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2016 Page 5
Places for People, Inc.
2016 Annual Enrollment
Medical Plan Cost Sharing
Below are the employee
monthly
costs associated with each medical plan option being offered effective January 1,
2016. Places for People will continue to pick up the majority of the employee and dependent cost in the H.S.A. Plan. If
you choose to participate in the PPO Plan or PPO High Deductible Plan, you will pick up more of the cost.
Places for People will also continue to provide an annual tobacco-free premium discount to employees who certify that
they and any of their dependents who are enrolled in our health plan, are “tobacco-free”. A Tobacco Usage Affidavit
(attached) must be completed and returned to Human Resources prior to
December 12, 2015
to receive the tobacco
free premium discount.
Remember, as an Anthem participant, you will now have access to over-the-counter smoking cessation medications at
no cost to you when:
You are 18 years of age or older and enrolled in a Anthem medical plan.
The medication is prescribed by a physician.
The physician obtains prior authorization confirming you are participating in tobacco cessation counseling.
You fill the medication at a network pharmacy.
If the over-the-counter medications fail to be effective, Anthem will also cover buproban and Chantix at no cost.
Type of
Coverage
2016
Employee
Non-Smoker
2016
Employer
Cost
2016
Employee
Smoker
Employee
$162.07
$319.28
$178.28
Employee &
Spouse
$309.21
$609.15
$340.14
Employee &
Child(ren)
$270.56
$533.01
$297.62
Employee &
Family
$425.18
$837.60
$467.69
Anthem PPO High Deductible Plan
Anthem PPO Plan
Type of
Coverage
2016
Employee
Non-Smoker
2016
Employer
Cost
2016
Employee
Smoker
Employee
$86.88
$364.69
$95.57
Employee &
Spouse
$165.76
$695.79
$182.34
Employee &
Child(ren)
$145.04
$608.82
$159.55
Employee &
Family
$227.92
$956.71
$250.72
Anthem H.S.A. Plan
Type of
Coverage
2016
Employee
Non-Smoker
2016
Employer
Cost
2016
Employee
Smoker
Employee
$41.01
$385.30
$45.11
Employee &
Spouse
$117.37
$695.97
$129.10
Employee &
Child(ren)
$102.70
$608.98
$112.97
Employee &
Family
$161.38
$956.99
$177.52