Medical
As part of an exchange, employees have the ability to choose health insurance and benefit plans that fit their needs and budget from an ever growing range of choices.
ANTHEM OVERVIEW
Anthem is dedicated to delivering better care to our members, providing greater value to our customers and helping improve the health of our communities.
Anthem Healthcare Medical Plans
Network availability & ELIGIBILITY
ANTHEM |
NEW YORK |
NEW JERSEY |
CONNECTICUT |
NATIONWIDE |
| To enroll in PPO/EPO plans employees can Live/work/reside anywhere in the US. | PPO/EPO* | BlueCard | BlueCard | BlueCard |
| To enroll in Blue Access plans employees can Live/work/reside anywhere in the US. | Blue Access* | BlueCard | BlueCard | BlueCard |
| To enroll in Connection plans employees Can live/work/reside anywhere in the US. | Connection** | BlueCard | BlueCard | BlueCard |
| PPO/EPO & Blue Access Gated (G) plans – employees can live/reside in the 28-county service area.* Connection Gated (G) plans – employees must live/reside in the 9-county service area. |
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| ***Anthem PPO/EPO & Blue Access service area consists of five boroughs, Nassau, Suffolk, Westchester, Rockland, Orange, Putnam, Dutchess, Ulster, Sullivan, Delaware, Clinton, Essex, Albany, Columbia, Fulton, Green, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington counties (other New York areas and national access BlueCard Network). * **Anthem Connection service area consists of five boroughs, Nassau, Suffolk, Westchester and Rockland counties. No network access in Orange, Putnam, Dutchess, Ulster, Sullivan, Delaware, Clinton, Essex, Albany, Columbia, Fulton, Green, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington counties (other New York areas and national access BlueCard Network). |
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Pediatric Dental
ANTHEM |
NEW YORK |
NEW JERSEY |
CONNECTICUT |
NATIONWIDE |
| ANTHEM | Dental Complete | Dental Complete | Dental Complete | Dental Complete |
Pediatric Vision
ANTHEM |
NEW YORK |
NEW JERSEY |
CONNECTICUT |
NATIONWIDE |
| ANTHEM | Blue View Vision | Blue View Vision | Blue View Vision | Blue View Vision |
Telemedicine
- Is available through the Sydney Health mobile app or livehealthonline.com from their computer. Virtual visits are covered at no charge for non-HSA plans, this includes virtual behavioral health visits. HSA plans will be subject to $59 copay towards the deductible for medical visits.
Rx Networks:
- BaseRx Network – Includes Walgreens & Duane Reade
- Advantage Network – Excludes Walgreens & Duane Reade
Prescription Mail Order
- When a member uses CarelonRx to order a 90-day supply of a drug they will pay 2.5 months of copays.
Added Values
- Gym reimbursement – 50 visits per a 6-month period and earn $200
- Spouse/Domestic Partner and Dependents 18+ are also eligible for the $400 gym reimbursement per year
- Acupuncture is a covered benefit
- LASIK benefit:
- Premier LASIK Network – Save on LASIK when you choose a featured provider
- TruVision – save on LASIK eye surgery at over 1,000 locations
- $200 wellness incentives available through the Sydney Health mobile app for
completing certain activities throughout the year (annual physical, mammograms,
health assessments, colonoscopy, etc)
Emblemhealth Overview
EmblemHealth is one of the nation’s largest not-for-profit health insurers, serving more than three million people in New York City and the tristate area. For the past 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, healthcare is more complex than ever. That’s why EmblemHealth remains committed to finding new ways to deliver quality care at affordable prices.
EmblemHealth Medical Plans
Network availability & ELIGIBILITY
EMBLEMHEALTH |
NEW YORK |
NEW JERSEY |
CONNECTICUT |
NATIONWIDE |
| To enroll in Select Care plans employees must live/work/reside in NY. |
Select Care | N/A | N/A | N/A |
Pediatric Dental
EMBLEMHEALTH |
NEW YORK |
NEW JERSEY |
CONNECTICUT |
NATIONWIDE |
| EmblemHealth | Healthplex | Healthplex | Healthplex | N/A |
Pediatric Vision
EMBLEMHEALTH |
NEW YORK |
NEW JERSEY |
CONNECTICUT |
NATIONWIDE |
| EmblemHealth | EyeMed | EyeMed | EyeMed | EyeMed |
Telemedicine
- When a member uses their Teladoc services there is no charge excluding HSA plans there is a $0 copay after the deductible is met. AdvantageCare Physicians Centers are also available to schedule virtual visits. Medly Pharmacy medication delivery service is available at no cost.
Prescription Mail Order
- When a member uses Express Scripts to order a 90-day supply of a drug they will pay 2.5 months of copays. Register on-line at https://www.express-scripts.com
Added Values
- Gym reimbursement – 50 visits per a 6-month period and earn up to $200. The covered spouse earns $100 per 50 visits within a 6-month period.
- Acupuncture is covered for 12 visits
- LASIK benefit:
- Save 15% off the retail price of 5% off the promotional price
OXFORD OVERVIEW
Oxford serves millions of people from their earliest years through their working lives and into retirement. What unites them is their mission to help people live healthier lives and make the health system work better for everyone.
Oxford is working to play their part in creating a more sustainable healthcare system: one that works better for everyone.
Oxford Medical Plans
Network availability & ELIGIBILITY
Oxford |
NEW YORK |
NEW JERSEY |
CONNECTICUT |
NATIONWIDE |
| Liberty plans – employees can live anywhere in the continental US. | Liberty^ | Liberty | Liberty | Core |
| Freedom plans – employees can live anywhere in the continental US. | Freedom^^ | Freedom | Freedom | Choice Plus |
| Metro plans – employees must live/work in NY and NJ. | Metro^^^ | Metro | N/A | N/A |
| ^Oxford Liberty service area consists of five boroughs, Nassau, Suffolk, Westchester, Rockland, Orange, Putnam, Dutchess, Ulster and Sullivan counties (other New York areas and national access Core Network). ^^Oxford Freedom service area consists of five boroughs, Nassau, Suffolk, Westchester, Rockland, Orange, Putnam, Dutchess, Ulster and Sullivan counties (other New York areas and national access Choice Plus Network). ^^^Oxford Metro service area consists of five boroughs, Nassau, Suffolk, Westchester, Rockland, Orange, Putnam, Dutchess, Ulster and Sullivan counties. |
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Pediatric Dental
Oxford |
NEW YORK |
NEW JERSEY |
CONNECTICUT |
NATIONWIDE |
| Oxford | National Options PPO 20 | National Options PPO 20 | National Options PPO 20 | National Options PPO 20 |
Pediatric Vision
Oxford |
NEW YORK |
NEW JERSEY |
CONNECTICUT |
NATIONWIDE |
| Oxford | UnitedHealthcare Vision Network | UnitedHealthcare Vision Network | UnitedHealthcare Vision Network | UnitedHealthcare Vision Network |
Telemedicine
- Oxford – Members can access virtual doctor visits on myuhc.com or through the UnitedHealthcare mobile app. Virtual visits are covered at no charge excluding HSA plans have a $49 charge per virtual visit and no charge after deductible.
Prescription Mail Order
- When a member uses OptumRx to order a 90-day supply of a drug they will pay 2.5 months of copays. Register on-line at https://www.optumrx.com
Added Values
- The covered spouse and eligible dependents (age 13 and older) earn $100 for 50 visits per 6-month period
- Rewards Core – all plans except Liberty Motion (M) plan members can earn up to $300/year for reaching program goals and completing one-time reward activities
- Rewards Premium – Liberty Motion (M) members can earn up to $1,000/year for reaching program goals and completing one-time reward activities. Rewards deposited
directly into health savings accounts or used toward a Visa® gift card - Real Appeal – a personalized coach to help guide and customize steps to fit weight loss, personal preferences, medical history and goals. 24/7 online support
- One Pass Select – a subscription-based fitness and well-being program that supports a healthier lifestyle.
- Access to thousands of gyms, no long-term contracts or annual registration fees
- Flexible fitness options & ability to use locations nationwide (not limited to 1 gym/1 city)
- Add up to 4 family members (18+), 10% monthly discount & can change tiers monthly
UnitedHealthcare Overview
UnitedHealthcare’s wide range of plans offer a whole-person approach to health with benefits like wellness programs, behavioral health support and care management services.
UnitedHealthcare Medical Plans
Network availability & ELIGIBILITY
UnitedHealthcare |
NEW YORK |
NEW JERSEY |
CONNECTICUT |
NATIONWIDE |
| Choice plans – employees can live anywhere in the continental US. | Choice | Choice | Choice | Choice |
Pediatric Dental
UnitedHealthcare |
NEW YORK |
NEW JERSEY |
CONNECTICUT |
NATIONWIDE |
| UnitedHealthcare | National Options PPO 20 | National Options PPO 20 | National Options PPO 20 | National Options PPO 20 |
Pediatric Vision
UnitedHealthcare |
NEW YORK |
NEW JERSEY |
CONNECTICUT |
NATIONWIDE |
| UnitedHealthcare | UnitedHealthcare Vision Network | UnitedHealthcare Vision Network | UnitedHealthcare Vision Network | UnitedHealthcare Vision Network |
Telemedicine
- Members can access virtual doctor visits on myuhc.com or through the UnitedHealthcare mobile app. Virtual visits are covered at no charge excluding HSA plans have a $49 charge per virtual visit and no charge after deductible.