Health Care ReformNotifications
Please read this notice carefully and keep it where you can findit.
PatientProtectionandAffordableCareActthatwasrecentlypassedandprovidesyouwithimportantinformationthatyouneed to know. Please read this information carefully and contact your HR Department for furtherclarification.
PatientProtection
ThePlangenerallyallowsthedesignationofaprimarycareprovider,butitisnotrequired.Youhavetherighttodesignateanyprimary care provider who participates in our network and who is available to accept you or your family members. Forinformationonhowtoselectaprimarycareprovider,andforalistoftheparticipatingprimarycareproviders,pleasecontactthecustomerservice phone number on your medical IDcard.
Forchildren, youmaydesignateapediatricianastheprimarycareprovider,butitisnotrequired.
YoudonotneedpriorauthorizationfromAnthemorfromanyotherperson(includingaprimarycareprovider)inordertoobtainaccess to obstetrical or gynecological care from a health care professional in our network who specializes in obstetricsorgynecology.Thehealthcareprofessional,however,mayberequiredtocomplywithcertainprocedures,includingobtainingpriorauthorizationforcertainservices,followingapre-approvedtreatmentplan,orproceduresformakingreferrals.Foralistofparticipatinghealthcareprofessionalswho specializeinobstetricsorgynecology,pleasecontactthecustomerservicephonenumberon your medical IDcard.
Non-Grandfathered PlanNotice
This Plan is a “non-grandfathered health plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act)andwill a comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limitsonessentialbenefits.
Questionsregardingwhichprotectionsacanbedirectedtotheplanadministrator.YoumayalsocontacttheEmployeeBenefitsSecurity Administration, U.S. Department of Labor at 1-866-444-3272 or This website has atablesummarizingwhichprotectionsdoanddonotapplytograndfatheredandnon-grandfatheredhealthplans.
Notice Lifetime Limit No Longer Applies and EnrollmentOpportunity
Thelifetimelimitonthedollarvalueofbenefitsunderthe grouphealthplannolongerapplies.
Notice of Extension of Dependent Coverage to Age26
Thelimitingageforeligiblechildrenhasbeenextendedtoage26.Coveragewillterminatetheendofthemonthfollowingthe26thbirthday.
Notice of Pre-ExistingCondition
EffectiveJanuary1,2015,thegroupmedicalplanhaseliminatedthePre-ExistingConditionClauseforallplanparticipantsincluding new hires entering the plan on January 1,2015.
Health CareReformOctober2015