Dental, vision and life products for California
Complement your health coverage with other valued benefits.
A complete benefits package for your business
For groups with 2-50 employees
21736CAEENABC Rev. 09/14 21736CAEENABC Rev. 09/14
A single solution that
works smarter
When you add dental, vision and life benefits to your health plan, you get a
comprehensive benefits program that works smarter. Our enhanced dental,
vision and life benefits deliver more to improve the overall health of your
business and employees.
Dental
Anthem1 is a leader in the dental benefits business, with more than 40 years of experience. Together with our sister companies, we handle more than 70,000 groups and manage plans for more than 8 million people.
For dental selections, see page 3.
Vision
Blue View VisionSM membership has grown to more than 4 million people in just a few years.1 This is because of our great plans and service.
For a closer look at vision, see page 10.
Life
We are the #1 group life insurance carrier in the
under-100 employee market.2 We’re rated “A (Excellent)” for financial strength by A.M. Best Company. And we have “best in class life insurance claim payment turnaround time.” Our claim turnaround time is among the fastest in the industry — usually within two days.3
2
Dental coverage
From Anthem Blue Cross Life and Health Insurance Company and Anthem Blue Cross
We have the right dental plans for your
unique needs
Choosing a dental plan for your employees is all about balance. Cost matters. But so does your employees’ health. That’s why you have choices with Anthem dental. We’ll help you find the right mix of benefits that can have the best impact on your employees’ health. And no matter which dental plans you choose, you can count on:
Solid coverage at a good price.
Benefits that make sense for dental health — and total health.
Service you can trust.
Strong network access.
Preventive dental services
When employees take care of their teeth and go to the dentist for regular checkups, they can protect their overall health. These services can help find dental and other health problems early on. In fact, more than 90% of all diseases show signs and symptoms in people’s mouths.4 That’s why most of our Dental Prime, Dental Complete, Dental Blue® and Dental Net® plans cover routine cleanings, exams and X-rays at 100% at network dentists. Other preventive services include:
Special treatments for kids. We cover sealants for children up to age 15 and fluoride treatments up to age 18 — to protect teeth from decay and promote better dental health.
Brush biopsy benefits. A brush biopsy may help diagnose oral cancer when combined with a lab analysis and a surgical biopsy with lab analysis.
Extra services for members who are pregnant or living with diabetes. We offer an extra cleaning or periodontal maintenance procedure each year for members who are pregnant or living with diabetes.
Great dental plans to choose from
With a wide variety of dental PPO and DHMO plans to choose from, it’s easy to find a dental plan to fit your company’s and your employees’ needs. All of our dental plans include value-added member support services, including:
Easy-to-access information: We give your employees 24/7 online access to their claim and benefit information.
International Emergency Dental Program:5 Members who travel outside of the U.S. have access to emergency dental services. With one call, we’ll help them find a credentialed, English-speaking dentist for urgent dental care. We can even help them with translation services when they call the dentist’s office. Services received through this program do not count toward the member’s annual maximum, if their plan has one.
Dental health materials: These helpful pieces focus on teaching members the importance of dental health.
Dental Prime and Dental Complete plans —
designed for better health
When we created the new Dental Prime and Dental Complete plans, we made sure they could be custom fit to your needs. That means lots of choices in coverage, including options for:
Coverage for dental implants and composite (tooth-colored) fillings
on any tooth.
Optional orthodontic benefits for kids and adults.
Optional annual maximum carryover feature.
Dental networks that work hard for you
Dental Prime and Dental Complete members have access to one of the nation’s largest dental networks through the national Dental GRID.6 The national Dental GRID links dental networks, including the dental network of many of the nation’s Blue plans, and includes dentists in all 50 states — so your employees can find a dentist wherever they live or visit.
Dental Prime members have access to the GRID network, a deep-discount network (for the best savings) with more than 17,600 unique dentists (more than 30,000 access points) in California. This network has nearly 64,000 unique providers nationwide.
Dental Complete members have access to the GRID+ network, a broad network (for the most access) with more than 16,200 unique dentists (more than 36,000 access points) in California. This network has more than 85,700 unique providers nationwide.
What are unique dentists and access points?
Some carriers count “access points.” This means they count each dentist at each location he or she practices at — even if they go to a location once or twice a year. For example, if one dentist works at two different offices, that dentist has two access points. We recommend comparing unique dentists because each dentist is counted only once. That gives you a more accurate picture of how many dentists are available to see your employees.
Affordability is key, too
Our flexible dental plan designs fit into ourValue, Classic andEnhanced
categories. That way you can choose the level of benefits that fit your needs and budget.
Plus, we also offer voluntarydental plans so you can offer dental coverage to your employees without adding to your expenses. And, our voluntary dental plans are available when you keep at least five enrolled employees.
Dental Prime and
Dental Complete
4 * Carryover is included with the Classic Complete CA-2R option only. All above dental plans include brush biopsy and an additional cleaning for pregnant and diabetic members.
This chart is an overview of coverage. A comprehensive description of coverage, benefits, exclusions and limitations can be found in the Combined Evidence of Coverage and Disclosure Form.
Value
Plan Calendar-year
maximum Deductible
Coinsurance for diagnostic and
preventive/basic/major periodontic and oral Endodontic, surgery services
Posterior
composites Orthodontia
Out-of-network reimbursement level In-network Out-of-network
Value Complete CA-1A $1,000 $50/$150 100/80/0 100/80/0 Basic Yes No 80th
Classic Plan Calendar-year maximum Deductible
Coinsurance for diagnostic and
preventive/basic/major periodontic and oral Endodontic, surgery services
Dental implants posterior composites
Orthodontia reimbursement levelOut-of-network In-network Out-of-network
Classic Complete CA-2A $1,000
$50/$150 100/80/50 80/60/50
Major
Yes
No 80th
Classic Complete CA-2S
$1,500
Basic
Classic Complete CA-2G
No
Classic Complete CA-2K $2,000 90th
Classic Complete CA-2L $1,000
$50/$150 100/80/50 100/80/50 Basic
Yes No
90th
Classic Complete CA-2N
$1,500
80th
Classic Complete CA-2Q Child and adult
Classic Complete CA-2E
No
No
80th
Classic Complete CA-2F
90th
Classic Complete CA-2R *
Yes
Classic Complete CA-2M
Classic Complete CA-2P Child only
Classic Complete CA-2J
$2,000 No No 80th
Classic Complete CA-2H 90th
Enhanced
Plan Calendar-year
maximum Deductible
Coinsurance for diagnostic and
preventive/basic/major periodontic and oral Endodontic, surgery services Dental implants posterior composites Orthodontia Out-of-network reimbursement level In-network Out-of-network
Enhanced Complete CA-3A
$2,000
$50/$150 100/90/60
100/80/50
Basic Yes
No 80th
Enhanced Complete CA-3B Child and adult 90th
Enhanced Complete CA-3E $2,500 No 80th
Enhanced Complete CA-3C $2,000
100/90/60 No 90th
Enhanced Complete CA-3D $2,500
Voluntary
Plan Calendar-year
maximum Deductible
Coinsurance for diagnostic and
preventive/basic/major periodontic and oral Endodontic, surgery services Dental implants posterior composites Orthodontia Out-of-network reimbursement level In-network Out-of-network
Voluntary Prime CA-4A
$1,500 $50/$150 100/80/50 80/60/50 Major Yes No 80th
Our menu of dental plan options offers more flexibility
On many of our dental plans you can choose the annual deductible and benefit maximum. And you can pick whether to include orthodontic coverage or our annual maximum carryover feature. Plus, you can choose your plan’s level of out-of-network reimbursement:
1. 80th percentile of FAIR Health. This means the amount we pay for a service is equal to or greater than 80% of the charges for that service in a given ZIP code, based on data collected by FAIR Health, a third-party vendor.
2. 90th percentile of FAIR Health. This means the amount we pay for a service is equal to or greater than 90% of the charges for that service in a given ZIP code, based on data collected by FAIR Health, a third-party vendor.
3. MAC fee schedule. This is an affordable option when your employees see out-of-network dentists.
How the annual maximum carryover feature works
When you include the annual maximum carryover feature in one of our Dental Prime or Dental Complete plans, your employees can carry over unused benefit dollars to the next plan year. Here are the guidelines to qualify:
Members must be enrolled in the dental plan for the full benefit
(calendar) year.
They must submit at least one claim for a covered service during
that year.
The total benefit amount that we pay out for covered services in that
same year can’t be more than $500.
When these guidelines are met, members can carry over $250 each year until they reach $1,000. They can then use the money in a future year, giving them a higher maximum for all covered services.
6 Dental Blue Silver 100-80 Dental Blue Silver Plus 100-80 Dental Blue Gold 100-80 Dental Blue Gold Plus 100-80 Dental Blue Platinum 100-80 Dental Blue Platinum Plus 100-80
In-network Out-of-network In-network Out-of-network In-network Out-of-network In-network Out-of-network In-network Out-of-network In-network Out-of-network
Out-of-network
reimbursement 80th percentile
Annual deductible
Waived in-network for diagnostic and preventive services (single/family)
$50/$150 $50/$150 $50/$150 $50/$150 $50/$150 $50/$150
Annual maximum $1,000 $1,500 $1,500 $1,500 $2,000 $2,000
Diagnostic and preventive
(cleanings, exams, X-rays)
100% 80% 100% 80% 100% 80% 100% 80% 100% 100% 100% 100%
Minor restorative
(fillings) 80% 60% 80% 60% 80% 60% 80% 60% 90% 80% 90% 80%
Major restorative
Oral surgery
(tooth extraction) 50% 50% 80% 60% 50% 50% 80% 60% 60% 50% 90% 80%
Endodontics
(root canal therapy) 50% 50% 80% 60% 50% 50% 80% 60% 60% 50% 90% 80%
Periodontics
(scaling/root planing) 50% 50% 80% 60% 50% 50% 80% 60% 60% 50% 90% 80%
Prosthodontics
(crowns, bridges and
dentures) 50% 50% 50% 50% 50% 50% 50% 50% 60% 50% 60% 50%
Orthodontics
Adult and child 50% up to $1,000 Not covered 50% up to $1,000 50% up to $1,000 50% up to $1,500 50% up to $1,500
Waiting periods No waiting periods
Our Dental Blue PPO plans offer:
More than 12,700 dentists with more than
30,000 access points in California and more than 94,200 access points nationwide.
One bill and one premium check for all of
your benefits.
Cleanings, exams and X-rays — at no cost
when using in-network dentists.
Fillings at 80% (or even 90%) when using
in-network dentists.
More extensive services like oral surgery,
crowns and root canals.
Orthodontic services covered on most plans.
No waiting periods.
An extra cleaning or periodontal maintenance
procedure each year for members who are pregnant or living with diabetes.
Dental PPO plans
Dental Blue PPO plans
This chart is an overview of coverage. A comprehensive description of coverage, benefits, exclusions and limitations can be found in the
This chart is an overview of coverage. A comprehensive description of coverage, benefits, exclusions and limitations can be found in the Combined Evidence of Coverage and Disclosure Form.
Our Dental Net DHMO plans offer:
Nearly 8,800 general dentist and specialist access
points in California. (Services must be received from Dental Net providers. Members choose a primary care dentist who coordinates any specialty care or orthodontic services that are needed.)
No annual maximums,* no deductibles and no
waiting periods. That’s unlike many dental plans that limit the amount of services members can get in a year.
Set copays for nearly 300 different procedures,
including fillings and crowns. This gives members a good idea of their costs ahead of time.
Composite (tooth-colored) fillings on any tooth and general anesthesia for oral surgery.
Orthodontic coverage with lower costs than you
might expect:
– $1,695 for children up to age 18 – $1,895 for adults
– $200 for retention for children and adults
* There is no maximum or age limit for pediatric dentistry performed by your participating dentist. If your participating dentist believes he or she is unable to give care to a child, or your dental plan makes that determination, then your child may be referred to a pediatric dentist. This would be a benefit for children under the age of five with a $750 maximum. Exceptions are made on a pre-approval basis only.
Plan Designs
You’ve got three great plans to choose from. All are available on an employer-paid or voluntary basis. The following chart includes a sampling of the nearly 300 different services and procedures covered by our three new Dental Net plans. For a complete list of copays for each of the covered Current Dental Terminology (CDT) codes, please see the Dental Net fee schedule brochure.
CDT code Benefit
Member’s copay
Plan 2000A Plan 2000B Plan 2000C
Diagnostic services
D0120 Periodic oral exams $0 $0 $0
D0210 Intraoral X-rays — complete series (including bitewings) $0 $0 $0
Preventive services
D1110 or D1120 Teeth cleaning (prophylaxis) — adult or child — two per year $0 $0 $0
D1208 Topical fluoride, covered to age 18 $0 $0 $0
D1351 Sealants, per tooth, through age 15 $7 $5 $0
Restorative services, fillings (permanent)
D2140 Amalgam (silver colored) one-surface fillings $0 $0 $0
D2330 Resin-based composite (tooth-colored) fillings on anterior
(front) tooth, one surface $0 $0 $0
D2391 Resin-based composite (tooth-colored) fillings on posterior
(back) tooth, one surface $30 $20 $10
D2393 Resin-based composite (tooth-colored) fillings on posterior
(back) tooth, three surfaces $55 $45 $30
Oral surgery services
D7140 Simple extraction of erupted tooth or exposed root $15 $5 $5
D7210 Surgical extraction of erupted tooth $30 $25 $20
D7220 Removal of impacted tooth — soft tissue $50 $45 $40
D7230 Removal of impacted tooth — partial bony $70 $60 $50
D7240 Removal of impacted tooth — completely bony $100 $70 $60
Endodontic services
D3220 Therapeutic pulpotomy (excluding final restoration) $20 $15 $10
D3310 Root canal: anterior (front tooth) (excluding final restoration)
$90 $70 $65
D3320 Root canal: bicuspid (excluding final restoration) $125 $80 $75
D3330 Root canal: molar (excluding final restoration) $160 $140 $130
Dental DHMO plans
8
In addition to Dental Prime, Dental Complete,
Dental Blue and Dental Net, other dental plans
may be available in your area.
Visit
anthem.com/specialty, or contact your
broker or Anthem Sales representative for
more information or a quote.
CDT code Benefit Member’s copay
Plan 2000A Plan 2000B Plan 2000C
Periodontic services
D4210 Gingivectomy: four or more contiguous teeth, per quadrant $95 $70 $55
D4211 Gingivectomy: one to three teeth touching each other
(contiguous), per quadrant $48 $20 $15
D4261 Osseous surgery, one to three contiguous teeth, per
quadrant $150 $115 $90
D4342 Periodontal scaling and root planing, per quadrant, one to
three teeth $23 $15 $10
D4910 Periodontal maintenance $25 $13 $13
Prosthodontic services
D2750 Crown: porcelain fused to high noble metal (i.e., gold) $175* $170* $90*
D5110 or D5120 Complete upper or lower denture $175 $150 $125
D5211 or D5212 Partial upper or lower denture, resin base (including
conventional clasps, rests and teeth) $150 $125 $100
D5730, D5731, D5740 or D5741
Denture reline: chair side
$40 $20 $0
D6240 Pontic (bridge), porcelain fused to high noble metal
(i.e., gold) $175* $150* $125*
Orthodontic services
24 months of standard orthodontic coverage, exclusive of records/retention fees
D8080 Child (through age 17) $1,695 $1,695 $1,695
D8090 Adult $1,895 $1,895 $1,895
D8680 Retention (placement of retainers) $200 $200 $200
Other services
Out-of-area emergency care maximum payment $100 All charges over $100
All charges over $100
All charges over $100
D9215 Local anesthesia $0 $0 $0
D9220 General anesthesia — first 30 minutes $160 $145 $130
D9440 Office visit: after hours $25 $25 $25
D9940 Occlusal guards (mouth guards) $100 $75 $50
* Plus costs for noble or high noble metal, not to exceed $125, and/or costs for porcelain, not to exceed $100.
Dental Net is available in the following counties: Alameda, Contra Costa, Fresno, Los Angeles, Marin, Orange, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Luis Obispo, Santa Barbara, Santa Clara, Solano and Sonoma. Dental Net has limited availability in El Dorado, Kern, Kings, Monterey, Placer, Riverside, San Mateo, Santa Cruz, Tulare and Ventura counties.
Dental Net can be offered on a dual-option basis with a Dental Prime or Dental Complete plan. We will administer each product separately. Talk to your Anthem rep about participation rules.
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Get vision coverage and see
increased productivity
Comprehensive, low-cost vision plans can help manage the overall health and well-being of your employees. It’s been shown that regular eye exams and wearing corrective eyewear when needed can greatly decrease the risk of more serious, long-term eye diseases, and could even lead to the early detection of other chronic health conditions.7 Healthy employees who are able to see at their best are more productive. You get the picture, and so do we. That’s why you should consider a Blue View VisionSM plan.
Blue View Vision and Blue View Vision Plus feature:
One of the nation’s largest vision networks: Blue View Vision members can visit a private practice doctor, call or click online at 1-800 CONTACTS or choose from national optical stores like:
LensCrafters®, Sears OpticalSM, Target Optical® and
JCPenney® Optical.
Convenience: Our network includes popular retail stores with evening and weekend hours. This makes accessing vision care even more convenient. Plus, with Blue View Vision, members can get an eye exam at one location and purchase eyewear from another.
Value-added savings: Employees can enjoy additional savings of 15% to 40% on extra pairs of eyewear, conventional contact lenses, lens treatments, specialized lenses and various accessories — even after they’ve exhausted their covered benefits.
They’ll also enjoy:
Factory scratch coating on standard eyeglass lenses included at
no extra cost.
Transitions® and polycarbonate lenses for kids under 19 years old
at no extra cost.
Transitions lenses for adults at a fixed price of $75.
Tiered pricing for premium progressive lenses and premium
anti-reflective coatings, which can help to limit out-of-pocket costs. Easy-to-use benefits:
In-network providers verify eligibility and handle all of the paperwork. All a member has to do is:
Make an appointment with a network provider.
Show the member ID card at the visit.
Pay any applicable copay amounts or balances in excess of
covered benefits. A commitment to care:
Members who have our vision coverage and our health and wellness
program included in their health plan may be enrolled in our ConditionCare: Diabetes program if their vision claims include a diabetic-related diagnosis.
We are the first vision plan to enable two-way communication between
eye doctors and primary care doctors. We help them work together, share information and coordinate care all through one company. Employees benefit from an approach that makes the eye exam far less routine.
There’s more to offer with Anthem vision and health plans:
Two-way communication between network eye care and
health care providers.
Care alerts to help employees manage ongoing health problems like
diabetes and heart disease.
Nurse coaches to help employees stay on top of their conditions.
We help connect the information — and all of our network providers — so they can all see eye-to-eye on our members’ care.
Blue View Vision plans are available on an employer-paid or voluntary basis. With voluntary benefits, if you feel like your budget is too tight and you can’t afford to spend more on benefits, you can give your employees access to the additional coverage they need — and at no extra cost to you.
Vision coverage
This is an overview of coverage. A comprehensive description of coverage, benefits, exclusions and limitations can be found in the Combined Evidence of Coverage and Disclosure Form.
Vision plans
Take a closer look at the
value of adding vision
coverage to your employee
benefits package. It’s value
you can see.
Blue View Blue View Plus Rate structure — 4-tier Monthly premium Monthly premium
Employee only $7.19 $14.38
Employee + spouse $12.32 $23.62
Employee + child(ren) $12.02 $23.11
Employee + family $18.54 $36.10
Blue View Blue View Plus Rate structure — 4-tier Monthly premium Monthly premium
Employee only $9.24 $17.46
Employee + spouse $15.41 $29.78
Employee + child(ren) $14.79 $28.65
Employee + family $23.42 $45.86
Employer-paid Vision rates
The availability of group life insurance is subject to underwriting, and the rates are subject to change. See your Certificate for Exclusions and Limitations. For a copy of the Certificate, call 1-800-627-8797.
Life coverage
From Anthem Blue Cross Life and Health Insurance Company
Get life … and share the benefits
of your employees’ security
Your employees depend on you, and their families depend on them. Life insurance is an easy, low-cost way to help your employees improve their families’ financial security. Your employees will appreciate that you took the time to include their families’ future in your company’s benefits package.
Save with composite life rates
Enroll 10 or more employees and you’ll automatically receive our composite life rates. Composite rates mean your group will receive a single rate per $1,000 of life coverage no matter what the age or gender of the employees enrolling. What’s in it for you? Easier administration and yet another way to possibly get lower rates.
Life is easy with Guaranteed Issue amounts
All of our Anthem Blue Cross health benefits groups with two or more enrolled employees can get some life coverage without going through health underwriting. And there are no health questionnaires to fill out.
Improve employee productivity and well-being with our member assistance programs
Resource Advisor
Life demands a lot, and asking for help can be difficult. That’s why we automatically include Resource Advisor in our plans. The program gives employees and their families access to confidential support and resources that they may need to deal with any problems they’re facing before they become an emotional or financial burden. Services include face-to-face counseling, telephone counseling, online support and identity theft victim recovery services. And when an employee dies, Beneficiary Companion is there to help. With one phone call, beneficiaries (executors of the
estate) can get help to settle the estate. This gives them more time to focus on healing. Grief counseling and legal and financial counseling are also available.
Travel assistance
Our group term life and Accidental Death and
Dismemberment (AD&D) insurance plans include travel assistance benefits. These services are available 24/7 through the multilingual Europ Assistance USA Coordination Center. When employees are traveling more than 100 miles from home, they can get help with emergency medical assistance, travel services and pre-departure information. All active employees with life and AD&D coverage, as well as their dependents, can use travel assistance.
Enjoy the ease of one application, one bill
You need to fill out only one application for both health coverage and life insurance. And you’ll get just one monthly bill that includes both health and life.
Strength, stability and service
When you choose Anthem Blue Cross Life and Health Insurance Company, you’ll feel confident knowing:
We’re the #1 group life insurance carrier in the under-100
employee market.8
We’re rated “A (Excellent)” for financial strength by
A.M. Best Company.
We have the “best in class life insurance claim payment
turnaround time.” That’s because our claim turnaround time is among the fastest in the industry — usually within two days.9
All of this means you can give your employees the valuable benefit of life insurance, knowing it’s backed by the strength and stability of one of the most respected names in the industry.
Basic term life coverage
When you offer basic term life, your employees and their families will gain extra peace of mind and financial support in the event of untimely death or great physical loss (i.e., the loss of a limb). AD&D benefits are included automatically.
The life benefit is payable if a member dies at any time. And the automatic AD&D feature gives employees an additional benefit — equal to the amount of the life benefit — in case of an accidental death or a serious qualifying accident. With the Living Benefit, members who have 12 months or less to live can ask for up to 75% of their death benefit.
Extras included with AD&D coverage:
If your employee should pass away while their kids are still in school, AD&D
pays an additional benefit to cover college expenses, up to $40,000 total.
A seat belt provision that adds the lesser of 10% of the coverage amount
or $15,000 and airbag benefit pays an additional 10% up to $10,000 to the AD&D benefit.
A $5,000 maximum repatriation benefit for preparation and transportation
services should death occur more than 75 miles from home.
A coma benefit of 1% of the AD&D benefit for each month of coma.
Common carrier benefit.
This is an overview of coverage. A comprehensive description of coverage, benefits, exclusions and limitations is contained in the Life Insurance contract (policy and Certificate).
Dependent and optional supplemental life coverage
You can choose to offer dependent life plans. Dependent life is a benefit to employees if their insured dependent dies. You can also offer optional supplemental life insurance, which lets employees who are enrolled in their group’s basic term life coverage buy extra life coverage. This is a great way to give your employees the chance to protect themselves with more coverage — at no extra cost to you.
Life plan options
This chart gives you details about basic term life. And to give you the full picture, it shows
you what coverage can look like when you add dependent and/or supplemental life benefits. Benefit amounts available
Employer contributions and participation requirements
Guaranteed issue guidelines Basic Term Life — choose one of three options:
Schedule A: Flat dollar amounts for all employees
You select one flat dollar amount for all employees. Schedule B: Life benefits graded by job title*
You select one amount in $1,000 increments for Class I employees (officers, managers, supervisors) and another amount for Class II employees
(all others).
Schedule C: Salary-based life insurance
You select either one or two times* the employee’s annual salary. All employees must have the same salary schedule.
— Salary-based benefits have a minimum benefit of $25,000 and maximum benefits of:
Groups of 2-9: up to $100,000 Groups of 10-19: up to $250,000 Groups of 20-50: up to $300,000
Flat benefit amounts: Groups of 2-9: $25,000, $30,000 or $50,000
Groups of 10-19: $25,000, $30,000, $50,000 or $100,000 Groups of 20-50: $25,000 to $300,000
If employer pays between 25% and 99%, then 75% employee participation is required. Minimum employer contribution is 25%. If employer pays 100%, then 100% employee participation is required.
Groups of 2-9:
$30,000
Groups of 10-50:
Varies by group, see Anthem proposal for each group.
Dependent Life — dependent life coverage is available:
Groups of 2-19:
— $10,000 for spouse, $5,000 for children. Available only if employee life benefit is $20,000 or more.
— $5,000 for spouse, $2,500 for children. In addition, groups of 20-50 can also choose:
— $20,000 for spouse, $10,000 for children.
— $15,000 for spouse, $7,500 for children.
— $2,000 for spouse, $1,000 for children.
Children are eligible from coverage from 15 days to 26 years of age. AD&D benefits are not available with dependent life coverage.
Employer is not required to contribute toward the cost of dependent life coverage. If employees are paying part of the premium, at least 50% of all eligible employees with dependents must participate in dependent life coverage.
All amounts are Guaranteed issue.
Optional Supplemental Life
Available for groups with 20 or more employees. 100% employee paid.
Available in four flat benefit amounts: $15,000, $25,000, $50,000 or $100,000.
Premiums are 100% employee paid. Required
participation is 25%. $50,000
* Job title descriptions shown are examples. You may use them as a guideline or provide your own. There must be at least one person in each class (job description). Only one benefit schedule may be offered. The benefit amount for Class I can’t be more than 2.5 times
You know us for our health plans, but did you
know we’re also among the leading dental, vision
and life companies in the country? It’s easy to add
these products to your health plan. And you can
feel good knowing that they’re backed by the
same reputation and levels of service that you
already expect from us.
Visit
anthem.com/specialty
, or contact your
broker for more information or a quote.
16
1 Anthem and affiliated companies. 2 2010 JHA Life Survey of Inforce Cases. 3 LIMRA Marketscan 2011.
4 Academy of General Dentistry website: Importance of Oral Health to Overall Health (October 2008): knowyourteeth.com/infobites/abc/article/?abc=O&iid=320&aid=1289. 5 The International Emergency Dental Program is managed by DeCare Dental. DeCare Dental is an independent company offering dental management services to Anthem Blue Cross.
6 The national Dental GRID is managed by the GRID Dental Corporation (GDC), a separate company that provides access to dental networks and services on behalf of Anthem Blue Cross Life and Health Insurance Company.
7 American Optometric Association, aoanet.org. 8 2010 JHA Life Survey of Inforce Cases. 9 LIMRA Marketscan 2011.
Life products underwritten by Anthem Blue Cross Life and Health Insurance Company. Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.
