April 14, 2026
Important Updates about Our Medical Plans
We want to share some upcoming changes to the medical plans offered through the Bucks and Montgomery County Schools Health Care Consortium. These updates take effect on July 1 and include changes to existing plans, the discontinuation of a couple of options, and the addition of a new plan.
The goal of these updates is to keep our medical plans stable and affordable over the long term, something the Consortium has done very successfully over the past several years.
Click on the below to view a video of what’s changing and what you can expect as you prepare to make your benefit selections during open enrollment.
QUICK HIGHLIGHTS
- The Open Choice 1 (OC1) plan and the Point‑of‑Service (POS) plan will be sunset on June 30, 2026.
- A new plan, OC4, will be introduced. Please check with your HR office to determine if this plan is being offered to you.
- Only our medical plans are changing.
- While the plans are changing, our plan administrator remains Aetna.
The prescription drug benefit manager will continue to be CVS Caremark. Prescription drug benefits continue to follow the agreements in place between your bargaining unit and your school entity/Board of School Directors. Your HR office or Benefits Coordinator will provide this information as part of open enrollment.
OC2 Plan – Changes
The OC2 plan changes include higher cost sharing for out-of-network deductibles, emergency room visits, and urgent care services, along with a reduced copay for primary care visits and no copay for virtual Teladoc mental health visits.
Please refer to the plan comparison chart for more details.
OC3 Plan – Changes
The OC3 plan updates include higher out‑of‑network deductibles, a lower out‑of‑pocket maximum for family coverage on out‑of‑network services, increased copays for inpatient hospital stays, outpatient surgery, and emergency room visits (which are waived if admitted), along with no copay for virtual Teladoc mental health visits.
Please refer to the plan comparison chart for more details.
OC4 Plan – NEW
This new plan offering features defined in‑network and out‑of‑network deductibles, no coinsurance for in‑network services and higher cost sharing out of network and clearly set out‑of‑pocket maximums for both coverage levels.
Please check with your HR office to determine if this plan is being offered to you.
See the plan comparison chart for more details.
Other Key Changes
- Deductibles Moving to a Plan‑Year Cycle – The deductible period will change from a calendar year to a plan year. Now your deductible will accumulate from July 1 to June 30 of the following year. This change was made to match the way the Consortium plans operate.
- New 4th‑Quarter Deductible Carryover – There is a new 4th-quarter deductible carryover feature. Services incurred from April to June will count toward the next plan year’s deductible.
- Special One – Time Transition for OC3 Members – There will be a one-time transition feature for Members currently enrolled in the OC3 plan. For July 1, 2026, OC3 members will receive deductible credit for the amounts accumulated from January through June 2026.
Your New Benefits Guide!
A new tool called ALEX will be available to help you compare medical plans. By answering a few simple questions, ALEX makes it easier to understand your options and estimate potential costs— so you can choose with confidence.
A link to Alex featuring plan costs for your school entity and bargaining unit will be sent to you from your HR department.
For additional information, visit https://bmshc.org/updates/
Have You Experienced the Power of Our Wellness Programs? Your Story Can Inspire Others!
Wellness programs can make a real difference—and we want to hear how they’ve helped you. Did Headspace bring you peace of mind? Did Hinge Health help you move without pain? Have you had success with one of the Weight Management Programs such as WeightWatchers or Betr Health?
If you’ve benefited from any of our wellness offerings, we’d love for you to share your experience. Your story could encourage others to take that first step toward better health and well-being.
Email us at [email protected] and let us know how wellness has worked for you!
The Bucks and Montgomery County Schools Health Care Consortium
www.bmshc.org
Benefits Basics is intended for distribution to members enrolled in the Bucks and Montgomery County Schools Health Care Consortium insurance plan. The Summary Plan Description available at the website provides full details of all coverage including exceptions and limitations.