Health Benefits Anthem Blue Cross Blue Shield
Washington and Lee University is pleased to offer medical insurance through Anthem BlueCross BlueShield. The Anthem Keycare 15 PPO gives employees the flexibility to receive the care they want from the provider they want, without the need to select a primary care physician or to obtain referrals for service.
The Anthem KeyCare 15 PPO plan offers dfferent levels of in-network and out-of-network benefits. Coverage levels in the plan are higher when you use in-network providers. Please read the details of the plan carefully to understand the benefits provided.
The University pays 72% of the cost of the plan. The University subsidizes the cost of health insurance so that no benefit-eligible employee need pay more than 10% of his/her family income for health insurance premiums. Please contact Human Resources for more information and to determine whether you qualify. Discounts are also available for employees who participate in the University's wellness program.
|Medical/Prescription Drug Plan Rates 2014-15
|Employee Only||University Pays||$384.24||$192.12|
|Employee + 1||University Pays||$864.50||$432.25|
- CHIPRA Notice
- See page 8 of the 2014-15 Benefits Guidebook for information on the Wellness discount and University's offer to subsidize premiums.
- Summary of Benefits and Coverage: What this Plan Covers & What it Costs
- Glossary of Health Coverage and Medical Terms
- Anthem Keycare 15 Plan Summary
- Member Booklet: This member booklet fully explains your health care benefits and how you can maximize them. Treat it as you treat the owner's manual for your car - store it in a convenient place and refer to it whenever you have questions about your health care coverage. This booklet is valid through June 30, 2014. Revised booklet will be available later this fall.
Blue View Vision offers you one of the largest vision care networks in the industry, with a wide selection of experienced ophthalmologists, optometrists, and opticians. Blue View Vision's network also includes convenient retail locations, many with evening and weekend hours. If you choose to receive care outside of the Blue View Vision network, you will receive an allowance toward the eye exam and you pay the rest. (Network benefits and discounts will not apply.) Just pay in full at the time of service and then file a claim for reimbursement. Log in to the Anthem website for detailed information.
Prescription Drug Coverage
Washington and Lee provides comprehensive prescription drug coverage through our medical provider, Anthem BlueCross BlueShield. We offer a tiered drug list/formulary, or list of covered medications, which assigns drugs to specific tiers based on cost. Tier 1 drugs have the most affordable copay. Tier 2 drugs cost slightly more, and Tier 3 drugs have the highest copay amounts. Visit anthem.com to view the formulary.
Your prescription drug copayments are designed so that you'll pay less out-of-pocket when your prescriptions are filled with generic drugs. You can also increase the value of your prescription benefits by using the mail order program to obtain valuable savings on 90-day supplies of maintenance medications.
Coverage Outside Lexington
Anthem's BlueCard Program gives you access to doctors and hospitals almost everywhere, giving you the peace of mind that you'll be able to find the healthcare provider you need. Within the United States, you're covered whether you need care in urban or rural areas. Outside of the United States, you have access to doctors and hospitals in nearly 200 countries and territories around the world through the BlueCard Worldwide® Program.
- Full-time and part-time benefit-eligible employees (part-time benefit-eligible employees should consult "Benefits for Part-Time Benefit-Eligible Employees" on p. 37.)
- Spouses, dependents through the end of the month in which they turn age 26, and/or eligible domestic partners. Dependents are identified by W&L as your naturally born and/or adopted children, step children or other dependents for whom you are the legal guardian. Coverage is available regardless of their student, marital or tax dependent status and regardless of their access to another employer sponsored group plan. Benefits for non-IRS dependents may be taxable to the employee. Employees should notify HR when this occurs.
Employees may select either an Individual membership, a membership for self and one legal dependent, or a Family membership.
When Coverage Begins
Coverage may begin on the first day of employment.
Timely Enrollment is Necessary
Health insurance coverage is not automatic if the employee does not enroll him/herself, and/or dependents, within 31 days of the employee's eligibility for insurance. Thereafter, coverage may be added only during open enrollment periods (typically held in May with coverage to be effective July 1), or if an employee loses other coverage. A change in dependent coverage may be made only during the open enrollment period, or if there is a change in the employee's status (marriage, divorce, death of a spouse or child, birth or adoption of a child, and changes in the employment status or benefit eligibility of a spouse).
Benefits for Part-Time Benefit Eligible Employees
After one year of employment in this category, employees are eligible for health insurance for themselves only. In the initial and subsequent anniversary years the employee must work 1,000 or more hours to continue to be eligible. Insurance is only available if it is not available through Medicare or through a spouse or partner. The University pays 50% of the premium.
With Anthem's SpecialOffers program, you can access over 50 discounts on products and services that help promote better health and well-being. Log in to the Anthem website for detailed information.