Blue Shield Medical

The Blue Shield HDHP + HSA plan is one of Okta’s best-value medical plans for most employees.

It has two parts: a high deductible, HSA-compatible medical plan and a tax-advantaged health savings account.

This plan may be right for you if:

1. You want a low per-paycheck deduction—even if it means you have to meet a higher deductible.
2. You rarely need to see a doctor; an annual checkup is usually it for the year.
3. You feel comfortable paying for a large health expense that costs almost as much as your deductible.
4. You want the opportunity to accumulate savings and to invest and take part in the plan’s triple tax advantage for future healthcare expenses.
5. You plan to use network providers for your care, but like having the option to go out of the network.

Here’s how it works:

Paycheck costs

• Amounts deducted from your paycheck are lower than other options.
• Employee-only coverage is 100% paid for by Okta.

Health savings account

• In 2024, Okta will maintain its annual HSA contributions for employees: up to $800 for employee-only coverage and up to $1,600 if you cover one or more family members.
• You can contribute your own money to your HSA, too.
• Use your HSA funds to pay for healthcare expenses—including your annual deductible.

Doctors and other healthcare providers

• Go to any provider, but you pay less when you use Blue Shield or BlueCard network providers. (These are doctors, hospitals, therapists, and other healthcare providers who have contracted with Blue Shield to furnish services and supplies for a negotiated charge.)

Cost sharing between you and the plan

• You pay $0 for in-network preventive care and prescription drugs that qualify as preventive care.
• For all other care, you must meet the annual deductible before the plan cost sharing begins.
• The in-network annual deductible is $3,200 for an individual and $6,400 for families.
• Once you hit the annual deductible, the plan pays 100% of eligible in-network medical expenses.

Prescription drugs for Blue Shield medical plan members is available through Express Scripts. You will pay these copays after you satisfy the annual deductible:

See the prescription drug formulary list and preventive health drugs covered at no cost to you. If you need support finding the formulary for you, review this guide. 

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With the PPO plan, you may go to any provider, but you pay less when you use Blue Shield or BlueCard network providers.

This plan may be right for you if:

1. You and your family are frequent users of medical care and prescriptions.
2. You want a lower cost when you receive care—even if it means you pay more per paycheck.
3. You mostly use network providers, but you would like to have access to out-of-network providers in certain circumstances. 

Here’s how it works:

Paycheck costs

• The PPO plan has a higher monthly paycheck contribution because it offers the most choice of providers with a lower deductible.

Doctors and other healthcare providers

• Go to any provider, but you pay less when you use Blue Shield or BlueCard network providers.

Cost sharing between you and the plan

• You pay $0 for eligible preventive care and prescription drugs that qualify as preventive care.
• For all other care, you must meet the annual deductible before the plan pays benefits.
• In-network annual deductible:
  • $500 for an individual and $1,500 for families 
• Out-of-network deductible:
  • $1,500 for an individual and $4,500 for families
• Once you reach the annual deductible, you pay copays for some eligible in-network services and coinsurance for others.

In-network copays for frequently used services

• $150 for emergency room visits (waived if you’re admitted to the hospital from the emergency room)
• 10% coinsurance for inpatient hospital stays

Prescription drugs for Blue Shield medical plan members is available through Express Scripts. You will pay these copays after you satisfy the annual deductible:

See the prescription drug formulary list and preventive health drugs covered at no cost to you. If you need support finding the formulary for you, review this guide. 

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With the EPO plan, you must use in-network providers – if you go out-of-network, the plan will not cover your services. The EPO plan uses the same network of providers as our current Blue Shield/BlueCard plans, which gives you access to a wide range of providers throughout the U.S.

This plan may be right for you if:

1. You only use providers in the Blue Shield/BlueCard network.
2. You prefer to pay a fixed cost at the time you need care.
3. You’re not required to meet a deductible.

Here’s how it works:

Paycheck costs

• This plan has a higher monthly paycheck cost because you pay less when you use healthcare services.

Doctors and other healthcare providers

• You must use Blue Shield or BlueCard network providers.

Cost sharing between you and the plan

• You pay $0 for eligible preventive care and prescription drugs that qualify as preventive care.
• There is no deductible.
• You pay copays for eligible in-network services.
• There is no coverage for services received from out-of-network providers.

In-network copays/coinsurance for frequently used services

• Primary care office visit $15/visit
• Specialist care office visit $30/visit
• $100 for emergency room visits (waived if you’re admitted to the hospital from the emergency room)
• $250 copay per admission for inpatient hospital stays

Prescription drugs for Blue Shield medical plan members is available through Express Scripts. You will pay these copays after you satisfy the annual deductible:

See the prescription drug formulary list and preventive health drugs covered at no cost to you. If you need support finding the formulary for you, review this guide. 

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Need to confirm your current doctor’s affiliation with Blue Shield? Find a network specialist or hospital? An urgent care center? Chances are your current providers are in the Blue Shield network.

• California employees have access to Blue Shield’s “Full PPO and Full PPO Savings” network.
• Outside of California, employees use providers in the BlueCard network, which links local Blue plans across the United States and abroad.

Get help in finding a provider or confirming that your provider—including your regular doctor, specialists, hospital, mental health and alternative medicine providers and local urgent care center—is part of the Blue Shield network:

• Visit the Blue Shield website (created especially for Okta employees) to connect with a virtual assistant that can help you.
• Choose Find a Doctor and a chat box will appear. Your virtual assistant will ask for your ZIP code and address. Answer any additional questions and your virtual assistant will provide you with a list of providers based on your answers.

To find a provider:

• Go to BlueCard’s website.
• Make your selection based on the type of doctor or facility you're looking for. 
• Log in or continue as a guest. Enter your Zip code.
• Follow the prompts based on your location.
• When you are asked to find your plan by prefix, enter OTX.

For more information, follow the steps outlined in this guide. If you’re located outside of California, follow these steps outlined in this guide. You can also call Blue Shield at 855-599-2650 for more support.

Using the mobile app? View the mobile app flyer to get started.

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Okta’s Blue Shield medical plans offer a variety of ways for you to get the healthcare you need, when you need it. Here’s an overview of healthcare options you can receive in person or virtually.

In person care

For non-emergency illnesses and injuries, Blue Shield members have the option to use in-network urgent care centers. Urgent care is typically faster and costs less than an emergency room visit. Urgent care centers for non-emergency care can treat things like sore throats and coughs, allergies, rashes, sprains and cold and sinus infections. Learn more about choosing an urgent care center through Blue Shield.

Virtual visits

Blue Shield offers virtual visits—also known as telemedicine—so you can use your phone, tablet, or computer to immediately connect with a medical professional.

• With Teladoc Health, you have 24/7 access to board-certified doctors, available by video and phone at 800-835-2362. Learn more about Teladoc or go to the Teladoc Health website for more information.
• With NurseHelp, you can talk to a registered nurse, 24/7, by calling 877-304-0504. You can also go to the NurseHelp website for more information.

Not sure if you should have a virtual or in person visit? Check out this resource, which explains the differences between in person care and virtual visits.

View your options for care

Traveling out of state

For urgent and emergency care while traveling out of state, Blue Shield HDHP + HSA plan, EPO plan and PPO plan members have access to the BlueCard Program which gives you and your family access to covered services when you’re away from home. With over 90% of providers in the United States in BlueCard’s national network, and providers in 170 countries in the Blue Shield Global Core Network, you have access to care wherever you go.

View the information below on how to find locations, and coverage details, including how to submit an international claim:

• Easy access to coverage - nearly everywhere
• International claim form 

If you're enrolled in a Blue Shield medical plan, Express Scripts is your pharmacy benefits manager. If you have any questions about your prescription benefits program, contact Express Scripts by visiting their website, or calling member services at 866-229-5416. You can also contact the pharmacist help desk at 800-922-1557.

Additional resources

Visit Okta’s dedicated Express Scripts website to learn more about your prescription drug coverage through your Okta Blue Shield medical plans or review the below resources. 

• Overview video
• Mobile app registration
• 2024 prescription drug formulary
• Preventive prescription drug list
• Express Scripts frequently asked questions (FAQs)
• Home delivery starter’s guide
• Home delivery brochure
• Accredo specialty medications brochure

Get more details on the wellness program website.

The site includes:

• Discounted gym memberships
• Lifestyle programs
• Virtual consult solutions
• Preventive health guidelines
• Well-being discounts
• Mental health resources including live webinars

If you’re unable to attend a webinar, the recording will be placed online in approximately 2 to 3 weeks. To access previously recorded webinars at no additional cost:

• Go to lifereferrals.com and use code "BSC".
• Select the Member Services tab followed by On Demand Learning. Here, you'll see a library of recordings.

For more information, review the total health and wellness brochure.

Effective January 1, 2025, you can access Blue Shield’s Wellvolution platform. This platform gives you access to 60+ lifestyle-based tools with support designed to help you lose weight, treat diabetes, nurture your mental health, and more. You’ll get personalized plans, on-demand tools, and health coaches to assist you in reaching your goals.

Visit Blue Shield’s Wellvolution platform to get started. You’ll be prompted to create a Wellvolution account if you don’t have one already. If you have questions, call 866-671-9644 or review the resources below. 

• Wellvolution program flyer
• Wellvolution mobile app 

Get digital and virtual support for your pregnancy and postpartum needs. Maven is a program designed to support you and your partner during pregnancy, postpartum, and returning to work. You can also get support if you have experienced a pregnancy loss. Learn more about Maven maternity care.

Please refer to the following resources for support with your Blue Shield medical plan:

• Preventive care guide
• How to register for your ID card

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You may see or hear the term "ASO" when reviewing your benefits in your Blue Shield member portal or when speaking to a Blue Shield representative. Administrative Services Only (ASO) is related to Okta's contractual set up with Blue Shield on the backend. This does not impact your plan enrollment or eligibility for Okta benefits. The best way to verify your Okta plan enrollment is by reviewing your benefit elections in Workday. You can also view detailed plan coverage summaries and benefit documents on the Documents and Forms page.