Magnolia Open Access
Administered by Blue Cross Blue Shield of Louisiana and CVS Caremark
The Office of Group Benefits (OGB) offers multiple health plans, including the Magnolia Open Access Plan. The claims administrator is Blue Cross and Blue Shield of Louisiana, while the pharmacy benefit manager is CVS Caremark. The Magnolia Open Access offers moderate deductibles and coinsurance in exchange for a higher premium. It differs from the other Magnolia plans in that members enrolled in the Open Access plan will not pay copayments at physician visits. Instead, once a member’s deductible for allowable charges is met, he or she will pay 10% of the allowable amount for in-network care and 30% of the allowable amount for out-of-network care. Out-of-network care may be balance billed. Coverage is provided within the Blue Cross nationwide network, as well as out-of-network.
Contact Information
Medical Coverage
| Medical Coverage | Employee Only | Employee +1 (Spouse or Child) | Employee + Children | Family |
|---|---|---|---|---|
| Deductible (in-network) | $900 | $1,800 | $2,700 | $2,700 |
| Deductible (out-of-network) | $900 | $1,800 | $2,700 | $2,700 |
| Out-of-pocket max (in-network) | $3,500 | $6,000 | $8,500 | $8,500 |
| Out-of-pocket max (out-of-network) | $4,700 | $8,500 | $12,250 | $12,250 |
| Coinsurance (in-network) | 10% | 10% | 10% | 10% |
| Coinsurance (out-of-network) | 30%* | 30%* | 30%* | 30%* |
*Once a member's deductible for allowable charges is met, he or she will pay 30% of the allowable charge, plus 100% of the difference between the allowable charge and billed amount for out-of-network care.
Prescription Coverage
OGB uses the CVS Caremark formulary to help members select the most appropriate, lowest-cost options. Members will continue to pay a portion of the cost of their prescriptions in the form of a co-pay or coinsurance. The amount members pay toward their prescription depends on the tier of medication -generic, preferred brand, non-preferred brand, or specialty drug.
| Tier | Member Responsibility | Once You Pay $1,500 |
|---|---|---|
| Generic | 50% up to $30 | $0 co-pay |
| Preferred | 50% up to $55 | $20 co-pay |
| Non-Preferred | 65% up to $80 | $40 co-pay |
| Specialty | 50% up to $80 | $40 co-pay |
Access2day Health
Access2day Health is a clinic membership program and added benefit offered by OGB and the State of Louisiana, providing quality primary and urgent care services for $0 co-pay and out-of-pocket expense, with no appointment necessary!
OGB plan members, including covered spouses and dependents, enrolled in Pelican HRA 1000, Magnolia Local, Magnolia Local Plus, and Magnolia Open Access have access to Access2day Health clinic locations at no cost and are automatically enrolled. For more information, including a list of clinics, please visit the Access2day Health website.