Medical Insurance

 
 
In providing medical coverage to employees and retirees, St. Louis County participates in a program of self insurance. The County contracts with a health insurance company to administer the claims and health care coverage for subscribers. Because the County is self-insured, subscribers are encouraged to be prudent in obtaining health care services. In this way, subscribers may assist the County in its effort to curtail the increasing costs of health care. 

Coverage

St. Louis County offers a comprehensive major medical health plan to its employees and eligible retirees. This plan type features a deductible and an out of pocket maximum expense for participants. Since this plan is an open access plan, there is no need to select a primary care provider or to acquire a referral, however, there is an incentive to use preferred providers (see tiering information posted under NETWORKS). 

Summary of Health Coverage

2020 Summary of Benefit Coverage 
2019 Summary of Benefit Coverage
2018 Summary of Benefit Coverage
2017 Summary of Benefit Coverage
2016 Summary of Benefit Coverage

Complete health insurance booklet/manual

2020 Benefits Booklet 
2019 Benefits Booklet
2018 Plan Summary Description
2017 Plan Summary Description
2016 Plan Summary Description

Plan Prescription drug coverage information:
RxBin:  610455
RxPCN: HMHS
RxNetwork: ST. LOUIS COUNTY
Pharmacy Network:  Classic
Formulary Name: FlexRx

Medicare eligible retirees may enroll in one of two fully-insured Group Senior Gold/Medicare Blue Rx plans offered by Blue Cross/Blue Shield of Minnesota, through St. Louis County.  Compare coverages between the St. Louis County Self Insured plan and the retiree Group Senior Gold/ Medicare BlueRx plan offering.  

Request the link and password to access the recording of the 2021 Medicare Supplemental Information Session Webinar.  Note that this link will not be available prior to Friday 11/20.  You may request it prior but it will not be sent prior to Friday 11/20/2020.  

 

Cost

 
Medicare eligible retirees/retiree spouses only:
 
*Your start date for Medicare part A (see your Medicare card) determines if you pay Pre or Post MACRA rates.  If enrolled in part A prior to 1/1/2020 you pay PreMACRA rates and Senior Gold will pay your Medicare part B deductible.  If enrolled in Medicare part A on 1/1/2020 or later you pay PostMACRA rates and you will pay your own Medicare part B deductible.  
 
 

Forms

No printer?  Electronic Signature Instructions

St. Louis County Self-Insured Plan:
Medical Enrollment/Change Form

Login at www.bluecrossmnonline.com for access to these BlueCross forms:

  • Formulary Exceptions
  • Prescription Drug Reimbursements
  • Medical Claim Reimbursements
 
St. Louis County Group SeniorGold/MedicareBlueRx:

Networks

Find an in-network Pharmacy near you  (choose the CLASSIC network from the drop down list)

In-network providers will get you the most benefits for the least expense and paperwork. 

Tier 1 = Enhanced Value Network = Least Cost
Tier 2 = Standard Value Network = Higher Cost
Out-of-Network = Highest Cost

In-Network providers are providers in the St. Louis County Network

Find In-Network providers when you log in to your BlueCross member portal at www.bluecrossmnonline.com.

 

 

Prescription Drugs

Is my medicine covered by my St. Louis County medical insurance?  Find my Medicine

Are you missing a Medication Therapy Management (MTM) drug discount?   MTM HELP

Plan Prescription drug coverage information:
RxBin:  610455
RxPCN: HMHS
RxNetwork: ST. LOUIS COUNTY
Pharmacy Network:  Classic
Formulary Name: FlexRx

$0 Insulin Copay Initiative