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Plan Rates and Summaries for COBRA and Early Retirees

Plan Rates and Summaries

2019 COBRA and Early Retire Monthly Plan Rates

2019 Plan Comparison - This document includes information related to office visits, inpatient, ER, urgent care, wellness and prevention and medicine as they relate to each plan.

2019 Maximum Exposure Calculations - Please note these examples assume employee takes advantage of the Non-Tobacco Use Incentive and costs are incurred within the Anthem provider network.

Wellness CDHP

CDHP 1

CDHP 2

Traditional PPO

Prescription Coverage

Dental

Vision

Federal Notices

Notice regarding Medicaid and the Children’s Health Insurance Program (CHIP)

CMS Creditable Coverage Notice

USERRA (Military Leave) Notice

HIPAA Notice of Privacy Practices

NEWBORNS’ AND MOTHERS’ HEALTH PROTECTION ACT OF 1996

WOMEN’S HEALTH AND CANCER RIGHTS ACT OF 1998

HIPAA NOTICE OF SPECIAL ENROLLMENT RIGHTS

Notice Regarding Wellness Program

Nondiscrimination Notice