集美麻豆

集美麻豆 is committed to providing comprehensive health care options with a wide variety of primary care physicians, specialists, and facilities to choose from. Our coverage is just that.

Most hospitals in Virginia accept Anthem rates. Pre-Admission review is required for admission to a hospital, excluding out-patient services. If you are admitted in an emergency situation, pre-admission review must be done within 48 hours or the next business day.

If you travel outside of Virginia, the network of doctors and facilities does not apply. However, you should locate doctors and facilities that participate with Anthem in the state you are visiting. If you have a life-threatening emergency, either in-state or out-of-state, you will not be penalized for seeking services from a non-participating doctor or facility.

Two Plan Options to Choose From

Health Keepers (HMO) Plan 11 • $25.00 co-pay; $50.00 co-pay specialist • Deductible: $750 single/$1,500 family • Maximum Out Of Pocket: $3,250 single/$6,500 family • Coinsurance: Anthem Pays 80% of allowable charges, individual pays 20%

High Deductible Plan 7 • No co-pay once deductible reached • Deductible: $3,400 single/$6,800 family • Maximum Out of Pocket is reached once deductible is met • Coinsurance does not apply • Prescription Drugs are included in your $3,300 single/$6,600 family deductible.

Preventative Care: Under both plan options, Anthem covers 100% of checkups, routine physicals, including office visits, lab work, immunizations, mammograms, pap tests, gynecological exams, Prostate-Specific Antigen, colorectal cancer screenings, and certain blood and urine screenings and labwork. These tests are not considered routine if the procedure is performed due to a medical condition or diagnosis. If, in the course of a routine screening procedure, an abnormality or problem is identified that requires immediate intervention, the service may be converted from routine to diagnostic.

Well Baby Care: Under both plan options, Anthem’s Well Baby Care covers children from birth through age 6. In addition, expectant mothers may enroll in the Future Moms Program by contacting the Benefits Manager or Anthem directly.

Spousal Carve Out: If your working spouse is eligible for coverage through his/her employer’s group health plan for affordable, minimum essential coverage as defined by the Affordable Care Act, the spouse is NOT eligible to enroll in medical coverage under the VPC Consortium medical plan. Employee’s whose spouses do not have affordable health coverage elsewhere and who enroll in our plan must formally (legally) attest to this fact by signing the Spousal Affidavit.

For complete details regarding the plan coverages please see the Anthem Booklet for Low Deductible Plan 11 and High Deductible Plan 7 and Anthem Application.

Live Health Online:

Anthem’s LiveHealthOnline benefit allows you to visit with local board-certified doctors online via video using your phone or computer anytime, from practically anywhere.

• National provider network is available 24/7, including holidays to provide affordable quality care.
• Online physicians can diagnose, treat, and write prescriptions for routine medical conditions.
• Behavioral Health and Dermatology services are also available.  
• Virtual Visit, $59.00 fee for Plan 7 High Deductible and $59.00 per visit for Non-Anthem members.

Health Advocate Services:

• Hands-on-support for a variety of health and well-being issues.
• Compassionate, confidential help available 24/7.
• Unlimited access for all active, benefit-enrolled employees, and their eligible family members.
• Interactive mobile app and website.
• Provided by VPC at no cost to you!
• Contact information: 1-866-395-8622

Anthem's Sydney App:

You've got quick access to your health care on the Sydney mobile app.  Register on anthem.com or the Sydney mobile app.  See the Sydney mobile app. information.

Virtual Primary Care:

This benefit is available to members who are 18 to 64 years old.  $39.00 copay High Deductible Plan 7 and $0.00 copy for Low Deductible Plan 4.  See the informational flyer for additional information.

Surgery Plus:

All active employees and covered dependents enrolled in the Anthem Network medical plans are eligible for this service.

• Access to a network of thousands of highly qualified surgeons
• You receive excellent surgical care at little to no cost
• Your personal care advocate will support you every step of the way
• See the information flyer for complete details

Anthem (Medical/Prescription) Forms:

• Medical Insurance Forms:
  • Application
  • Election Participation Form
  • Spousal Affidavit
• Plan 7 Information Booklet
  • Insurance Rates:  Plan 7
  • Summary of Benefits and Coverage Plan 7
• Plan 11 Information Booklet
  • Insurance Rates:  Plan 11
  • Summary of Benefits and Coverage Plan 11
• Preventative Care
• Anthem Preventative Prescription List
• LiveHealth Online
• Non-Grandfathered Status
• Women's Health & Cancer Rights Act
• Coverage for Spectrum Disorder
• Summary of Wellness Services
• Newborns and Mothers Health Protection Act
• Qualifying Life Events Election Guide

Your prescription drug coverage is with Anthem Carelon Rx. Coverage and Co-pays are listed below.

Health Keepers (HMO) Plan 11

• Your copay will be based on which tier the drug is in.
• Tier 1 and 2 usually include low-cost and generic drugs.
• Visit www.anthem.com to find out your drug cost based on the tier.
• Generic drugs on the preventive drug list will be covered at 100%.
• For complete details see the Anthem Booklet for Health Keepers Plan 11 and the Preventive Drug List located on our website.

High Deductible Plan 7

• No Copay
• You pay the cost of the prescription based on which tier the drug is in.
• The drug cost is applied to your annual deductible. Once this deductible is met for the year you pay $0.00 for prescriptions and medical.
• Generic drugs on the preventive drug list will be covered at 100%.
• For complete details see the Anthem Booklet for PPO Plan 7 and the Preventive Drug List located on our website.

Rx Maintenance 90 Program
Refill your prescriptions for a 90-day supply of maintenance drugs through Rx Maintenance 90.  Maintenance drugs treat long-term conditions like asthma, heartburn or diabetes.  When you use your Rx Maintenance 90 benefit, you must fill prescriptions for maintenance drugs at a Rx Maintenance 90 pharmacy, or through home delivery.  Whether you choose a Rx Maintenance 90 pharmacy or home delivery, you'll pay the same home delivery copay!  It's easy and convenient.

Important Reminders:

• Walgreens, Rite Aid, Giant, Publix and Wegmans retail pharmacies are NOT in the pharmacy network.
• A participant’s in-network cost for a 30 day supply of insulin will be capped at $50 and $150 for 90 day supply (if not on the excluded drug list).
• Preventive Drug List are subject to change at any time. The lists are developed and maintained by Anthem…and will be inflexible.

The College partners with to provide a full range of services, including orthodontia. Delta Dental covers the four main types of dental expenses:

Preventative and Diagnostic Care including routine exams and cleanings, fluoride treatments, sealants, and bitewing x-rays – Paid at 100%, no deductible

Basic Services including fillings, oral surgery, extractions, root canals, periodontal services, and denture repair – Paid at 80% after the deductible — $50 single, $150 family. $1,000 Annual Benefit Maximum per enrollee per calendar year.

Major Services are available with the voluntary high option (including crowns, bridges and dentures) – Paid at 50% after the deductible — $50 single, $150 family. $2,000 Annual Benefit Maximum per enrollee per calendar year.

Orthodontia is available with the voluntary high option — paid at 50%, no deductible, lifetime maximum benefit of $2,000 (separate from regular deductible/maximums). 

Dental Plan Enhancements:  Special Health Care Needs Benefit

• Extra care for members with physical, developmental, mental, sensory, behavioral cognitive, emotional impairment or limiting conditions that requires medical management, health care intervention or use of specialized services or programs.
• Members can get extra exams, cleanings, and treatment delivery modifications.
• Low Plan Option:  Annual Calendar Year Maximum is $1,000.
• High Plan Option:  Annual Calendar Year Maximum is $2,000 and Orthodontia lifetime maximum is $2,000.

All preventive care is paid at 100%.  Excluded from annual maximum.

Delta (Dental) Forms:

• Information On Low Option
• Information on High Option
• Delta Dental Network Providers
• Dental Insurance Application

Basic Vision insurance is included in your Anthem health insurance coverage.

Note: If during a routine exam a problem is found, the claim may become diagnostic and may become a medical claim.

In-Network Basic Plan — Exam co-pay is $15. Frames, lenses, and contacts are discounted dependent upon selection and cost.

Out-of-Network — $30 reimbursement towards the cost of a routine eye exam or $35 towards the cost of contact lens exam. There is no benefit for Frames, Lenses, and Contacts.

In-Network Voluntary High Option — This coverage is with Blue View Vision (myvision.org/)

• Exam co-pay is $15 and a contact lens exam is an additional $15 co-pay.
• Frames: $130 allowance, then 20% off remaining balance every 2 years.
• Lenses: $15 co-pay, then covered in full for single, bifocal, and trifocal — see brochure for upgrades.
• Contacts: $130 allowance, then 15% off the remaining balance for conventional; $130 allowance for disposable lenses.

Blue View (Vision) Forms:

• Information Booklet on High Option
• Blue View Application

The Hartford provides the following supplemental plan options:

• Short Term Disability – coverage available to employee only (60% of your weekly salary, plus an additional $50)
• Supplemental Term Life – coverage available to employee, spouse and children (maximum of $250,000/employee and $125,000/spouse)
• Accident – Low and High Plans available; coverage available to employee, spouse and children
• Critical Illness – coverage available to employee, spouse and children
• Hospital Indemnity – coverage available to employee, spouse, and children

Supplemental Insurance Forms:

• Enrollment Form
• Short-term Disability
• Supplemental Term Life
• Accident
• Critical Illness
• Medical Indemnity

Flexible Spending Accounts (FSA)

Health Equity oversees the College’s flexible spending accounts. Monies are withheld on a before-tax basis to be used in:

Health Care Account — Medical expenses not covered by insurance. IRS approved health-care-related items, including certain over-the-counter items. $3,300 annual limit. Carryover Rule: $660 maximum per year.

Dependent Care Account — Coverage of dependent child and/or adult care expenses. $7,500 annual limit.

Limited Purpose FSA— Dental and Vision expenses only when enrolled in an HSA. $3,300 Annual limit. For more information on flexible spending accounts, visit www.healthequity.com

• The maximum contribution amount for Dependent Care reimbursement is $5,000.00.
• If you enroll in PPO Plan 7 (High Deductible Plan) with an HSA (Health Savings Account), you are eligible for a "Limited Purpose" Flexible Spending Account. The eligible expenses under the "limited purpose" account are vision and dental charges that are not covered by your insurance.

Health Savings Accounts (HSA)

Health Equity oversees the College’s health savings accounts.

• An HSA is a savings account that can be used to reimburse eligible medical expenses, like doctor’s visits, prescriptions, vision and dental expenses.
• The money is deposited on a tax free (after tax contribution). Those funds remain tax free when used to pay or reimburse for eligible healthcare expenses.
• The College will make a front load contribution in January and will make an additional matching contribution each month based on the employee’s coverage.
• For complete details please see the HSA Contribution Structures and HSA Enrollment & Agreement Form.
• Annual Maximums: Individual - $4,400.00, Family - $8,750.00, and Catch-up Contribution - (if age 55 or older by 12.31.2025) $1,000.00.

FSA and HSA Forms:

•  FSA (Health Equity) Enrollment Form
•  FSA Information
•  Limited Purpose FSA Information
•  Dependent Care Information
• HSA Contributions Structures
• HSA Member Brochure
• HSA Payroll Deduction Form

Provides assistance for your everyday problems and questions, big or small, by phone, in-person or online, 24/7. Call (800) 346-5484 or visit anthemEAP.com and enter VPCBC to log in.

• Find child, elder, or pet care.
• Work on achieving work-life balance.
• Parent a child with special needs.
• Deal with addiction and recovery.
• Set retirement goals.
• Find mental health resources and information (5 Free counseling sessions per life event).
• Address financial or legal issues.
• Contact information: 1-800-346-5484.

• Annual Notices
• COBRA Continuation Coverage Rights
• HIPAA Special Enrollment Rights
• HIPAA Privacy Notice

Open enrollment is the annual period during which employees can make updates to their health insurance and benefits enrollments.