PHBP Benefits for Staff Employees

MEDICAL PLANS AVAILABLE TO STAFF EMPLOYEES

Covered staff employees may choose from all of the following Anthem Blue Cross medical and prescription drug benefits. All plans utilize the most extensive networks offered by Anthem Blue Cross and its affiliated “Blue Card” Blue Cross Blue Shield networks where available. Employer contributions will vary by employer, but must provide at least 51% of the cost of employee’s chosen medical plan.. Check with your employer to find out what additional costs may be covered. Coverage begins the 1st of the month following a 30 waiting period from the start of coinciding with the employee’s first day of work.

• PHBP Classic Premier PPO. With the highest annual premiums and lowest deductible and out-of-pocket costs, this is the richest of all of our PPO medical options.
• PHBP Classic Plus PPO. With lower annual premiums but higher out-of-pocket costs than the Premier PPO, this option offers employees meaningful coverage while costing less.
• PHBP California Classic HMO. With lower annual premiums and out-of-pocket costs than the above PPO plans, and a zero dollar deductible , this a high value / low cost option to employees in California only.
• PHBP HSA. This high-deductible PPO is IRS qualified for an associated Health Savings Account. This option brings our menu of medical benefits in line with current healthcare trends. While annual premiums are the lowest of all the options, out-of-pocket costs are the highest, but employees and employers can make pre-tax contributions to a rolling health savings account and use the funds to pay the deductibles and other medical expenses. Refer to your Enrollment Guide for a more detailed summary of benefits, or call the Plan office at (323)647-PHBP.
  

BUNDLED BENEFITS AVAILABLE TO STAFF EMPLOYEES

​Bundle #1 - Vision and Dental

• Dental: Provided by Anthem Dental PPO - enjoy a large network of providers to receive the best discounts. Out-of-Network charges are reimbursed at a lower rate.
• Vision: Provided by Anthem, one of the largest Vision networks in the country - provides significant discounts with excellent coverage.

Bundle #2 - Basic Life, AD&D and Disability (Optional to Employers)

Note: This coverage is not available through all employers. Check with your employer to see if you have this coverage. Check your Benefit Summary for full descriptions, limits and other important information. The below is a basic summary only.

• Employee Basic Life/AD&D Insurance pays a death benefit to your designated beneficiary if you suffer a loss of life or limb.
• Short-Term Disability covers a percentage of your weekly base salary if you are disabled on a short term basis.
  
• Long-Term Disability covers a percentage of your monthly base salary if your are disabled on a long term basis.
  
• Employee Assistance Program provides you guidance and support for a wide range of personal issues.
• Bundle #2 is 100% employer paid and is non-contributory for employees
  

Supplemental Plans

Note: Supplemental Life and AD&D is limited to those whose employers have provided Bundle #2, the Basic Life and AD&D package as described above. Check with your employer to see if you have those coverages.

• Supplemental Life Insurance of up to $1Million, with Spousal and child coverage, along with the accompanying Accidental Death & Dismemberment coverage, may be purchased for additional fees, paid by the employee.
  

Voluntary Plans

Note: Voluntary Plans are offered by MetLife and available for purchase to all PHBP covered employees.

• Hospital Indemnity Insurance pays a lump sum if you are hospitalized.
• Critical Illness Insurance pays a lump sum if you are diagnosed with a Critical Illness.
• Accident Insurance pays a lump sum for injuries sustained in an accident.

Additional Services Included with coverage

• LiveHealth Online: Live, online video appointments with doctors specializing in medical, medical for kids, allergy, psychology and psychiatry. Sign up at livehealthonline.com
  
• If your employer provides Bundle #2 (basic life and disability coverage), you have access to MetLife’s Employee’s Assistance Program, which offers resources on a myriad of life and well being matters, including counseling for emotional, financial, work, relationship and legal issues. See your enrollment guide for details to log in.
  

COST TO THE EMPLOYEE

• Your employer may require you to share up to 49% of the cost of insuring you as noted above.
• Your employer may require you to share up to 100% of the cost of your dependents.
• Supplemental and Voluntary benefits are employee paid and may not be paid with pre-tax dollars.
  

See your employer for details on their contribution towards the cost of your particular benefits.

ADD DEPENDENTS

You may add dependents at specific times:

• During your initial enrollment.
• Within 30 days of a “special enrollment event” such as a wedding, birth, or loss of a spouse/domestic partner’s employer provided benefits.
• During open enrollment, typically in October or November, for coverage effective Jan 1.

COBRA

• If your PHBP coverage is terminated due to a reduction in ours or other qualifying events, you may qualify for COBRA continuation coverage.
• You may pay the cost of your insurance premium plus a small administration fee and continue your PHBP coverage for up to 18 months.
  
• Click here to contact the Plan Administrator to get current costs for COBRA continuation coverage.
• Click here to get more information about COBRA continuation coverage.

RESTRICTIONS AND EXCLUSIONS

Some restrictions apply:

• Due to regulatory requirements of the Hawaii Prepaid Health Care Act, Hawaii resident full-time staff employees and owners of PHBP Participating Employers will be excluded from PHBP Medical, Vision and Dental coverage but will remain eligible for Basic Life/AD&D/Disability benefits if elected by and provided the Participating Employer . (This exclusion does not apply to Hawaii resident Freelance employees who have met eligibility requirements for Freelance Coverage.)
• Staff coverage might not be available to California resident employees of Post Production Participating Employers. Contact seanc@phbp.org for details.
  

QUESTIONS ABOUT PLAN POLICIES OR PROCEDURES?

• References to or concerning Plan rules, terms, conditions and documents, including carrier insurance contracts, are intended as general statements for informational purposes only. Official plan documents, policies and certificates of insurance contain the details, conditions, maximum benefit levels and restrictions on benefits and in all cases the text of such documents shall control.
• For complete eligibility rules, see the Summary Plan Description and accompanying amendments in the Summary of Material Modifications.
• Click here to contact the Plan’s Administrator.