $500 per month credit. (Please note this is taxable income). For anyone that is currently on the plan but wants to waive coverage you will receive $500 per month for employees only coverage or $1,000 for employee and spouse, employee and children, or family coverage.
You must show proof that you have other coverage to receive the incentive payment.
Some things to consider before waiving coverage:
If you are Medicare eligible (over the age of 65) you can enroll in Medicare at any time as long as you have creditable health and prescription coverage (Core Pipe’s plan is creditable).
