Health and Wellness

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Medical

Quick reference

Your medical plan network is the Blue Cross Blue Shield of Arizona (BCBSAZ) PPO network. This plan gives you the flexibility of a national network of doctors and the freedom to see specialists without a referral from a primary care provider. You can also choose to receive out-of-network care, but you’ll pay more out of pocket.

Telehealth

The most cost-effective way for you to receive care is through telehealth with BCBSAZ BlueCare Anywhere. Licensed doctors, counselors, and psychiatrists are available for 24/7 visits on your computer, mobile phone, or tablet for only a $10 copay. If you’re dealing with a nonemergency medical condition, consider telehealth as a convenient alternative to visiting urgent care.

To access your telehealth benefits, log in to BlueCare Anywhere or use the mobile app.

Using a patient-centered medical home (PCMH)

PCMH doctors have your total health in mind while you’re managing ongoing medical conditions. They coordinate with your other medical providers to give you the best care possible. When you visit a PCMH doctor, there’s a flat copay and no deductible.

To find a PCMH doctor, use the BCBSAZ Find a Doctor tool, and select Advanced Search.

Other programs

Your medical plan gives you access to helpful, 100% free health resources for every stage of your life.

  • Nurse On Call. Ask questions 24/7 about symptoms, medications, and preparing for a doctor visit. Call 866-422-2729.
  • HealthyBlue Beginnings. Adding a new member to your family is a big step, and BCBSAZ gives you all the resources you need to feel confident about the process. Whether you’re in the family planning stage or you’re expecting a child, HealthyBlue Beginnings guides you through your options, pregnancy, and post-maternity care. All you have to do is sign up for a MyBlue account.
  • Case management. Complex or chronic conditions are difficult enough to manage without worrying about how your benefits play a role. A dedicated case manager—also a registered nurse—through BCBSAZ can help you coordinate your care among your various providers, identify community support resources, and explain how your benefits cover your care. Call 866-422-2729 to get started.
  • Disease management. Managing a chronic condition can be difficult, but BCBSAZ is here to help. If you’re diagnosed with asthma, COPD, diabetes, or another chronic condition, call 866-422-2729 or visit the BlueCross BlueShield Arizona website.

Plan highlights

What you pay
In-Network
Out-of-Network
Deductible
Individual: $200
Family: $400
Individual: $2,000
Family: $4,000
Out-of-pocket max
Individual: $4,000
Family: $10,000
Individual: $10,000
Family: None
Preventive care
No charge
50% after deductible
Telehealth visit
$10 copay, no deductible
N/A
Office or specialist visit
Patient-centered medical home (PCMH): $10 copay, no deductible
Others: 20% after deductible
50% after deductible
Urgent care visit
$100 copay, no deductible
$100 copay, no deductible
Diagnostic tests
20% after deductible
50% after deductible
Emergency room visit
$300 copay, no deductible
$300 copay, no deductible
Inpatient hospital care
$200 + 20% after deductible
50% after deductible

Prescription drug

Quick reference

Your prescription drug coverage, administered by MedImpact, offers you convenient and affordable access to the medications you need. When you enroll in the medical plan, prescription drug coverage comes with it.

Save $$$ with generic medications

Most prescriptions have a generic option available. Ask your doctor to prescribe generic drugs whenever possible to save the most money.

Drug tiers

The amount you pay for prescription drugs depends on which tier your prescription falls under.

  • Generic (Tier 1) drugs are chemical equivalents to brand-name drugs, giving you an effective medication option at a lower cost.
  • Preferred brand (Tier 2) drugs are brand-name drugs on a list of drugs that MedImpact covers at a higher rate.
  • Non-preferred brand (Tier 3) drugs are brand-name drugs that are the most expensive for you out of pocket.

Tips for filling prescriptions

You save money when you fill prescriptions at a network retail or specialty pharmacy, like CVS, Safeway, or Walgreens.

For prescriptions you take regularly, ask for a 90-day supply at your retail pharmacy, or use the MedImpact mail-order pharmacy. You can get three 30-day supplies of your medication for the price of two!

Plan highlights

Prescription
In-Network
Retail or Specialty Pharmacy
In-Network
Retail (90-day supply) or Mail Order
Out-of-Network
Retail, Mail Order, or Specialty
Tier 1: Generic
$10 copay or 10%
(whichever is greater)
$20 copay
40%
Tier 2: Preferred brand*
$20 copay or 20%
(whichever is greater)
$40 copay
40%
Tier 3: Non-preferred* brand
$50 copay or 50%
(whichever is greater)
$90 copay
40%
Out-of-pocket max (per year)
(prescription drug only)
Individual: $1,000
Family: $2,000
Individual: $1,000
Family: $2,000
Individual: $10,000
Family: Unlimited
* Please note, if a brand drug is filled when a generic is available, the member pays the difference between the brand and the generic.

Dental

Quick reference

The dental plan, administered by Delta Dental, covers three types of services: preventive care, basic services, and major services. See the active dental summary.

  • Preventive care stops dental problems before they start. The Plan covers two teeth cleanings and exams each year at 100%.
  • Basic care is common dental work like fillings, root canals, and gum treatments.
  • Major care is more involved dental work, such as prosthodontics and bridges.

Your $2,500 annual maximum for dental coverage applies to both in- and out-of-network care. However, you should still use network dentists whenever possible. Charges are usually higher with out-of-network providers, and your annual maximum won’t go as far.

Plan highlights

Service
Coverage (in- and out-of-network)
Annual deductible
Individual: $100
Family: $300
Annual out-of-pocket max
$2,500
Preventive care
100% (deductible doesn’t apply and not subject to the annual dental maximum)
Basic services
80%
Major services
60%

Using network dentists

Smile! Dentists who participate in the Delta Dental network make your dental care easier and more cost-effective.

Find a dentist

Vision

Quick reference

Your vision care benefits are provided through VSP (Vision Service Plan). You’ll choose from an extensive list of providers and receive coverage for exams, frames, and contacts as shown in the chart below.

Plan highlights

Service
Coverage (in-network)
Annual eye exam
$10 copay, one per year
Essential medical eye care exams
$20 copay
Prescription glasses
$10 copay, once per year
Frames

$225 frame allowance (or $245 for certain brands), once per year

$120 Costco frame allowance (prescription glasses only)

$225 ready-made non-prescription sunglasses/ready-made non-prescription blue light filtering glasses (under the Lightcare benefit)

Single, bifocal, and trifocal lenses
Fully covered, once per year
Contact lenses
Exam and fitting: up to $60 copay
Contacts instead of eyeglasses: $150 allowance, once per year
LASIK eye surgery
Not covered; discounts available from VSP facilities

Employee Assistance Program

Everyone needs additional support sometimes. The Employee Assistance Program (EAP), provided by ComPsych can help you and each member of your family deal with personal issues—no matter how major or routine.

The EAP can counsel you and your family on:

  • Depression
  • Anxiety
  • Grief
  • Substance abuse
  • Family issues
  • Financial or legal problems
  • Work-related conflicts
  • Anything else that’s on your mind

You and your family members receive six free sessions with a licensed counselor per issue, per year. And, if you require long-term care to address the issue, ComPsych Options will help you find a licensed mental health professional in your community.

For more information on these resources call ComPsych toll-free at 866-365-0801 or visit their website at guidanceresources.com (web ID: IBEW).

Life, AD&D, and short-term disability

Income protection for your family is essential, in case something serious happens to you. Life, AD&D, and short-term disability coverage, administered by Zenith American Solutions, protects your family’s financial security in those situations.

Life insurance

Your life insurance coverage pays a benefit of $10,000 to your beneficiary in the event of your death. You receive a benefit of $1,000 in the event of your spouse’s or child’s death.

AD&D

Accidental death and dismemberment coverage (AD&D) pays your beneficiary $10,000 in the event you sustain serious injuries or die from an accident. Dependents aren’t eligible for AD&D coverage.

Short-term disability

If an injury or illness leaves you disabled and unable to work, Plan A and Plan B active employees are eligible for a weekly benefit of $150 for up to 13 weeks. The benefit ends when you return to work or after 13 weeks (whichever is sooner). If disability is due to pregnancy, the weekly benefit is increased to $600 for the first six weeks for a vaginal delivery, or the first eight weeks for a cesarean delivery.

Update your beneficiaries

Tell us who should receive your life or AD&D benefit. To update your beneficiary information, contact Zenith American Solutions at 800-553-2801 or log in to your account on their website.

Medicare retirees

As a member of the Humana Group Medicare Advantage PPO Plan, you receive Medicare health benefits and services, prescription drug coverage, and dental coverage. Your dental benefits are administered by Delta Dental, with a $25 deductible and a $200 maximum benefit per year. See the dental summary for details.

See below for a summary of your Medicare health benefits and prescription drug coverage. For details, check the Humana Certificate of Coverage booklet.

Medical plan highlights

What you pay
In-Network
Out-of-Network
Deductible (medical only)
Individual: $215 combined in- and out-of-network
Individual: $215 combined in- and out-of-network
Out-of-pocket annual max
(medical only)
Individual: $4,400 combined in- and out-of-network
Individual: $4,400 combined in- and out-of-network
Preventive care
No charge
No charge
Office or specialist visit
No charge after deductible
No charge after deductible
Urgent care visit
$65 copay, no deductible
$65 copay, no deductible
Diagnostic tests
No charge after deductible
No charge after deductible
Emergency room visit
$80 copay, no deductible
$80 copay, no deductible
Inpatient hospital care
$200 copay per admission, subject to deductible
$200 copay per admission, subject to deductible

Prescription drug plan highlights

Prescription
In-Network
Retail or Specialty Pharmacy
In-Network
Retail (90-day supply)
In-Network
Mail Order
(up to 90-day supply)
Out-of-Network
Retail, Mail Order, or Specialty
Tier 1: Generic
$10 copay or 10% (whichever is greater)
$30 copay or 10% (whichever is greater)
$20 copay
N/A
Tier 2: Preferred brand*
$20 copay or 20% (whichever is greater)
$60 copay or 20% (whichever is greater)
$40 copay
N/A
Tier 3: Non-preferred* brand
$50 copay or 50% (whichever is greater)
$150 copay or 50% (whichever is greater)
$90 copay
N/A
Tier 4: Specialty
$50 copay or 50% (whichever is greater)
N/A
N/A
N/A

* Please note that under Humana’s prescription drug plan, copays are reduced once your out-of-pocket costs reach a total of $7,050 (for 2022). This amount and rules for counting costs toward this amount have been set by Medicare.

No Surprises Act

The No Surprises Act took effect on January 1, 2022. This law protects you from balance billing if you get treated by an out-of-network provider from an in-network hospital or emergency room. Balance billing happens when an out-of-network provider charges you the difference between the total cost of your care and what your health plan agreed to pay. This law protects you from balance billing if you get emergency care or are treated by an out-of-network provider at an in-network facility.  You can find more info about the No Surprises Act here.

Sometimes, in-network emergency rooms and hospitals employ out-of-network doctors. In these cases, you might receive care from an out-of-network provider, through no fault of your own. Also, you might not have time to choose between an in- or out-of-network provider in a medical emergency. The No Surprises Act is designed to ensure that you aren’t balance billed if you receive care under these circumstances. It protects you from paying extra when the circumstances are beyond your control.

You should still use network providers whenever possible. Visit the Blue Cross Blue Shield of Arizona website to find a list of network providers near you.

If you believe that you’ve been wrongly billed, contact the Employee Benefits Security Administration (EBSA) at 866-444-3272 or through their website.