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MEDICAL PACKAGE Anthem Logo

Prince William County†Schools (PWCS) provides health insurance to employees and dependents under one program.† Anthem Blue Cross/Blue Shield is the medical insurance carrier.†Employees who work at least 17 1/2 hours per week are eligible.†

The package includes:

Anthem Blue Cross and Blue Shield (BCBS) Medical Insurance

Prescription Drug Plan

Blue View Vision

Preventive Health Benefits


There are three (3) BCBS health insurance plans to choose from:††
  • Anthem Healthkeepers
  • Anthem KeyCare Enhanced
  • Anthem KeyCare Core

Referrals: Keycare Enhanced and KeyCare Core use the same PPO network and do not require referrals to specialists. Healthkeepers HMO costs the least in premiums, but requires the use of a designated primary care physician and referrals.

Prescription Drugs:

Effective July 1, 2016† all health plans will include the
prescription drug plan through WelldyneRX.

31 Day Supply: Retail: $10 Generic; $35 Brand; $70 effective High-Cost Brand

90 Day Supply:
Pharmacy/Retail: $30 Generic; $105 Brand;†††† $210 High-Cost Brand

Mail Order $20 Generic; $70 Brand;
$140 High-Cost Brand

Summary of Benefits and Coverage (SBC)
As part of the Affordable Care Act, group health plans are required to provide employees with a short, easy to understand, summary of health benefits and coverage options. The format of the SBC is standardized so that information is comparable across different plans. Please click on the plan listed below to view the information. Electronic versions are available below:††

Blue View Vision: Provides participants with routine eye care.

Premiums: Health, dental, and vision insurance premiums are automatically withheld pre-tax through payroll deduction.

Eligible dependents for PWCS' benefits include:

  • your legal spouse,
  • your biological children, stepchildren, adopted children (or children placed for adoption), and children for whom you have been appointed legal guardian or granted legal custody and who are under the age of 26 (special provisions apply for disabled children).†
PWCS requires documentation demonstrating all insured dependents meet the eligibility criteria.† Please click hereto view the required documents. You have 30 calendar days from your hire/re-hire date (or date of status change or qualifying event) to submit your enrollment forms and applicable documentation before coverage becomes effective.

Lost your ID card?† Newly enrolled and haven't received your card yet?† You can go to www.anthem.com and print out a soft copy of your ID†card using the attached instructions.† You must register with the website and know your ID†card number to print your card.
ENROLLMENT/CANCELLATION
TIME-LINE
  • Employees have 30 days from their hire date to enroll in the health package. All employees will be required to sign a Health Insurance Acknowledegment at the New Employee Orientation.
  • Annual open enrollment - April 15 to May 15 effective July 1 of each year.
  • Within 30 days of a family status change such as birth or adoption of a child, marriage, death of spouse, change in employment, or involuntary termination of spouse's/child(ren) health insurance coverage.
ADDITIONAL PLAN INFORMATION
COBRA

Employees and families who lose health insurance because they are no longer eligible for coverage under Prince William County Public Schools health insurance program may continue coverage by paying the full monthly premium plus two percent. Employees who lose coverage because of termination of employment (except for gross misconduct) or reduction in hours may continue an additional 18 months. Covered spouses and dependents may also continue coverage usually for an additional 36 months if they lost coverage for spouse/parent's death, divorce, or, when a covered child has reached the maximum age limit for coverage under the parent's policy. To continue coverage, the Prince William County Public Schools Office of Benefits and Retirement Services must be contacted no later than 60 days from when coverage ceased.

Warning! This Web page may contain links to one or more Web sites outside the PWCS network, which are not PWCS venues and may not reflect the views or opinions of PWCS. PWCS does not control the content of such Web sites and does not sponsor or endorse any messages, products, or services contained on such Web sites.

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