Benefits and Open Enrollment

WELCOME!

The open enrollment period for benefit elections effective January 1, 2025 begins Monday, October 14, 2024 and ends at 5:00 pm on Friday, November 8, 2024.

Spousal carve-out:  If your working spouse is eligible for coverage through his/her employer's group health plan for affordable, minimum essential coverage as defined by the Affordable Care Act, the spouse is NOT eligible to enroll in medical coverage under the VPC Consortium medical plan.  Employee's whose spouses do not have affordable health coverage elsewhere and who enroll in our plan must formally (legally) attest to this fact by signing the Spousal Affidavit which is linked below.  A new Spousal Affidavit is required every year.

Important Notices:

1. Medical Insurance Plans:

The College will continue with Anthem through the VPC Benefits Consortium as the medical/basic vision carrier.

Anthem Medical Insurance: Employees will have three plan options to choose from for 2025.

• Plan 4 (Low Deductible with a $20.00 co-pay, $40.00 Specialist co-pay and $750/$1,500 deductible and Out-of-Pocket Maximum $3,250/$6,500)
• Plan 7 (High Deductible Plan with no co-pay and $3,200/$6,400 deductible)
• Plann 11 HMO (Low Deductibile with a $25.00 co-pay; $50.00 Specialist co-pay and $750/$1,500 deductible and Out-of-Pocket Maximum $3,250/$6,500)
• Medical Insurance Rates for 2025 increased by 12.5%.  See the attached 2025 Rates Sheets.
• Salary Classifications and Tiers changed for 2025. If you received a raise in 2024 and you moved into a new Tier your insurance premiums will be adjusted to the new rate for 2025.

For complete details regarding the plan coverages please see the attached Anthem Booklet for Plan 4, Plan 7 and Plan 11.

2. Dental Insurance Plans:

There will be no changes to the annual maximums, co-pays or deductibles for 2025.

Dental Plan Enhancements:  Special Health Care Needs Benefit

• Extra care for members with physical, developmental, mental, sensory, behavioral cognitive, emotional impairment or limiting conditions that requires medical management, health care intervention or use of specialized services or programs.
• Members can get extra exams, cleanings, and treatment delivery modifications.

Low Plan Option:  Annual Calendar Year Maximum is $1,000.

High Plan Option:  Annual Calendar Year Maximum is $2,000 and Orthodontia lifetime maximum is $2,000.

All preventive care is paid at 100%.  Excluded from annual maximum.

Right Start 4 Kids – basic and major services covered at 100% for dependents up to age 13. See Right Start 4 Kids flyer

3. Vision Buy Up Insurance Plan:

Vision benefits will be offered through Blue View Vision in collaboration with Anthem.  If elected, Buy Up Vision will be included on your Anthem Medical card.  There are no changes in premiums and coverage for 2025. For complete details regarding services available please see the link for Blue View Vision.  See the 2025 Insurance Rate Sheet.

4. Prescription Drug Coverage:

Carelon Rx will provide Prescription Drug Coverage for 2025.  

Prescription medicines or drugs are listed in groups called tiers. Your cost is based on which tier the drug is in. Tiers 1 and 2 usually include low-cost and generic drugs.

Once you’re a member, you can check the price of a drug at different pharmacies at www.anthem.com and see if there are lower-cost drugs available. Visit www.anthem.com/nationaldirect4tierva for the VA 4 Tier Drug List.

Rx Maintenance 90 Program: 

Refill your prescriptions for a 90-day supply of maintenance drugs through Rx Maintenance 90.  Maintenance drugs treat long-term conditions like asthma, heartburn or diabetes.  When you use your Rx Maintenance 90 benefit, you must fill prescriptions for maintenance drugs at a Rx Maintenance 90 pharmacy, or through home delivery.  Whether you choose a Rx Maintenance 90 pharmacy or home delivery, you'll pay the same home delivery copay!  It's easy and convenient.

Important Reminders 

• Walgreens, Rite Aid, Giant, Publix and Wegmans retail pharmacies are NOT in the pharmacy network.
• A participant’s in-network cost for a 30 day supply of insulin will be capped at $50 and $150 for 90 day supply (if not on the excluded drug list).
• Preventive Drug List are subject to change at any time. The lists are developed and maintained by Anthem…and will be inflexible.

Co-pays are as follows:

PPO Plan 4

• Your copay will be based on which tier the drug is in.  
• Tier 1 and 2 usually include low-cost and generic drugs.
• Visit www.anthem.com to find out your drug cost based on the tier.
• Generic drugs on the preventive drug list will be covered at 100%.
• For complete details see the Anthem Booklet for PPO Plan 4 and the Preventive Drug List located under the Anthem (Medical) Tab.

PPO Plan 7

• No Copay
• You pay the cost of the prescription based on which tier the drug is in.
• The drug cost is applied to your annual deductible. Once this deductible is met for the year you pay $0.00 for prescriptions and medical.
• Generic drugs on the preventive drug list will be covered at 100%.
• For complete details see the Anthem Booklet for PPO Plan 7 and the Preventive Drug List located under the Anthem (Medical) Tab.

HMO Plan 11

• Your copay will be based on which tier the drug is in.  
• Tier 1 and 2 usually include low-cost and generic drugs.
• Visit www.anthem.com to find out your drug cost based on the tier.
• Generic drugs on the preventive drug list will be covered at 100%.
• For complete details see the Anthem Booklet for PPO Plan 4 and the Preventive Drug List located under the Anthem (Medical) Tab.

5. FSA (Flexible Spending Accounts) for 2025:

Health Equity will continue to serve as our FSA Administator for 2025.

• The Health Care allowable contribution is $3,200.00. You still have until March 31st of the following year to submit expenses incurred in the current year.
• HSC allows a Rollover option of unused funds at the end of the plan year. Participants may carry over health care balances up to $640.00 into the following plan year.  *In order to rollover funds, you must complete an enrollment form for 2025.
• The maximum contribution amount for Dependent Care reimbursement is $5,000.00.
• If you enroll in PPO Plan 7 (High Deductible Plan) with an HSA (Health Savings Account), you are eligible for a "Limited Purpose" Flexible Spending Account. The eligible expenses under the "limited purpose" account are vision and dental charges that are not covered by your insurance.
• Reminder: You MUST complete a new application every year in order to participate in the FSA. If you do not complete an application you will NOT be included in the plan for 2025.
• For complete details please see the attached, Health Equity Informational Flyers for 2025.

6. HSA (Health Savings Accounts) for 2025:

Health Equity will remain as the administrator for our Health Savings Accounts (HSA’s) for 2025.

• Maximum HSA Contributions have increased for 2025.
• Annual Maximums: Individual - $4,300.00, Family - $8,550.00, and Catch-up Contribution - (if age 55 or older by 12.31.2025) $1,000.00.
• For complete details please see attachments below.
• If you would like to make changes to your contribution amounts please complete the HSA Payroll Deduction Form below.

7. MetLife Supplement Insurance Plans 2025:

MetLife will continue to provide supplemental plan options for 2025.  If you are currently participating in the Supplemental Insurance Plans and do not want to make a change no action is required by you.  If you want to enroll or make a change in coverage you will need to complete the attached MetLife Enrollment Form.  You can select from the following plan options:

• Short Term Disability
• Supplemental Term Life (Maximum of $100,000.00 for employee and $50,000.00 for spouse with a Health Statement)
• Accident
• Critical Illness
• For complete details regarding these plan options and to access the enrollment form please click on the below Supplemental link.  Effective date of coverage will be January 1, 2025.

8. Live Health Online:

Anthem’s LiveHealthOnline benefit allows you to visit with local board-certified doctors online via video using your phone or computer anytime, from practically anywhere.

• National provider network is available 24/7, including holidays to provide affordable quality care.
• Online physicians can diagnose, treat, and write prescriptions for routine medical conditions.
• Behavioral Health and Dermatology services are also available.  
• Virtual Visit $5.00 co-pay for Plan 4 Low Deductible, $59.00 fee for Plan 7 High Deductible and $59.00 per visit for Non-Anthem members.

9. Health Advocate Services:

• Hands-on-support for a variety of health and well-being issues.
• Compassionate, confidential help available 24/7.
• Unlimited access for all active, benefit-enrolled employees, and their eligible family members.
• Interactive mobile app and website.
• Provided by VPC at no cost to you!
• Contact information: 1-866-395-8622

10. Anthem's Sydney App:

You've got quick access to your health care on the Sydney mobile app.  Register on anthem.com or the Sydney mobile app.  See the Sydney mobile app. information.

11.  Virtual Primary Care:

This benefit is available to members who are 18 to 64 years old.  $39.00 copay High Deductible Plan 7 and $0.00 copy for Low Deductible Plan 4.  See the informational flyer for additional information.

12. Employee Assistance Program

• Find child,
• elder, or pet care.
• Work on achieving work-life balance.
• Parent a child with special needs.
• Deal with addiction and recovery.
• Set retirement goals.
• Find mental health resources and information (5 Free counseling sessions per life event).
• Address financial or legal issues.
• Contact information: 1-800-346-5484.

13. Surgery Plus

All active employees and covered dependents enrolled in the Anthem Network medical plans are eligible for this service.

• Access to a network of thousands of highly qualified surgeons
• You receive excellent surgical care at little to no cost
• Your personal care advocate will support you every step of the way
• See the information flyer for complete details

Instructions for Completing Application Forms:

Medical (Anthem), Dental (Delta), Vision (UniView)

• Applications should be completed only if changes are being made. 
• Applications for each benefit are located below.
• Applications should be sent to:
  • Debbie Herndon, Benefits Manager, at one of the following:
    Email to: dherndon@hsc.edu
    Fax to: 434-223-7049
    Mail to: Campus Box 25 
    Delivered to: HR, 102 Gilkeson

All applications must be RECEIVED by 5:00 pm on Friday, November 8, 2024.

Important Reminders:     

• After Open Enrollment is closed, elections can only be made during the plan year if you experience a qualifying event. Otherwise you must wait until the next open enrollment period. A list of qualifying events can be located below under HIPAA Special Enrollment Rights.
• Premiums will be adjusted to the percentage applicable to your current salary based on the new salary classifications and tiers.
• For 2025 all medical plan options are non-grandfathered and are fully compliant with the required provisions established through national Health Care Reform legislations. (See Non-Grandfathered Status link below).
• Rights under the new Health Care Reform laws and each states Children's Health Insurance Plans are included (See Required Notices link below for complete details).
• For your convenience I have also attached a "Vendor Contact Information List."  See below for the link.

Medical/Dental/Vision/Supplemental Insurance

Flexible Spending Accounts

Health Savings Account (Health Equity):

HSA Contributions Structures
HSA Enrollment and Agreement Form
HSA Member Brochure
HSA Payroll Deduction Form

MetLife Supplemental Insurance

Enrollment Form
Short-term Disability
Supplemental Term Life
Accident
Critical Illness
Pet Insurance