Medical & Prescription
Connection Pointe Christian Academy offers a comprehensive benefits program to help you and your family protect your health and financial security. Your benefits are a valuable part of your compensation; we encourage you to learn how your medical plans work so you can get the most from them.
Watch this video to learn more about HDHP plan
Medical Highlights
Base HDHP
Network
Blue Access
Type of Deductible
Embedded
Plan Year Deductible (Individual / Family)1,2
$5,000 / $10,000
Your Coinsurance (Individual / Family)
0%
Out-of-Pocket Maximum (Individual / Family)
$6,900 / $13,800
Physician Visit (Specialist)
Deductible then$30/$50 Copay
Preventive Care Services3
Covered 100%
Emergency Room Visit
Deductible then $250
Urgent Care Visit
Deductible then $75
Buy-Up HDHP
Network
Blue Access
Type of Deductible
Embedded
Plan Year Deductible (Individual / Family)1,2
$3,300 / $6,600
Your Coinsurance (Individual / Family)
0%
Out-of-Pocket Maximum (Individual / Family)
$4,000 / $8,000
Physician Visit (Specialist)
Deductible then $30/$50 Copay
Preventive Care Services3
Covered 100%
Emergency Room Visit
Deductible then $250
Urgent Care Visit
Deductible then $75
Out-of-Network
Plan Year Deductible (Individual / Family)
$15,000 / $30,000
Your Coinsurance
30%
Out-of-Pocket Maximum (Individual / Family)
$20,700 / $41,400
Out-of-Network
Plan Year Deductible (Individual / Family)
$9,900 / $19,800
Your Coinsurance
30%
Out-of-Pocket Maximum (Individual / Family)
$12,000 / $24,000
- All covered services are subject to the deductible except Preventive Care services.
- Plan year deductible runs on calendar year.
- Preventive Care services include but are not limited to routine wellness exams, pelvic exams, pap testing, PSA tests, immunizations, annual diabetic eye exam, and routine vision and hearing exams rendered in a physician's office and outpatient service centers.
Both medical plan options are embedded. An embedded deductible means that each person covered on the plan (employee, spouse, child) has a personal deductible. When each personal deductible is met, coverage begins for that individual only.
Questions about your medical benefits? Anthem Customer Service: (800) 295-4119, www.anthem.com
Download the Anthem Sydney App on your tablet or mobile device
WHAT IS A...
Deductible: Amount you have to pay for a covered medical expense before your coinsurance kicks in.
Coinsurance: A percentage of the claim amount you pay (after your deductible is met), while your insurance plan pays for the rest. For example: You pay 0% and the plan pays 100%.
Copay: Fixed fee you may need to pay for healthcare services (i.e., office visits, prescriptions).
Out-of-Pocket Maximum: You will not have to pay more than this amount during your plan year – once you reach it, your insurance plan will cover all additional expenses.
Rx Highlights (CarelonRx)
Base HDHP
Retail Pharmacy (30 day supply)
Generic1
Level 1: Deductible, then $10 Level 2: Deductible, then $20
Brand Name Formulary1
Level 1: Deductible, then $35 Level 2: Deductible, then $45
Brand Name Non-Formulary1
Level 1: Deductible, then $75 Level 2: Deductible, then $85
Specialty Medication1
Level 1: Deductible, then 25% up to $350 Level 2: Deductible, then 25% up to $450
Mail-Order Pharmacy (90 day supply)
Generic1
Deductible, then $20
Brand Name Formulary1
Deductible, then $88
Brand Name Non-Formulary1
Deductible, then $188
Specialty Medication1
Deductible, then 25% up to $350
Buy-Up HDHP
Retail Pharmacy (30 day supply)
Generic1
Level 1: Deductible, then $10 Level 2: Deductible, then $20
Brand Name Formulary1
Level 1: Deductible, then $35 Level 2: Deductible, then $45
Brand Name Non-Formulary1
Level 1: Deductible, then $75 Level 2: Deductible, then $85
Specialty Medication1
Level 1: Deductible, then 25% up to $350 Level 2: Deductible, then 25% up to $450
Mail-Order Pharmacy (90 day supply)
Generic1
Deductible, then $20
Brand Name Formulary1
Deductible, then $88
Brand Name Non-Formulary1
Deductible, then $188
Specialty Medication1
Deductible, then 25% up to $350
- Once deductible is met, you will be responsible for the copay amount until your total expenses have reached the out of pocket maximum.
Level 1 Pharmacies: CVS, Walmart, Target and Kroger.
Level 2 Pharmacies: Costco, Sam’s Club, Meijer, Walgreens and Rite Aid.
Medical Contributions
(Based on 24 pay periods per year)
Employee Only
Base HDHP: $69.50
Buy-Up HDHP : $113.50
Employee + Spouse
Base HDHP: $161.50
Buy-Up HDHP: $255.00
Employee + Children
Base HDHP: $138.50
Buy-Up HDHP $218.00
Employee + Family
Base HDHP: $222.00
Buy-Up HDHP: $352.00
QUESTIONS? CALL THE CARE LINE
Care Line is an NFP-sponsored program that is staffed by dedicated professionals to help you understand the benefit options made available to you. Whether you have concerns about a recent claim or bill, finding an in-network doctor or just some guidance on which medical plan is right for you and your family, the Care Line can help educate and advocate. The Care Line is available to all employees and children over 18 who are enrolled on the benefit plan.
Contact the Care Line at (844) 717-8777, or you can submit your questions via email at support@callthecareline.com.
The Care Line is open Monday - Friday from 8:00am - 5:00pm (EST).