Welcome

Eligibility

As a fulltime employee regularly working 30 or more hours per week, you and your qualified dependents are eligible to enroll in our group benefit plans. You are eligible to participate in the North Texas Preferred Health Partners benefits program on the first day of the month that follows your date of hire. It is your responsibility to enroll in and manage your benefits program. An employee’s spouse and children who are under the age of 26 are eligible for coverage. 

Enrollment Forms

2024 Benefits Guide

Benefit Election NoticeOnline Enrollment Notice | Enrollment Login | Employee Acknowledgement of Receipt of SPD

Informational Notices

Wrap Summary Plan Description | Wrap Plan Document | Premium Conversion Plan

Contribution

NTPHP contributes towards the employee-only medical, and 100% towards the employee only dental and vision plan costs. The employee is responsible for for any difference in the employee cost and 100% of dependent costs. NTPHP provides basic life, long term disability, and short term disability insurance.  The employee may purchase supplemental life insurance for themselves and their eligible dependents. Employees electing the HDHP must open an account with Optum Bank in order to receive the employer HSA contribution, they may also contribute additional funds to their Health Savings Account through payroll deductions. The combined employer and employee HSA contributions may not exceed the IRS annual contribution limits.

Employee Portion

The employee portion of the costs is included below for policy period January 1, 2024 to December 31, 2024. 

Semi-Monthly Cost Medical Dental Vision
PPO Plan $2500 PPO HSA $4000 PPO HSA $6000 HMO Plan $1500 HMO HSA $4000 HMO HSA $6000
Employee Only $5.68 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Employee & Spouse $371.47 $322.07 $269.94 $247.09 $232.96 $195.21 $19.84 $2.91
Employee & Child(ren) $370.73 $321.43 $269.40 $246.47 232.49 $194.82 $31.97 $3.23
Employee & Family $736.51 $643.50 $539.34 $550.27 $465.44 $390.03 $58.82 $6.28

Employees electing the HDHP PPO HSA plan $4000 will receive, from their employer, a contribution to their HSA account of $75.00 per month, $180.00 per month for the HDHP PPO HSA plan $6000, $250.00 per month for the HDHP HMO HSA plan $4000, and $330.00 per month for the HDHP HMO HSA plan $6000.

Enrollment

You must enroll prior to the effective date, and you are responsible to enroll and manage your benefit selections. 

Details of each plan are contained in various insurance contracts and other legal documents. In the event of a conflict between information contained here and the contracts and plan documents, the contracts and plan documents prevail.

Medical

Medical Benefit Plan Description

North Texas Preferred Health Partners offers medical coverage with BlueCross BlueShield and offers multiple plan options.  To review the plans please click the links below. Employees electing an HDHP/HSA plan must complete the HSA enrollment forms in order to receive employer contributions to their HSA account.

BCBS Medical Benefit Summary
PPO $2500 | PPO HSA $4000 | PPO HSA $6000 | HMO $1500 | HMO HSA $4000 | HMO HSA $6000

BCBS Medical Certificate of Coverage
PPO $2500 | HSA $4000 | HSA $6000 | HMO $1500 | HMO HSA $4000 | HMO HSA $6000

Group Number: 333817 Please have your Group Number & Identification Number available when contacting the insurance carrier.

Sign Up for Blue Access for MembersSM (BAM)

Blue Access for Members Virtual Tour | Go Mobile with the BCBSTX App

apple_app_store_icongoogle_play_icon

Use the mobile app to access provider finder, get your ID card, view benefits and claims.

Claims & Customer Service: 1.800.521.2227 | Making Your Insurance Work For You | Provider Network | PPO & HMO Provider Finder Instructions | Sanitas Medical Centers

Wellness Services | Wellness Site | Blue Points Reward Program | Member Rewards | Fitness Program | Behavioral Health | Blue365

BCBS Claims Online | BCBS Rx Claims | Preferred Pharmacy Network | Express Scripts Mail Order PharmacyRx Formulary | Downloadable Forms

MD Live

Blue Cross Blue Shield PPO FAQs

Refer to your Combined Evidence of Coverage and Disclosure Form or Plan Agreement for a more detailed listing of benefits and coverage, including exclusions, limitations and conditions applicable.

I misplaced my ID card, how can I request another?
You may request a duplicate ID card online by clicking here, or access ID from mobile app.
I recently moved, how can I change my address?
Submit a request to change your address in writing, or contact the Customer Service Department.
How can I add a newborn to my contract?
You must submit a request to add a newborn to your contract in writing. BlueCross BlueShield of Texas must receive this form within 31 days from the date of birth. *Your employer must be notified of any change to your coverage before sending this application to BlueCross BlueShield.
How long can my children remain on my contract?
An existing dependent child may remain on the plan until their 26th birthday.
Where can I get a list of physicians or hospitals that participate in the BlueCross BlueShield of Texas Network?
This information is available in the Provider Search or you can contact the Customer Service Department to request a provider directory, or use the mobile app.
How can I get referred to a specialist?
For BlueCross BlueShield (PPO) Members: If you select a specialist that participates in the BlueCross BlueShield Network, a referral is not required. If you select a specialist that does not participate in the BlueCross BlueShield Network, your personal financial costs will be considerably higher than when you use participating providers. You will have to pay any part of a provider's bill which is over what BCBS allows in benefits for non-participating providers.
How can I get a claim form so I can submit my doctor's bill to BlueCross BlueShield?
Open the Medical Claim Form. Print this form on your printer. Follow the instruction on the form and send it to Blue Cross or contact the Customer Service Department to have a claim form mailed to you, or use the mobile app.
What is the status of my medical claim?
Claim status is available online by clicking here, or use the mobile app.

Dental

Dental Benefit Plan Description

North Texas Preferred Health Partners offers dental coverage through BlueCross BlueShield. Your dentist office will need the social security number of the insured employee to access benefits. To review the plan please click the link below.

Dental Benefit Summary

BCBS Certificate of Coverage

Group Number: 333817 Please have your Group Number & Identification Number available when contacting the insurance carrier. bcbs-tx

 Member Services: 1.800.521.2227 | Provider Finder

 

HSA

HSA Custodian

Health Savings Accounts are savings accounts that allow employees to pay for qualified out-of-pocket medical, dental and vision expenses using pre-tax dollars. The funds in the HSA belong to the employee and the employee can spend their funds as they wish. The funds may be used to pay any eligible expense incurred by the employee and their immediate family members. In order to establish an HSA, the employee must enroll in a qualified High Deductible Health Plan (HDHP). In order for expenses to be eligible for reimbursement from an HSA, the account must be open prior to incurring the expense.

Your employer has elected to use Optum Bank as their HSA custodian for employee deposits. You will need to establish an HSA account in order to receive employer and/or employee contributions. You may have additional HSA accounts and you may elect to transfer funds to other HSA accounts with investment options.

Employees may contribute funds through payroll deductions to their Health Savings Accounts. The IRS provides annual maximum contributions limits which are the annual limits for combined employer and employee contributions.  Key HSA Features

Enrolling in benefits for the first time or becoming eligible for Medicare creates partial-year eligibility HSA contribution questions. HSA Contributions and Partial-Year Eligibility | HSA & Medicare

Investment Options | Income Tax Regulations / Eligible Expenses / Medicare and HSA's

Optum Bank HSA enrollment form is online.

OptumBankLogo

Life

Life Benefit Plan Description

North Texas Preferred Health Partners offers Life coverage through Dearborn National/BCBS. To review the plan please click the link below.

Life/AD&D Benefit Summary
Voluntary Life/AD&D Benefit Summary
Voluntary Life/AD&D Rates
Evidence of Insurability Information

Beneficiary Review Guide

Dearborn National/BCBS Certificate of Coverage
Life/AD&D & Voluntary Life/AD&D

Providing for your family in the event or your death is a fundamental of risk management. And life insurance benefits that replace your income may be one of the best ways to meet your family’s ongoing financial needs. This calculator is designed to help you estimate the amount of life insurance you would need to produce a sufficient income stream for your family.

Group Number: VF027881 Please have your Group Number & Identification Number available when contacting the insurance carrier.

dearbornbcbs-tx

Claims & Customer Service: 1.877.442.4207 Beneficiary Resource Services | Dearborn Cares - Support for Beneficiaries | Travel Resources | Downloadable Forms

If you need additional life insurance for yourself or other family members, or if you simply want to compare individual term life insurance rates, click here for additional insurance quotes and information.

Vision

Vision Benefit Plan Description

North Texas Preferred Health Partners offers vision coverage through Dearborn National/BCBS. Your vision provider will need the social security number of the employee and the group number to access benefits. To review the plan please click the link below.

Vision Benefit Summary

Dearborn National/BCBS Vision Certificate of Coverage

Group Number: VF027881 Please have your Group Number & Identification Number available when contacting the insurance carrier. bcbs-tx

Customer Service: 855.556.8796 | Vision Benefit Information & Resources | Vision Benefit App - Powered by EyeMed

Disability

Disability Benefit Plan Description

North Texas Preferred Health Partners provides Long Term Disability and Short Term Disability coverage through Dearborn National/BCBS. To review the plans please click the links below.

Benefit Summary
Long Term Disability | Short Term Disability

Dearborn National/BCBS Certificate of Coverage
Long Term Disability | Short Term Disability

Chances of Disability Protect Your Most Valuable Asset – Your Paycheck | Real-life Disability Story Videos | Disability Insurance Calculator

Group Number: VF027881 Please have your Group Number & Identification Number available when contacting the insurance carrier. bcbs-tx

Customer Service: 877.442.4207 | Member Flyer | Disability Resource Services | Downloadable Forms

Legal Plan

Affordable, Personal Legal Services

MetLife Legal Plans provides you and your family members with convenient access to legal services at an affordable monthly cost. Many consumers who need a lawyer do not seek legal help, partly because they fear the cost or struggle to find the right attorney. MetLife Legal Plans offers fully covered legal services for $24 per month through payroll deduction. Enroll online during Annual Enrollment or when you are newly hired.

Legal Plan attorneys: https://www.legalplans.com/

MetLife Legal Plan Overview

Compliance

NTPHP 2023-2024 Legal Notice Medicare Part D Notice of Creditable Coverage For Active Employees

Health Insurance Exchange Notice

The following is a compilation of various required federal compliance notices which are to be provided to employees. If you have questions or need a copy of a specific notice, please contact your Human Resources administrator. If any conflicts between the plan documents and the information provided exist, the plan document language is to be relied upon.

The information and notices are provided in the following order:

New Hires / Upon Eligibility for Health Plan  Upon Enrollment in Group Health Plan

*Documents Included in Wrap Summary Plan

Upon Coverage Termination General