Frequently Asked Questions

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Our medical plan is administered by BlueCross BlueShield.  We are part of the BlueSelect Plus Network.  The difference between the High Deductible and the Traditional plan is the deductibles.  The High Deductible plan’s deductible is $2750 and the Traditional plan is $1000.  

If you chose a BlueSelect provider (In-Network tier), you will pay the first $1000 (Traditional)/ $2750 (High Deductible) per person or $2500 (Traditional)/ $5500 (High Deductible) for a family.  Once your deductible is met, you will pay 20% of the cost.  

Should you chose a provider outside the BlueSelect network (Out of Network tier), you will pay 75% of the cost.

NKCH has an additional benefit, the Domestic tier.  Since we’re in the healthcare business, were able to provide discounts to our employees and their covered family members.   If you choose the Traditional plan and use the hospital and i’s services, you have a $0.00 deductible.  All the services are co-pay based.  The High Deductible plan does have a $500.00 deductible, then the hospital services are co-pay based.  

Meritas Health is a subsidiary of NKCH and is comprised of a group of physicians, imaging centers, sleep labs and outpatient physical therapy.  If you use the Meritas physicians, Fremont Imaging, Medical Imaging, Green Hills Sleep Center, or the North Oak Medical Park PT, the same co-pay based benefit applies to these services and to the Centrus network of primary, pediatrician and OB/GYN physicians.  

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Our dental provider is MetLife.  We are part of the PDP Plus Network.  The difference between the 2 plans is the amount of coverage.  In the Limited plan, you have an additional $1000 to spend annually, but in the Basic plan you have $1250 annually.  

The other difference is the percentage of coverage.  With the Basic plan, you bi-annual cleanings, e-ray and dental exam are free, however in the Limited plan, these services are 90% covered.  Other services have a difference in coverage.

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The vision plan is administered by MetLife.  The plan gives the participant an annual eye exam and you can choose either a pair of glasses or contacts.  The glasses coverage is $150 towards the frames and the lens are free, until you add to the basic prescription.  If you choose contacts instead of glasses, there is a one-time fitting fee, but the contacts are provided free.

Flexible dependent spending programs are regulated by the IRS.  This program gives you a way to pay for your daycare or day camp expenses tax free for your dependents 13 years or younger.  You choose a dollar amount between $1-$5000.  We will divide the amount by the number of pay periods in your benefit year.  This amount will be deducted before taxes are calculated.  You can use the tax free deduction to reimburse yourself for your daycare and day camp expenses during the same tax year.


Caution:  This program requires that the tax free deduction must be spent in the year it was deducted.  If you have a balance left at the end of the year, it is forfeited and will not be returned or rolled to the next tax year.

Flexible medical spending programs are regulated by the IRS.  This program gives you a way to pay for your medical, pharmacy, dental, vision and other related expenses tax free for you and your dependents.  You choose a dollar amount between $1-$2700.  We will divide the amount by the number of pay periods in your benefit year.  This amount will be deducted before taxes are calculated.  You will receive a debit card loaded with your total annual deduction.  You can use the debit card to pay for IRS approved expenses during the same tax year.


Caution:  This program requires that the tax free deduction must be spent in the year it was deducted.  If you have a balance left at the end of the year, it is forfeited and will not be returned or rolled to the next tax year.

Coinsurance- Your share of the costs of a healthcare service, usually figured as a percentage of the amount charged for services. You start paying coinsurance after you’ve paid your plan’s deductible. Your plan pays a certain percentage of the total bill, and you pay the remaining percentage.


Copay- A fixed amount you pay for a specific medical service (typically an office visit) at the time you receive the service. The copay can vary depending on the type of service. Copays cannot be included as part of your annual deductible, but they do count toward your out-of-pocket maximum.


Deductible- The amount you pay for healthcare services before your health insurance begins to pay. For example, if your plan’s deductible is $1,000, you’ll pay 100 percent of eligible healthcare expenses until the bills total $1,000 for the year. After that, you share the cost with your plan by paying coinsurance.


In-Network- A group of doctors, clinics, hospitals and other healthcare providers that have an agreement with your medical plan provider. You’ll pay less when you use in-network providers.


Out-Of-Network- Care received from a doctor, hospital or other provider that is not part of the medical plan agreement. You’ll pay more when you use out-of-network providers.


Out-Of-Pocket Maximum- This is the most you must pay for covered services in a plan year. After you spend this amount on deductibles, copayments and coinsurance, your health plan pays 100 percent of the costs of covered benefits, excluding your copay amount. However, you must pay for certain out-of-network charges above reasonable and customary amounts.