2018 Insurance Plan Covered and Non-Covered Services

If you are going to the doctor and want know which specific services are covered, click on the plan charts below.

These charts provide a detailed list of a variety of services, which are covered and non-covered, and percentages the insurance company will pay both in and out of network.

Non-Union Benefits eGuide or Union Benefits eGuide for weekly contributions

Medical (bargaining unit)

• Anthem PPO
• Anthem EPO
• Anthem HMO
• Kaiser Permanente California
• Kaiser Permanente Mid-Atlantic
• Selman & Company / ASI Tricare Supplement

Medical (non-union)

• Anthem PPO
• Anthem EPO
• Anthem HMO
• Anthem CDHP
  • CDHP FAQs
  • HSA investment options – CDHP only
    • How to open your Act Wise HSA account
    • Health Savings Account Mutual Fund Options
    • UMB Bank HSA Deposit Account Terms and Conditions
    • UMB Bank HSA Custodial Agreement
  • Anthem / HSA Registration packet (how to use your HSA on line)

• Kaiser Permanente California
• Kaiser Permanente Mid-Atantic
• Selman & Company / ASI TRICARE Supplement
  • Supplement medical coverage form

Flexible Spending Accounts (FSA)

• Health Care and Dependent Care FSA

Coverage Advisor (non-union)

• Anthem – Plan Comparison Tool (PPO, EPO, HMO, CDHP)

• 2018 Anthem Medical Plan Benefits ~ Power point presentation with voice-over

Preventive Care Benefits

• Anthem – Quick reference flyer
• Express Scripts – Preventive medications list to be used as a guide

Mobile and On-line Apps

• Anthem
  • Mobile App – Available for all Anthem members 
  • LiveHealth Online – Available for Anthem PPO, EPO, and CDHP members.
    • At home or on the go, see a doctor or therapist. 
• Kaiser – My Health Manager
  • Mobile App – email doctor’s office, view test results, refill most prescriptions, etc. Register at kp.org/registernow
  • Telephone – call in to speak with a doctor for minor health conditions. Southern California only.

Express Scripts ^®

Anthem EPO, EPO, CDHP

• Online resource to help you learn about and manage your prescription benefit program to include:
  • Review pharmacy benefit plan highlights
  • Find a local participating pharmacy
  • Compare prescription medication costs
  • Formulary – look up drugs by name
  • Find potential lower-cost options with Savings Advisor
• Preventive medications list to be used as a guide
• Accredo -Express Scripts specialty pharmacy for “specialty prescriptions”
  • Refer to the Benefits eGuide, page 14, for the process to obtain specialty prescriptions
    • Specialty Drug Listing pdf
    • Phone 877-985-9697
    • Refer to the Benefits eGuide, page 14, for the process to obtain specialty prescriptions

Vision (bargaining unit)

• VSP

Dental (bargaining unit)

• Delta Dental
• Dental Net
• Cigna Dental

Vision (non-union)

• VSP

Dental (non-union)

• Delta Dental
• Dental Net
• Cigna Dental