Medical & Prescription Plans

In our continuous effort to ensure the well-being of you and your family,

Spreetail will continue to provide medical plans through

BlueCross BlueShield of Nebraska.

BlueCross BlueShield (BCBS) members have access to BCBS’s nationwide network of physicians and hospitals. If you choose the PPO Plan or HDHP you can choose any provider you choose; however, you will spend considerably less money by only seeing in-network providers.

What to consider when choosing a plan
Healthcare Terminology Glossary

Spreetail offers two medical plans – PPO and HDHP (HSA) – provided by Blue Cross Blue Shield of Nebraska (BCBSNE); both have the same great network of providers. RxBenefits and OptumRx are our pharmacy benefit manager, which gives us access to more pharmacies nationally, including CVS! This also means you will receive a separate pharmacy ID card. If you have any questions about your prescription drugs, please reach out to RxBenefits at 800.334.8134 or [email protected] as they are our support team for OptumRx. In addition to offering a HDHP, Spreetail will contribute up to $500/year (*$375 for 9 months) to an employee’s Health Savings Account (HSA) when they enroll in Employee Only coverage and up to $1,000/year (*$750 for 9 months) when enrolling with one or more dependents. *The HSA employer contribution is split up over 12 or 26 pay periods. If you start after January 1st, the employer HSA contribution is pro-rated amongst the remaining pay periods in the year.

  • Bi-weekly: $19.23 for employee only coverage
  • Bi-weekly: $38.46 for dependent tiers
  • Monthly: $41.66 for employee only coverage
  • Monthly: $83.33 for dependent tiers

A HSA will automatically be opened with Navia once you enroll in the HDHP. Please notify HR if you are also enrolled in another medical plan (parents, spouse, Medicare, etc.) as it may limit your eligibility to receive HSA contributions. Please take the time to register at Nebraskablue.com and create your personal account. If logged into your account, when searching for in-network providers the system will know your plan and show you accurate results. If searching as a guest, please select the “NEtwork BLUE” network. Employee's premiums are staying the same for 2026! *Imputed income applies for domestic partner premiums, post-tax.

Group Number
Service Number
106075
844.201.0763

Find an In Network Doctor or Facility

BCBSNE PPO Summary of Benefits & Coverage
RxBenefits PPO Prescription Benefits Coverage
BCBSNE HDHP Summary of Benefits & Coverage
RxBenefits HDHP Prescription Benefits Coverage
BCBSNE Member Resources
RxBenefits Member Services
BCBS of NEBRASKA
MEDICAL
PPO 1500
HDHP 3300
with HSA PLAN
Network
In-Network | Out-of-Network
In-Network | Out-of-Network
Calendar Year Deductible
  • Individual
  • Individual with Family
  • Family
$1,500 | $3,000
$3,000 | $6,000
$3,000 | $3,000
$3,400 | $3,400 $6,000 | $6,000
Out-of-Pocket Maximum
  • Individual
  • Family
$3,000 | $6,000 $6,000 | $12,000
$4,000 | $6,000 $8,000 | $12,000
Preventive Care
No charge | 40%*
No charge | 50%*
Primary Office Visit
$15 copay | 40%*
20%* | 50%*
Specialty Office Visit
$40 copay | 40%*
20%* | 50%*
Telemedicine
$10 copay | Not covered
20%* | Not covered
Chiropractic Care
$20 copay
20%* | 50%*
Acupuncture
$40 copay | 40%*
20%* | 50%*
Lab and X-ray
No charge | 40%*
20%* | 50%*
Hospitalization
20%* | 30%*
20%* | 50%*
Outpatient Facility
20%* | 30%*
20%* | 50%*
Emergency Room
$200 copay + 20%*
(waived if admitted)
20%*
Urgent Care
$60 copay | 40%*
20%* | 50%*
PRESCRIPTION DRUGS
Retail (30-Day Supply)
Tier 1: Generic
$10 copay
20%* | 50%*
Tier 2: Preferred
$30 copay
20%* | 50%*
Tier 3: Non-Preferred
$50 copay
20%* | 50%*

*after deductible has been met

Contributions

EMPLOYEE COST
PPO 1500
MONTHLY
PPO 1500
BI-WEEKLY
HDHP 3000
MONTHLY
HDHP 3000
BI-WEEKLY
Employee Only
$0.00
$0.00
$0.00
$0.00
Employee + Spouse
$274.40
$126.65
$233.16
$107.61
Employee + Children
$196.01
$90.47
$166.54
$76.86
Employee + Family
$496.54
$229.17
$421.89
$194.72

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Disclaimer: This presentation provides a summary of the employee benefit programs offered by Spreetail. Should any discrepancies arise, please refer to the actual plan documents, which supersede this presentation. Once enrolled, you will receive a Combined Evidence of Coverage and Disclosure Form detailing the exclusions, limitations, and the full range of covered services of your plan.