Skip Ribbon Commands
Skip to main content

Benefits

:

Medical Insurance

​​

Medical Insurance 

Albemarle County employees can choose from two medical insurance plan options that are administered by Anthem of Virginia. With Anthem, members have access to a nationwide network and services like educational videos, web-based cost comparison tools, mobile apps and online physician consultations that give members 24-hour a day access to a physician at one low flat fee. Medical coverage is available for the eligible employee and their eligible spouse and children under age 26.   Learn more about eligibility criteria here.  

 
Both plans cover the same services - what varies are the monthly premiums and out of pocket costs for services rendered. Each plan has an annual maximums that limit your out of pocket costs if you have significant health care expenses during the year. 
 
Our plan year runs from October 1st through September 30th.
 
The Select and Choice plan options provide:
  • outpatient, inpatient, and major medical coverage
  • preventive care
  • prescription benefits
  • vision benefits
For new hires, coverage is effective the first of the month following your date of hire. Employees enrolling for the first time ever in County medical insurance will receive a one-time benefit of the first month of coverage free!  Non-benefits-eligible employees who subsequently become eligible and those who previously declined coverage will be treated the same as new employees regarding coverage start date and premium payments.  Employees who are re-enrolling in County medical insurance will be required to pay the premium for the first month of coverage.  Medical and dental premiums are paid in advance of the month of coverage. 
 
Does your spouse also work for the County or County Schools? Two married benefits-eligible employees qualify for reduced or free health coverage! Please inform HR in order to receive your discount.
 
Summary of Options for the 2017-2018 Plan Year
·         Albemarle Select is a traditional PPO insurance plan that features co-pays for provider visits and pharmacy. For services like labs, xrays, procedures, ER visits and hospitalizations, the plan pays at 80% after you meet the plan year deductible
 
·         Albemarle Choice is a Consumer Driven High Deductible plan that comes with an HSA (Health Savings Account).  A Consumer Driven Health Plan gives you as a consumer more choice as to how you spend your health care dollars. This plan features lower monthly premiums than a traditional health insurance plan, but higher out of pocket costs when you seek services. The Health Savings Account that is offered with this Consumer Driven Health Plan is an account that can be used to pay those higher out of pocket costs. This account features an employer contribution, but you can also contribute to this plan – to pay eligible out of pocket costs, or to save for future retiree medical expenses.
 
If you’re not familiar with Consumer Driven High Deductible Plans or HSAs, here are some details:
 
workingtogetherfor you.png
howtheyworktogether.png
Pay yourself first! Take your premium savings and put those funds into your HSA:
 
payyourselffirst.png 
 
 
By selecting an HSA-powered plan with a higher deductible, you are qualified to contribute tax-free* money into a health savings account (HSA). Your HSA funds can then be used tax-free to pay for qualified medical expenses. In addition, your HSA deposits earn tax-free interest and carry over from year to year, even if you change jobs or retire. Because HSA-powered health plans cost less than traditional plans, the money saved can be used to contribute to your HSA.
 
HSA eligibility
 
To make tax-free* deposits to an HSA, the IRS requires that:
·         you are covered by an HSA-qualified health plan
·         you have no other health coverage (such as other health plan, Medicare, military health benefits, medical FSAs)
·         you are not claimed as a dependent on another individual's tax return
 
Want to know more about HSAs? We’ve got a lot of great information on our HSA info page.

How to choose a plan
Once you understand the plans and how they work, compare the plans’ out of pocket costs:
Comparing out of pocket costs.JPG 

Next, compare the rates 
 
The following rates (full-time, 12-pay schedule) will be effective as of March 1, 2018:
2017/2018 Plan Year (Medical)
Select
Choice
Employee
$86
$15
Employee + Child
$129
$50
Employee + Children or Spouse
$260
$134
Family
$330
$179
* Rates shown for full-time employee on a 12-pay schedule.​ ​ ​
 NOTE:  For COBRA, Retiree, Career Leave, and Leave of Absence rates, please see the appropriate rates document in the "Medical Documents" section (on the right-hand side of the page). If you are a part-time employee, use the Insurance Premium Estimator to calculate your rates.  If you are newly enrolling in the plan, we suggest verifying your premium costs with payroll if you are not a full-time 12-month employee.
Now, decision time!
There’s no one plan that’s best for everyone. Deciding between your options doesn’t have to be difficult if you consider:
·         Who are you planning on covering - just you, or others?
·         How do you and your covered dependents use medical benefits – frequently, or not that often?
·         What is the maximum annual out of pocket cost you’ll be responsible for?
·         Do you prefer to pay higher monthly costs in order to pay lower out of pocket costs if/when you seek services OR do you prefer to pay lower monthly rates and then pay higher out of pocket costs  if/when you seek services?
·         Don’t forget to factor in any employer HSA contributions you might receive
 
 
One more thing…. FSA (Flexible Spending Accounts):
If you typically have medical or dental expenses during the year, an FSA (Flexible Spending Account) is a smart way to use pre-tax dollars to pay for those eligible expenses. With an FSA, you have a monthly voluntary pre-tax salary reduction contributed into your FSA and then you use those pre-tax dollars to pay for medical and dependent care expenses that would otherwise be paid for with after-tax dollars. Our medical FSAs feature a convenient debit card.  Want to learn more? Visit our FSA info page HERE.
 
 
We offer medical and dental coverage to regular employee who work at least 50% of the full time schedule for their position (e.g., full-time teachers work 7.25 hours per day; a part-time teacher would need to work at least 3.63 hours per day to be eligible for medical/dental coverage. Definition of eligible dependents:
·         Your spouse (to whom you are currently, legally married) who does not have access to affordable medical coverage under his/her own employer (See Below *)
·         Your natural children, children of your current spouse, legally adopted children, or those for whom you have legal custody/guardianship (including eligible foster children) under the age of 26
·         Certain disabled dependents over the age of 26 (subject to eligibility criteria)   
 
*Spousal Eligibility:  Spouses who have access to “affordable” medical coverage that provides "minimum essential value" under their own employer’s plan will no longer be eligible for coverage on our medical plan*. The only spouses who are eligible for coverage on our medical plan are those who:
  • Do not have access to “affordable” coverage that provides “minimum essential value” through their own employers (see explanation below); or
  • Are spouses who are employed by Albemarle County Schools or Local Government divisions
*Please note that the eligibility criteria does NOT apply to the following:
  • Dental plan coverage
  • Eligible dependent children you wish to cover on your medical plan
  • Spouses who are Medicare-eligible and do not have other employer coverage
 
How do I figure out if my spouse has "affordable" medical coverage?  Please visit our affordability calculator here.  Check with your spouse’s employer to determine if their employer-sponsored coverage meets the "minimum essential value" standard. If either the affordability standard OR the minimum essential value standard is not met, your spouse remains eligible for coverage on the Albemarle County Plan.
 
 
 
 
 
**IMPORTANT NOTICES**
  • Augusta Medical Center back in Anthem network as of July 1st (Augusta Medical Group [doctors] return still in progress).  Please click here for full details.

Medical Links
  
  
  

Medical Documents

  
  
Albemarle Choice Plan Benefits Summary 2019.pdfAlbemarle Choice Plan Benefits Summary 2019
Albemarle Choice Plan FAQ.pdfAlbemarle Choice Plan FAQ
Albemarle Choice Plan SBC (Summary of Benefits and Coverage) 2019.pdfAlbemarle Choice Plan SBC (Summary of Benefits and Coverage) 2019
Albemarle Select and Choice Plans Find a Doc Guide.pdfAlbemarle Select and Choice Plans Find a Doc Guide
Albemarle Select Plan Benefits Summary 2019.pdfAlbemarle Select Plan Benefits Summary 2019
Albemarle Select Plan SBC (Summary of Benefits and Coverage) 2019.pdfAlbemarle Select Plan SBC (Summary of Benefits and Coverage) 2019
Anthem Care Comparison.pdfAnthem Care Comparison
Anthem Getting Started With Home Delivery Rx.pdfAnthem Getting Started With Home Delivery Rx
Anthem Medical Enrollment Change Form.pdfAnthem Medical Enrollment Change Form
Anthem Preventive Care Information.pdfAnthem Preventive Care Information
BlueCard Worldwide (care outside of the US).pdfBlueCard Worldwide (care outside of the US)
BlueVision Benefits.pdfBlueVision Benefits
Employee Spousal Affidavit.pdfEmployee Spousal Affidavit
Full Medical and Dental Benefits Guide.pdfFull Medical and Dental Benefits Guide
Health Care Reform and Your Albemarle County Benefits.pdfHealth Care Reform and Your Albemarle County Benefits
HIPAA Privacy Notice.pdfHIPAA Privacy Notice
HSA Member Guide.pdfHSA Member Guide
HSA Payroll Deduction Form.pdfHSA Payroll Deduction Form
Keycare PPO Anthem.com Find A Doctor instructions (PPO  HDHP).pdfKeycare PPO Anthem.com Find A Doctor instructions (PPO HDHP)
Medical Plan Highlights Side By Side Comparison 2019.pdfMedical Plan Highlights Side By Side Comparison 2019
PreventiveRX Drug List.pdfPreventiveRX Drug List
Rates  - COBRA, Retirees, Career Leave, LOA.pdfRates - COBRA, Retirees, Career Leave, LOA
Rates - Active Employees.pdfRates - Active Employees
Winning with an HSA.pdfWinning with an HSA

 

Contact Information

Anthem Customer Service (M-F 8:30-6:00; Sat. 9-1):

  • Albemarle Select (Traditional) Plan members: 1-800-445-7490
  • Albemarle Choice (Consumer Driven High Deductible with HSA) Plan members:  1-800-582-6941

Human Resources:

Phone: 434-296-5827
Email:  Benefits