Medical Coverage

Medical Coverage

Here at Wilbur-Ellis, we are proud to offer you three medical plan choices, through Blue Shield of California (BSCA), designed to give you and your family the freedom to get care that best meets your needs at an affordable price.

HSA Yellow

The Health Savings Account Yellow PPO offers health coverage with the ability to choose to visit in-network or out-of-network providers. Because this is an HSA-eligible plan, you may be eligible to enroll in an HSA which allows you to pay for certain medical expenses with tax-free money. However, this plan requires you to satisfy a higher deductible before the carrier will begin paying toward your medical services. Find an in-network provider at the Blue Shield website or on the Blue Shield of California mobile app.

HSA Black

The Health Savings Account Black PPO plan also offers health coverage with the ability to choose to visit in-network or out-of-network providers. Because this is an HSA-eligible plan, you may be eligible to enroll in an HSA which allows you to pay for certain medical expenses with tax-free money. This plan requires you to satisfy a higher deductible than the HSA Yellow before the carrier will begin paying toward your medical services, however it has the cheapest monthly premiums to make up for it. Find an in-network provider at the Blue Shield website or on the Blue Shield of California mobile app.

Traditional Preferred Provider Organization (PPO)

The Traditional Preferred Provider Organization (PPO) plan offers the flexibility to choose an in-network or out-of-network provider each time you need care, with a lower deductible than the HSA-eligible plan. You will save more money when you visit in-network providers. Find an in-network provider at the Blue Shield website or on the Blue Shield of California mobile app.

2026 Medical Plan Comparison

Plan Features HSA Yellow HSA Black PPO
In-Network In-Network In-Network
Annual Deductible Individual/Family $2,000 / $4,000*
(non-embedded)
$4,000 / $8,000
(embedded)
$750 / $1,500
(embedded)
Annual Out-of-Pocket Maximum
Individual/Family
$5,000 / $10,000 $5,000 / $10,000 $3,500 / $7,000
Wilbur-Ellis Annual HSA Contribution
Individual/Family
$1,000 / $2,000** $400 / $800** N/A
  You pay (after deductible): You pay (after deductible): You pay (after deductible):
Preventive Care Covered in full*** Covered in full*** Covered in full***
Primary Care 20% 20% $25***
Specialist 20% 20% $40***
Urgent Care 20% 20% $25***
Emergency Room 20% 20% $200 copay, plus 20%
Inpatient/Outpatient Hospital 20% 20% 20%
Outpatient Mental Health 20% 20% $25***

*The HSA Yellow plan uses non-embedded deductibles. The plan begins to pay 100% of the covered benefit after the full family annual out-of-pocket amounts are reached through any one or combination of family members meeting the deductible. The out-of-pocket maximum applies to the entire family’s expenses, not an individual’s.
**Employer contributions are funded quarterly. You must be enrolled on or prior to the first day of the quarter to receive that quarter’s contribution. Please note: For 2026, your HSA funding is tied to your health. Complete a Health Risk Assessment with BSCA by May 31, 2026, and confirm your tobacco-free status (or enroll in a tobacco cessation program) during Open Enrollment to continue receiving the same quarterly contributions as in 2025.
***Deductible waived.

2026 Prescription Drug Coverage Comparison

Plan Features HSA Yellow HSA Black PPO
In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network
You pay (after deductible): You pay (after deductible): You pay (deductible waived):
Retail (Up to a 30-day supply)
Tier 1 $10 $10 plus 25% $10 $10 plus 25% $10 $10 plus 25%
Tier 2 $40 $40 plus 25% $40 $40 plus 25% $40 $40 plus 25%
Tier 3 $80 $80 plus 25% $80 $80 plus 25% $80 $80 plus 25%
Tier 4 20% up to $200 20% up to $200 plus 25% 20% up to $200 20% up to $200 plus 25% 20% up to $200 20% up to $200 plus 25%
Mail Order (Up to a 90-day supply)
Tier 1 $20 Not covered $20 Not covered $20 Not covered
Tier 2 $80 $80 $80
Tier 3 $160 $160 $160
Tier 4 20% up to $400 20% up to $400 20% up to $400

FREE In-Network Preventive Care

Annual checkups help you stay healthy, which is why both of our BSCA medical plans provide you and your family FREE in-network preventive care benefits each year! Preventive care visits allow you to take action early and keep treatable health issues from becoming chronic conditions.

Call your doctor and dentist to schedule your FREE annual checkup today. Need to find a doctor? Go to the Blue Shield website or download the Blue Shield of California mobile app.

Shield Concierge Services

Insurance coverage can be overwhelming at times. BSCA provides Concierge Services that can help you navigate the healthcare system when you need it most. Find doctors, get cost estimates, or solve billing problems with help.

Benefits of Concierge Services:

  • Receive health counseling, education, and support in accessing care.   
  • Find the best doctor, dentist, or eye care professional in your area to meet your healthcare needs.   
  • Save money on medical care with price comparisons before receiving care.   
  • Pay less for prescriptions by exploring lower cost options.   
  • Get help reviewing your medical bills to make sure you’re not being overcharged.   
  • And more!

Reach out to speak to a Shield Concierge at 888-279-8012 from 5:00am to 7:00pm PCT, Monday – Friday.