Health Insurance

Carolina Caring currently offers two health insurance options for full-time and part-time benefit eligible staff members.  Employees are eligible 30 days from start date for either plan.  Carolina Caring pays a portion of the dependent costs. 

Option 1: Reference Based Pricing (RBP)

The RBP model uses the Prime Network as a physician’s network, but a network is not needed for any provider with this plan. If you elect this plan, your portion of the premiums is $52.29 every two weeks (per pay period) for employee-only coverage.  This rate is the discounted amount for staff who meet wellness requirements. 

For in-network, non-preventive services, all services apply to the employee deductible of $1500 or $3000 employee + dependent deductible. 

Maximum out of pocket for the employee including deductible is $1500 for employee coverage and $3,000 for employee + dependent coverage.

Once the out of pocket is met, benefits and services are paid at 100% by the plan for the remainder of the year.  

The plan has unlimited lifetime benefits. 

Employees that elect this plan will receive $1000 employer contribution to their Health Savings Account (HSA).

Option 2: PPO Plan

This plan is within the Cigna Network and EMBS acts as the Third Party Administrator (TPA). If you elect this plan, your portion of the premiums is $87.15 every two weeks (per pay period) for employee-only coverage. This rate is the discounted amount for staff who meet wellness requirements.

For in-network, non-preventive services, all services apply to the employee deductible of $1750 or $3250 employee + dependent deductible. 

Once the in-network deductible is met, $1000 co-insurance will apply. The company will pay 80% and employee will pay 20% out of pocket until $1,000 has been reached.

Maximum out of pocket for the employee including deductible is $2,750 for employee coverage and $4,250 for employee + dependent coverage.

Once the out of pocket is met, benefits and services are paid at 100% by the plan for the remainder of the year.  

The plan has unlimited lifetime benefits. 

Note: The above information is a summary only and anytime there is a difference between this information and plan documents, Carolina Caring will adhere to the plan documents.

In accordance with federal Transparency in Coverage rules, health plan pricing is made available at https://caa.ebms.com/Carolina%20Caring,%20Inc./index.html.