Medical Plan Options
Anthem Plans
Anthem HMO – No employee contribution required
Anthem HMO Plan Summary – (Anthem HMO Enrollment Form)
Anthem HMO Network Enrollment Guide
Anthem Sydney Health App – Access to ID card
Anthem HMO Network Provider Search (follow prompts below)
>Select the “Find Care” tile
>Select “HMO (Full Network)”
>Enter the zip code for the region you would like to find a doctor
>You can either select a care provider tile or search by provider name/group name
>The results of the search can be emailed or saved as a file
Anthem PPO 80E – No employee contribution
Anthem PPO 80E Plan Summary – (Anthem 80E PPO Enrollment Form)
Anthem PPO Network Enrollment Guide
Anthem Sydney Health App – Access to ID card
Anthem 80E PPO Provider Search (follow prompts below)
>Select the “Find Care” tile
>Select “PPO”
>Select “Search for a PPO Network Provider”
>Enter the zip code for the region you would like to find a doctor
>You can either select a care provider tile or search by provider name/group name
>The results of the search can be emailed or saved as a file
Anthem PPO 100A – Requires employee contribution
Single = $226.00/12 mo. & $271.20/10 mo.
2 Party = $445.00/12 mo. & $534.00/10 mo.
Family = $627.00/12 mo. & $752.40/10 mo.
Anthem PPO 100A Plan Summary – (Anthem 100A PPO Enrollment Form)
Anthem PPO Network Enrollment Guide
Anthem Sydney Health App – Access to ID card
Anthem 100A PPO Provider Search (follow prompts below)
>Select the “Find Care” tile
>Select “PPO”
>Select “Search for a PPO Network Provider”
>Enter the zip code for the region you would like to find a doctor
>You can either select a care provider tile or search by provider name/group name
>The results of the search can be emailed or saved as a file
Kaiser Plans
Kaiser HMO – No employee contribution
Kaiser HMO Plan Summary (Kaiser HMO Enrollment Form)
Find a Kaiser doctor
Kaiser HDHP with Employer Funded WEX HSA – No employee contribution
IMPORTANT: Employer contributions to the WEX HSA are considered employee state taxable income, state income tax withholding will increase on the October and April paycheck.
Kaiser HDHP Plan Summary (Enrollment Form)
Find a Kaiser doctor
Kaiser HDHP Plan Includes Employer Funded WEX Health Savings Account
WEX Customer Service: (833-225-5939) Set up your WEX account online
Single annual employer contribution = $3,400.00
Family annual employer contribution = $6,800.00
50% of the employer contribution is deposited in October and 50% of the employer contribution is deposited in April each plan year.
Dental Plan Options
DeltaCare USA HMO – No employee contribution
DeltaCare USA DHMO Plan Summary (DeltaCare USA Enrollment Form)
Find a DeltaCare USA HMO Dentist (select the DeltaCare USA option from the drop-down list)
Understanding Your Plan
Delta PPO – Requires employee contribution
$44.30/12 mo. & $51.60/10 mo.
Delta PPO Plan Summary (Delta PPO Enrollment Form)
Find a PPO Dentist (select the PPO option from the drop-down list)
Delta Premier – Requires employee contribution
$71.00/12 mo. & $85.20/10 mo.
Delta Premier Plan Summary (Delta Premier Enrollment Form)
Find a Premier Dentist (select the Premier option from the drop-down list)
EyeMed Vision Plan
Insight Network – No employee contribution
EyeMed Plan Summary (EyeMed Enrollment Form)
Basic Long Term Care – No employee contribution
Long Term Care Policy Information
Term Life, AD&D, LTD – No employee contribution
VOYA Life and AD&D Enrollment Form (Life Policy Information)
Required VOYA Evidence of Insurability
Long Term Disability (LTD) – No employee contribution
VOYA Long Term Disability Plan Summary – This policy replaces employee state disability benefits