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MEDICAL INSURANCE AND PRESCRIPTIONS 2012

Dartmouth College offers four medical insurance plans administered through Anthem Blue Cross and Blue Shield of New Hampshire and prescription coverage administered through CVS Caremark.

Additional Information

Medical Insurance Plan Options

Medical Insurance Costs

Preventive Care Services

Prescription Drug Coverage & Mail-Order Prescriptions

Vision Coverage

Fitness Reimbursement

Smoking Cessation Benefits

Infertility Reimbursement

Making Changes to Your Medical Insurance

Retiree Medical Insurance

Finding a Doctor

Understanding the Explanation of Benefits

Forms

Additional Information

Whom to Contact

 

Medical Insurance Plan Options

You have the option of selecting one of three plans:

•  Indemnity - High deductible health plan with Health Savings Account eligibility (also referred to as a Comprehensive Plan)

•  Blue Choice - Point-of-Service (POS) plan

•  Preferred Blue - Preferred Provider Organization (PPO) plan

An overview of the three plans can be found on the Comparison Chart.  For more detail, you should refer to the Subscriber Certificate of the appropriate plan.

When reviewing the Comparison Chart and information on this page, you may find it useful to refer to the Benefits Terminology and Definitions.

If you are having difficulty choosing a plan, you may find that the Benefit Plan Decision Guide or the Overview of Benefit Plans will help you choose the most appropriate plan for you and your family.

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Medical Insurance Costs

The cost of your medical insurance is determined by your benefit plan and you should refer to the Enrollment Booklet for more information on the costs associated with this coverage:

Dartflex—for Faculty, Exempt and Nonexempt Staff, and IATSE Union Employees

Union—for SEIU Employees

Standard—for Research Fellows and Research Associate B Employees

Retiree

DartFlex and Union employees may also use the online Employee Medical Plan Cost Estimator to help determine the cost of medical insurance for 2013, please refer to your 2012 FlexOnline enrollment window for costs for your 2012 plans.

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Preventive Care Services

With the implementation of the Health Care Reform Bill, preventive care services are available to you at no cost (i.e. no co-pay, deductible, or coinsurance).  The United States government has determined the list of preventive care services and further information is available at the links below:

•  Preventive Services Covered Under the Affordable Care Act

•  U.S. Preventive Services Task Force Recommendations

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Prescription Drug Coverage & Mail-Order Prescriptions

Prescription drugs are covered according to the medical plan that you elect. Click here for more information about your prescription drug coverage.

CVS Caremark (for those on the BlueChoice [POS], Preferred Blue [PPO], and Dartmouth College Medicare Supplemental [DCMS] Plans)

CVS Caremark replaced Anthem/Express Scripts as our Pharmacy Benefit Administrator for the BlueChoice (POS), Preferred Blue (PPO), and Dartmouth College Medicare Supplemental (DCMS) health plans on January 1, 2012.  Employees on the High Deductible Health (Indemnity) Plan remain with Anthem/Express Scripts this year.

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Vision Coverage

Vision care is covered as part of your medical insurance.  Preventive care services cover an annual eye exam at no cost (i.e. no co-pay, deductible, or coinsurance).

Corrective lenses (ex. glasses or contact lenses) are not covered.  A $40 reimbursement toward corrective lenses is offered on the Blue Choice Plan.  If you are enrolled in the dental plan, you may also be eligible for vision discounts.  More information is available on the Dental Insurance page.

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Fitness Reimbursement

When you enroll in one of Dartmouth's medical insurance plans, you have the option of submitting for up to a $200 reimbursement as part of the Fitness Reimbursement Program

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Smoking Cessation Benefits

For the overall health and wellness of all Dartmouth employees and covered dependents, you can receive enhanced smoking cessation benefits through any of Dartmouth's health plans.

Prescription nicotine therapy drugs (e.g., Buproprion SR and Chantix) and Nicotine Replacement Therapies (NRTs) are available without a copay. Over-the-counter treatments such as patches, inhalers, and nasal sprays are now eligible for full reimbursement.

Effective January 1, 2012, CVS Caremark became the Pharmacy Benefit Management (PBM) administration for those on the Blue Choice (POS), Preferred Blue (PPO), and Dartmouth Medicare Supplemental (DCMS) plans. [Note: Those on the DCMS plans are primarily retirees]. Those on the High Deductible Health (Indemnity) plan will remain with Anthem/Express Scripts for pharmacy & prescription needs.

CVS Caremark (for POS, PPO, and DCMS plans): Present your CVS Caremark ID card to the pharmacist. A prescription is required for the over-the-counter items to be processed.

Anthem/Express Scripts (for Indemnity plan): Present your Anthem ID card to the pharmacist and make sure the pharmacist codes the prescription as a smoking cessation product. Click here for Anthem's Smoking Cessation reimbursement information and form.

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Infertility Reimbursement

An Infertility Reimbursement is available for expenses not covered by your medical plan.  Details on the program are available here.  It is recommended that you contact Anthem prior to submitting for reimbursement to find out what benefits are covered by your medical plan.

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Making Changes to Your Medical Insurance

You may only elect or make changes to your medical insurance as a new hire, as part of Open Enrollment, or with a qualifying Status Change Event. Click here for a 2012 Status Change Form

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Retiree Medical Insurance

Retirees under age 65 may elect the Indemnity, Blue Choice, or Preferred Blue Plans and be eligible for all benefits outlined on this page.

Retirees over age 65 may elect the Dartmouth College Medicare Supplement Plan. More information is available here.

For more information, please refer to the Retiree Enrollment Booklet.

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Finding a Doctor

If you are new to the area, or new to Anthem, you may need assistance finding a healthcare provider.  There are a number of ways that may assist you in doing this:

•  Contact Anthem

• Visit Anthem's website and choose "Find A Doctor"

• Visit Dartmouth Hitchcock Medical Center's Find A Doctor website or call the Provider Finder line at (603) 653-3211

• Ask around.  Friends, co-workers or family in the area may be able to recommend a provider.

In your search for a provider, you should remember to ask the following:

•  Do you accept Anthem Blue Cross Blue Shield?

•  Are you accepting new patients?

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Understanding the Explanation of Benefits (EOBs)

When you seek services, Anthem may send you a document called an Explanation of Benefits (EOBs).  This is not a bill for services.  This document may assist you in understanding how to read your Explanation of Benefits.  If you have further questions, you should contact Anthem.

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Forms

All forms can be found on the Human Resources website in the Forms section. 

Commonly used provider forms are below:

•  Fitness Reimbursement Log Card

•  Fitness Reimbursement Request Form

•  Incapacitated Dependent Certification Form

•  International Claim Form (Anthem)

•  Mail-Order Prescription Form (Express Scripts)

•  Prescription Drug Claim Form (Express Scripts)

•  Smoking Cessation Prescription Reimbursement Form

•  Subscriber Claim Form (Anthem)

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Additional Information

The following list of resources may be beneficial to some employees:

•  HealthCare.gov

•  Vermont Health Assistance Program (VHAP)

•  Service Link (for NH residents)

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Whom to Contact

Benefits Office (for questions on enrolling in medical insurance or making changes to your medical insurance)

Website: http://www.dartmouth.edu/~hrs/benefits/

Email:  human.resources.benefits@dartmouth.edu

Phone: (603) 646-3588

Fax: (604) 646-1108

For questions on your membership, coverage, or to request new ID cards, you should contact Anthem.

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Anthem

Phone: 1-800-437-9282

Mail: 3000 Goffs Falls Road, Manchester, NH 03111

To mail claims: PO Box 660, North Haven, CT 06473-0660

Website: http://www.anthem.com/

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CVS Caremark

Phone: 1-855-465-0032 

Website: http://www.caremark.com/dartmouth

Last Updated: 3/3/13