Southern Piedmont Piping & Fabrication · Medical renewal
Your BCBS renewal vs. CoAdvantage
Blue Cross is renewing at +23.8%. CoAdvantage's Aetna plan keeps the same $1,500 deductible, cuts coinsurance from 30% to 10%, and costs less, even after its admin fee.
Prepared for Kristina Horton by Beverly Griffin and Caleb Sherrill, Contemporary Benefits Advisors
Saved in the first year, all in
$13,256
Option A, after CoAdvantage's admin fee for 8 employees
BCBS renewal
$118,076
CoAdvantage, all in
$104,820
Blue Cross renewal+23.8%On 12/1/2026, about $22,700 more a year
On the plan6 enrolled4 employee only, 1 employee + children, 1 family
CoAdvantage ratesLocked to 9/30/27Then they renew every October 1
Where you are today
Blue Cross wants about $22,700 more next year
Blue Options Gold 1500, medical premium per year
This year$95,400 about
Renewal, 12/1/2026$118,076 $9,839.68 a month
+$22,700
+23.8% for the same plan and the same people.
Plan
BCBS NC Blue Options Gold (Copay) 1500. A PPO with a $1,500 deductible and 30% coinsurance.
Enrolled
6 on the plan: 4 employee only, 1 employee + children, 1 family. 8 on payroll.
Rating
Priced by each person's age. Employee-only rates run $724 to $1,836 a month.
If nothing changes
The renewal takes effect 12/1. It stays your fallback while you decide.
Southern Piedmont Piping & FabricationSource: Blue Cross NC renewal, 9/5/2026
The quotes
Why we're recommending CoAdvantage
We took your group to five PEOs. CoAdvantage came back lowest, with a plan that's richer than what you have today.
CoAdvantage
Recommended
Medical: Aetna's national network, no referrals needed.
Two plans to pick from: Managed Choice 1500 (closest to today, keeps out-of-network coverage) or EPO 1500 ($0 lab work, in-network only).
Rates: locked through 9/30/2027, then renew every October 1.
Admin fee: $95 per employee per month, covering payroll, HR support and compliance.
Other quotes
For reference
VensureHR: Aetna, same plan design as today. Costs more than CoAdvantage once fees are in, and its rates reset 7/1/2027.
Prestige: UHC with a $2,000 deductible. Leaner plan, higher premium, no admin fee provided.
LBMC: BCBS of Tennessee. Costs more than renewing once its $1,200 monthly minimum fee is added.
TriNet: your group is under their minimum size.
Side by side · Medical
Each CoAdvantage plan next to the renewal
Both plans are Aetna, same $1,500 deductible as today. Option A is the closest match and keeps out-of-network coverage. Option B costs a little less and has $0 lab work, but covers in-network care only.
Option A · RecommendedAetna Managed Choice1500 / 10% · Open Access POS
Option B · $0 labsAetna EPO1500 / 0% · in-network only
Deductible (single / family)
$1,500 / $3,000
$1,500 / $3,000
$1,500 / $3,000
Coinsurance
30%
10%
0%
Out-of-pocket max (single / family)
$5,750 / $11,500
$5,500 / $11,000
$5,000 / $10,000
Primary care / specialist
$35 / $70 copayFirst 3 visits to your chosen PCP are free
$25 / $50 copay
$30 / $60 copay
Urgent care / ER
$70 / $500
$85 / $500
$85 / $500
Lab work and bloodwork
30% after deductible
10% after deductible
$0, no deductible
X-rays, MRI and CT
30% after deductible
10% after deductible
0% after deductible
Hospital stay
30% after deductible
10% after deductible
$300 a day, $1,500 max, after deductible
Prescriptions
$4 / $15 / $35 / $50
$10 / $45 / $70
$10 / $45 / $70
Specialty drugs, per fill
25%, $50 min, $100 max
Preferred 30%, $300 maxNon-preferred 50%, $500 max
Preferred 30%, $300 maxNon-preferred 50%, $500 max
Out-of-network
Covered, higher cost
Covered: $3,000 deductible, then 50%
Not coveredEmergencies are always covered
Monthly premium by coverage level
Employee only4 on the plan
$1,202 avgAge-rated: $724 to $1,836 a person
$876.00
$874.00
Employee + spouseNone on the plan today
Age-rated
$2,016.00
$2,010.00
Employee + child(ren)1 on the plan
$1,936.73
$1,754.00
$1,747.00
Family1 on the plan
$3,094.48
$2,717.00
$2,709.00
Total annual premium
$118,076
$95,700$22,376 less (19.0%)
$95,424$22,652 less (19.2%)
Admin fee $95 × 8 employees × 12
None
$9,120
$9,120
All in, per year
$118,076
$104,820$13,256 less vs. renewal
$104,544$13,532 less vs. renewal
Swipe the table sideways to see both options →
$25 better for employees than today$85 employees pay more than todayplain = same as today
A
We recommend Option A. It's the closest match to today, keeps out-of-network coverage, and is richer on almost every line: 10% coinsurance instead of 30%, cheaper office visits and a lower out-of-pocket max. Option B is worth a look if first-dollar lab work matters more than out-of-network coverage. The trade-offs on both: higher prescription copays, $85 urgent care, and a move from Blue Cross to Aetna's network.
The cost of change
What Southern Piedmont would pay in a year, all in
Medical premium plus the PEO's admin fee, compared with renewing Blue Cross. The fee is charged on everyone on payroll, and it covers payroll, HR support and compliance, so anything you pay for those today comes off the other side.
Swipe the table sideways to see every option →
How the savings add up
Step by step, from what Southern Piedmont pays today to CoAdvantage, all in.
Workers' comp and unemployment tax aren't in any total yet; CoAdvantage is pricing workers' comp. VensureHR also charges $998 and LBMC $1,200 one time at setup.
Contribution strategy
Who saves what: the company or the employees
Pick a plan, then set how much of the premium Southern Piedmont pays. Everything is compared with renewing Blue Cross at the same split, so you can see where the savings land and what each person pays per paycheck.
Plan
0%25%50%75%100%
0%25%50%75%100%
Paychecks
Total savings vs. renewing, per year
$0
Company saves$0
Employees save$0
Employee only, per paycheckBlue Cross today
$0
Employee + children, per paycheckBlue Cross today
$0
Family, per paycheckBlue Cross today
$0
Company's yearly cost, medical plus feeBlue Cross today
$0
Starts at an example split; set it to match what Southern Piedmont pays today. Blue Cross prices each person by age, so its employee-only figure is the average of the 4 on the plan. The company column includes CoAdvantage's admin fee and the payroll and HR cost you entered above.
Your questions
What we found out from CoAdvantage's benefits team
1Specialty medications
"Will Aetna approve it? How are they with other high-end medications?"
Your medication is on Aetna's formulary as a covered specialty drug, on the non-preferred specialty tier.
Prior approval is required, as it was with Blue Cross. Have the details from your current plan handy; Aetna will often accept the approval your doctor already filed.
Quantity limit: 2 pens every 28 days.
Cost per fill: 50%, up to $500. Today on Blue Cross it's 25%, up to $100.
Pharmacy: CVS owns Aetna, so CVS Specialty is in network and is Aetna's main specialty pharmacy. Aetna also uses Aetna Specialty Pharmacy and Caremark Specialty for certain drugs.
Privacy rules mean the patient has to call: Pre-Enrollment 1-800-445-0128, Group 727530, Control 159468, 8 am to 6 pm ET.
To check any other drug: aetna.com, Find a drug, plan year 2026, "Advanced Control Plan - Aetna." Or send us the names and we'll look them up.
Confirming: is Panther Pharmacy in network, and do specialty fills count toward the out-of-pocket max?
2Doctors in Hartsville and York, SC
"We have several guys that live in Hartsville and York. Will they have good coverage?"
Both options use Aetna's national network, so coverage goes with people when they travel too.
CoAdvantage pulled in-network primary care doctors and hospitals within 25 miles of Hartsville and of York. The lists didn't come through last time; we're resending all four.
Anyone can check their own doctor at aetna.com/docfind using the network name "Managed Choice POS (Open Access)."
CoAdvantage can run lists for urgent care, specialists or any other town.
Confirming Option B's EPO uses the same doctors
3Testing and bloodwork
"BCBS only pays a percentage until the deductible is met."
Plan
Labs, x-rays and imaging
Blue Cross today
Deductible first, then you pay 30%
Option A
Deductible first, then you pay 10%
Option B
$0 labs from the first visit. X-rays and imaging $0 after the deductible.
Answered
4Is this really a better plan?
"Price comparison aside, do you genuinely think this is a better plan?"
Yes, for most people. Same deductible, 10% coinsurance instead of 30%, a lower out-of-pocket max, cheaper office visits, and rates locked through 9/30/2027.
Costs more: everyday prescriptions ($10 / $45 / $70), specialty drugs, and urgent care ($85). The 3 free PCP visits go away.
Changes: the network moves from Blue Cross to Aetna, so everyone should check their doctors.
Answered
Aetna numbers, for CoAdvantage's plan
CoAdvantage plan name NAT MC 1500/10% · Aetna plan name OA MC 1500/90% · Network: Managed Choice POS (Open Access). CoAdvantage's benefits specialist will also get on a call with your team if you move forward.
Pre-enrollment and customer service1-800-445-0128
Personal Health Advocate1-866-695-8622
CVS Specialty1-800-237-2767
Mail-order drugs1-888-792-3862
24-hour nurse line1-800-556-1555
Teladoc1-855-835-2362
Life, disability, dental and vision
The full picture, every benefit side by side
Today you have Lincoln for company-paid life and disability, Delta Dental that employees pay for, and no vision plan. Here's CoAdvantage's version of each, and what it adds up to.
Medical, Option A, all in$13,256Company · less than renewing
Life and disability$2,417Company · less than Lincoln
Dental, Enhanced plan$1,146Employees · less than Delta est.
Every line together$16,819a year, first year
Vision would be new coverage, not a saving: about $565 to $1,252 a year for the group depending on the plan, usually paid by employees. Dental and vision totals assume the same 6 people and coverage levels as medical; your Delta invoice will confirm who's enrolled.
Dental
Delta Dental is employee-paid today. Guardian's Enhanced plan is the closest match: same coverage levels, a higher annual max, and unused max rolls over. Its orthodontia lifetime max is lower ($1,500 vs. $2,000); Elite matches it.
Guardian also has a Core plan ($22 employee only) with 60% fillings, 40% crowns and no orthodontia. Delta's design is from your 2023 plan summary and its 12/1/2026 renewal (+3.5%).
Vision New coverage
You don't have a vision plan today. Guardian's plans use the VSP Choice network.
In-network
Basic
Plus
Premier
Eye exam, yearly
$10
$10
$10
Lenses, yearly
$20
$10
$10
Frames allowance
$150, every 2 years
$150, yearly
$200, yearly
Contacts instead
$150
$150
$200
Second pair
Discount
Discount
$200 allowance
Employee only, monthly
$5.54
$6.88
$12.29
Family, monthly
$15.50
$19.25
$34.37
Group per year Est.
$565
$701
$1,252
Life and disability Company-paid
Same $15,000 life with the same age reductions, and the same short-term disability. Long-term disability is richer with CoAdvantage.
Per year
Lincoln
CoAdvantage
Difference
Life and AD&D, $15,000
$448
$141
$308 less
Short-term disability60% up to $1,500 a week
$1,939
$1,079
$860 less
Long-term disability60%, 90-day wait. Monthly max $6,000 today, $10,000 with CoAdvantage
$2,673
$1,424
$1,249 less
Total
$5,061
$2,644
$2,417 less
First look for 7 employees; Jonathan is being added.
Need from youYour latest Delta Dental invoice
It shows who's enrolled and at what level, so we can confirm the dental totals and ask whether you can keep Delta.
In progressWorkers' comp
CoAdvantage is pricing it. We'll put it next to what you pay today.
Next steps
How soon you need to decide
To start December 1, plan to decide by early November. That leaves time for enrollment and payroll setup. CoAdvantage is confirming its exact cutoff.
TodayWalk through the options
Pick Option A or B, and the contribution split.
This week · CBAClose the open items
Pharmacy, workers' comp, dental, and the admin fee in writing.
Early NovemberDecide and sign
CoAdvantage's client agreement. Blue Cross stays in place until then.
