Anthem Blue Access Core Plan
Introduction - Coverage -
2013 Rates - 2012 Rates -
Forms/Documents
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 Core Plan Highlights
- 100% Preventive Care Coverage
- Deductible
- Network - $600 individual and $1,200 family
- Non-network - $1,200 individual and $2,400 family
- Out-of-pocket maximum
- Network - $3,000 individual and $6,000 family
- Non-network - $6,000 individual and $12,000 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; $40 brand formulary; $60 non-formulary; $80 specialty
- Mail Order (90-day supply)
- $20 formulary generic; $80 brand formulary; $120 non-formulary
Anthem Core 2013 Benefits Highlights
Anthem Core 2013 Summary of Benefit Coverage (SBC)
Anthem Core 2013 Plan Certificates coming soon
Anthem 2012 Plan Certificate
(top of page)
Anthem Core Rates for Plan Year 2013
Blue Cross/Blue Shield Blue Access Core Plan -
Salary $38,000
($3,166.67 monthly, $19.49 hourly) and above
|
2013 Rates |
Employee's Bi-weekly Premium |
Employee's Monthly Premium |
|
Single Plan |
$62.10 |
$124.20 |
|
Employee + Child(ren) |
$103.06 |
$206.12 |
|
Employee + Spouse |
$136.82 |
$273.64 |
|
Family Plan |
$170.42 |
$340.84 |
Blue Cross/Blue Shield Blue Access Core Plan -
Salary below
$38,000($3,166.67 monthly, $19.49 hourly)
|
2013 Rates |
Employee's Bi-weekly Premium |
Employee's Monthly Premium |
|
Single Plan |
$52.79 |
$105.58 |
|
Employee + Child(ren) |
$87.60 |
$175.20 |
|
Employee + Spouse |
$116.30 |
$232.60 |
|
Family Plan |
$144.86 |
$289.72 |
For Retiree and COBRA Rates, contact Brandy Smith
(top of page)
Anthem Core for Plan Year 2012
Blue Cross/Blue Shield Blue Access Core 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 |
$46.30 |
$92.60 |
|
Employee + Child(ren) |
$80.36 |
$160.72 |
|
Employee + Spouse |
$102.16 |
$204.32 |
|
Family Plan |
$129.69 |
$259.38 |
(top of page)
Forms and Documents
Anthem Medical Enrollment Application
Anthem Employee Change Form
Sample Anthem Core
Enrollment Form
Sample Anthem Form to Change to Core
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)