Health Plans

Creditable Coverage Notice

Plan Comparisons

For a detailed description of each plan, please review the following documents:

BENEFIT PLAN SUMMARYS

PPO KeyCare 30 Plan - Summary of Benefit Coverage

Lumenos with HSA Plan - Summary of Benefit Coverage

* For tier 3 drugs, copay or coinsurance whichever is greater up to $200 per script retail and $400 per script mail.

Blue View Vision Network

Your Anthem Health Plan comes with valuable benefits and discounts to help you take care of your eyes. You can access your benefits two ways – by using either in-network or out-of-network vision care professionals. Below is an overview of basic in-network benefits included in the Blue View Vision Network. Please refer to the summary plan description for complete benefit details.

Should you choose to receive your eye care from a non-participating vision care professional, your vision benefits still offer a $30 allowance toward the cost of the eye exam. You pay the non-participating provider for the exam at the time you receive the service, and then submit a claim to receive your allowance. (Anthem Blue Cross Blue Shield Member Services can provide you with a copy of this claim form and filing instructions.) One eye exam per member per calendar year is eligible for coverage, in-network and out-of-network combined.

Benefits through the Blue View Vision Network for your calendar year eye exam are for routine services only. If you need medical treatment for your eyes, select a participating eye care physician specialist from your medical network. Your out-of-pocket expenses related to the vision benefits do not count toward your annual out-of-pocket limit and are never waived, even if your annual out-of-pocket limit is reached. These vision services are not subject to an out-of-plan deductible.

NEW-Benefit Resource Center

FREE TO ALL FULL TIME EMPLOYEES AND DEPENDENTS

(Not required to have City insurance to utilize services)

Benefit Resource Center Flyer

The Benefit Resource Center assists employees and their family members with a variety of healthcare related services..  Benefit Specialists are available Monday-Friday 8:00 a.m. - 6:00 p.m. EST.  at 1-855-874-6699.  Please click on the above link to view the flyer for service details.

Premium Conversion Waiver

EMPLOYEES WHO DO NOT WISH TO HAVE THEIR HEALTH AND DENTAL INSURANCE PREMIUMS DEDUCTED ON A PRE-TAX BASIS MUST COMPLETE THE PREMIUM CONVERSION WAIVER FORM.

What is Premium Conversion?  A premium conversion plan is a way of providing you with valuable benefits and significant tax savings by converting your insurance premium deductions from after-tax to pre-tax payments.  These premium payments are considered salary reductions and, as a result, you own no tax on the premium amounts.  You take home additional dollars in your paycheck!  All participants enrolled in the City’s health benefit plan are automatically enrolled in Premium Conversion.

 PREMIUM CONVERSION WAIVER FORM