Employee Benefits
Healthcare Benefits





   

2014 - Health Care Assistance Plan (HCAP) Document
2014 - Summary of Benefits and Coverage (SBC)​


   

2014 - ARM Rewards Milestones



 

Medical: Independence Blue Cross

Medical Preferred Provider Organization (PPO) network, provider search, review paid claims, benefits summary, print temporary ID card &/or request new one.
Member Services (888) 276-4732 or email Healthcare@adventistrisk.org


   

Prescription: Express Scripts (Medco)

Prescription PPO network retail & mail order, provider search, review paid claims, benefits summary.
Member Services (888) 276-4732 or email Healthcare@adventistrisk.org



 

Dental: United Concordia

Dental PPO network, provider search, review paid claims history, benefits summary, member services.
Member Services (888) 276-4732 or email Healthcare@adventistrisk.org

   

Vision Benefits:

No PPO network required, review paid claims history, print Red ID card &/or request new one.
Member Services (888) 276-4732 or email Healthcare@adventistrisk.org

   

Other Benefits:

Chiropractic, Acupunture, Massage,
Refractive Eye Surgery, Hearing Aids

No PPO network required, review paid claims history, print Red ID card &/or request new one.
Member Services (888) 276-4732 or email Healthcare@adventistrisk.org



0

Major Medical

Preventive Services per Schedule paid at 100%

Other Services         
Co-Pay                  
Office Visit - $20                  
Emergency Room - $50         
Deductible:  $250/$500
Out-of-Pocket:                            
80%/20%                           
In Network $2,000/$4,000                           
Out-of-Network $4,500/$9,000


0

Dental

Preventive Services per Schedule paid at 100%
Restorative Services paid 80%/20%
Network available, but utilization not required
Claims paid per contracted rate whether in or out of network
Plan Year Maximum payable $3,000/$9,000
0

Prescription

Copays – Generic/Brand/Non-Preferred
Retail (30-day supply) - $10/$15/$25
Mail (90-day supply) - $20/$30/$50
Plan Year Maximum out-of-pocket $400/$800
0

Vision

Vision exams, glasses, contacts
Paid at 80%/20%
Plan Year Maximum payable $560
1

Alternative Therapies

  •  Massage – paid at 50%/50% (maximum allowable charge $90) 
  •  Chiropractic & acupuncture paid at 80%/20% 
  •  30 visit limit per therapy type – collectively 45 visit limit 
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