Anthem Blue Access Buy-Up Plan
Introduction - Coverage -
2013 Rates - 2012 Rates -
Forms/Documents
The Anthem Health Plans are available to regular full-time employees working on at
least a 75 percent academic or fiscal year appointment. Contact Human Resources
for information on those benefits applicable to temporary, part-time, or other
employee groups.
Coverage
Anthem Buy-Up Plan Highlights
- 100% Preventive Care Coverage
- Deductible
- Network - $300 individual and $600 family
- Non-network - $600 individual and $1,200 family
- Out-of-pocket maximum
- Network - $1,500 individual and $3,000 family
- Non-network - $3,000 individual and $6,000 family
- Co-Insurance
- Network - 80%/20%
- Non-network - 60%/40%
- Prescription Co-Payments -
Prescription Formulary -
Specialty Pharmacy
- Retail Pharmacies (30-day supply)
- $10 formulary generic; $24 brand formulary; $40 non-formulary; $70
specialty
- Mail Order (90-day supply)
- $20 formulary generic; $48 brand formulary; $80 non-formulary
Anthem Buy-Up 2013
Benefits Highlights
Anthem Buy-Up 2013 Summary of Benefit Coverage (SBC)
Anthem Buy-Up 2013 Plan Certificate coming soon
Anthem Buy-Up 2012
Plan Certificate
(top of page)
Anthem Buy-Up Rates for Plan Year 2013
Blue Cross/Blue Shield Blue Access Buy-Up Plan - The premium is inclusive of medical, prescription drug, and dental insurance coverage.
|
2013 Rates |
Employee's Bi-weekly Premium |
Employee's Monthly Premium |
|
Single Plan |
$104.07 |
$208.14 |
|
Employee + Child(ren) |
$172.55 |
$345.10 |
|
Employee + Spouse |
$229.02 |
$458.04 |
|
Family Plan |
$285.24 |
$570.48 |
For Retiree and COBRA Rates, contact Brandy Smith
(top of page)
Anthem Buy-up Rates for Plan Year 2012
Blue Cross/Blue Shield Blue Access Buy-Up Plan - The premium is inclusive of medical, prescription drug, and dental insurance coverage.
|
2012 Rates |
Employee's Bi-weekly Premium |
Employee's Monthly Premium |
|
Single Plan |
$73.35 |
$146.70 |
|
Employee + Child(ren) |
$125.12 |
$250.24 |
|
Employee + Spouse |
$161.55 |
$323.10 |
|
Family Plan |
$203.64 |
$407.28 |
(top of page)
Forms and Documents
Anthem Medical Enrollment Application
Anthem Employee Change Form
Sample Anthem
Buy-Up Enrollment Form
Sample Anthem Form to Change to Buy-Up
Sample Anthem Form to Drop
Medical Dependents
Sample Anthem Form to Drop All Coverage
To learn more about the Anthem plans, visit
Anthem.com.
(top of page)