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Choose the coverage that’s right for you and your family:
The Assurant Health Plan
You can select from a comprehensive and valuable benefits package that includes a range of options so you can choose the coverage that’s right for you and your family. By working together to make informed decisions and leveraging resources to be healthy, you can do your part to help ensure high-quality and affordable benefits at Assurant.

Choosing a Health Plan option can be overwhelming. We understand that you want the best care for you and your family, but you also want your health care to be affordable. The information below can help you choose the appropriate Plan option for your situation.

Assurant offers three quality and affordable Health Plan options - BLUE, GREEN and ORANGE Plan options administered by Anthem Blue Cross and Blue Shield. Click here for a summary of cost and coverage comparisons.

Choosing the coverage most appropriate for your own situation is your responsibility. Before you make your decisions, think about what your health care needs might be for the plan year or coverage period for which you’re enrolling, then review the examples here. When you consider the cost of the various options, remember that the per-paycheck deduction is just one factor. Your out-of-pocket costs (what you pay at the time you receive health care), tax advantaged accounts, personal preferences and finances are all important considerations. If you want to refer to a summary of coverage and costs under the Assurant Health Plan click here.

Get the most from your Health Plan by accessing the resources that can help you be your healthiest and earn wellbeing rewards that can help pay for your health care expenses.

Take a few minutes to be sure you understand the following terms and how they apply to each Plan option.

Coverage Level
You can choose coverage for Employee-only, Employee & Spouse/Domestic Partner, Employee & Children, or Employee & Family.

Per Paycheck Contribution
This is the amount that is deducted from each of your paychecks for your Assurant Health Plan coverage. Under the BLUE Plan option, you pay a higher per paycheck contribution and a lower deductible as compared to the GREEN and ORANGE Plan options. Under the ORANGE Plan option, your per paycheck contribution is the lowest but with the highest deductible, as compared to the BLUE and GREEN Plan options.

Deductible
This is the amount you must pay each year for your covered health care and prescription drugs before the Plan begins to share eligible health care costs with you. The exception is for preventive care and preventive prescriptions, which are covered before you meet your deductible.

There are separate in- and out-of-network deductibles for all three Plan options. If you are using providers outside of the Anthem Blue Cross and Blue Shield network, you’ll pay more for coverage, and be subject to a higher deductible. For all plan options, there are separate deductible and out-of-pocket maximums for your in-network and out-of-network utilization. They do not cross-apply.

If you elect Family coverage under the BLUE or GREEN Plan option, benefits begin once the entire Family deductible is met (except for preventive care benefits and preventive prescription drugs). If you elect Family coverage under the ORANGE Plan option, benefits begin for a family member once that family member satisfies the individual deductible. Benefits begin for the entire family once the entire Family deductible is met. Family coverage includes coverage for Employee & Spouse/Domestic Partner, Employee & Child(ren), and Employee & Family.

See the table below to see how the deductible works under each Plan option.

BLUE

In-network deductible (individual/family)

$950/$1,900

Out-of-network deductible (individual/family)

$1,950/$3,900
The individual deductible must be met before benefits begin for the individual.

The entire family deductible must be met before benefits begin for any covered family member. Any combination of you and/or one or more of your dependents can incur expenses to meet the family deductible.
GREEN

In-network deductible (individual/family)

$1,700/$3,400

Out-of-network deductible (individual/family)

$2,700/$5,400
The individual deductible must be met before benefits begin for the individual.

The entire family deductible must be met before benefits begin for any covered family member. Any combination of you and/or one or more of your dependents can incur expenses to meet the family deductible.
ORANGE

In-network deductible (individual/family)

$2,800/$5,600

Out-of-network deductible (individual/family)

$3,800/$7,600
The individual deductible must be met before benefits begin for the individual.

Benefits begin for a family member once that family member satisfies the individual deductible. Benefits begin for the entire family once the entire family deductible is met. Any combination of you and/or one or more of your dependents can incur expenses to meet the family deductible.

Coinsurance
This is the percentage of the cost that you pay for covered health care and prescription drugs after you've met the deductible. Expenses for eligible out-of-network medical care are subject to reasonable and customary limits.

Under the BLUE Plan option, you pay:

In-network - 20%
Out-of-network - 40%

Under the GREEN Plan option, you pay:

In-network - 20%
Out-of-network - 40%

Under the ORANGE Plan option, you pay:

In-network - 10%
Out-of-network - 30%

Providers in the Anthem Blue Cross and Blue Shield network have agreed to specific prices for covered services. It costs less to use providers in the network. You will pay higher coinsurance and have a higher out-of-pocket maximum when you use out-of-network providers.

You can see if your provider participates in the network by visiting Anthem.com.

To compare costs and quality for in-network covered services and prescriptions, visit Anthem.com to access the Care & Cost Finder tool. 

Out-of-Pocket Maximum This is the most you will pay out of your pocket in a given calendar year for your deductible and coinsurance. When you reach the out-of-pocket maximum, the Plan begins paying 100 percent for eligible covered services for the remainder of that calendar year. For all plan options, there are separate deductible and out-of-pocket maximums for your in-network and out-of-network utilization. They do not cross-apply.

For example, if you spend $200 on in-network services under the Green Health Plan option, employee-only plan, this $200 applies to your $1,700 in-network deductible and $4,200 in-network out-of-pocket maximum, and won’t apply to your out-of-network deductible or out-of-pocket maximum.

See the table below to see how the in-network out-of-pocket maximum works under each Plan option.


BLUE

The BLUE Plan option out-of-pocket maximums are (individual/family):

In-network - $3,450/$6,900

Out-of-network - $6,450/$12,900

Once the individual out-of-pocket maximum is reached, claims for that individual will be paid at 100%.

Claims will be paid at 100% by the Plan only when the family out-of-pocket maximum is met. Any combination of you and/or one or more of your dependents can incur expenses to meet the family out-of-pocket maximum.
GREEN

The GREEN Plan option out-of-pocket maximums are (individual/family):

In-network - $4,200/$8,400

Out-of-network - $7,200/$14,400

Once the individual out-of-pocket maximum is reached, claims for that individual will be paid at 100%.

Once the individual out-of-pocket maximum is reached by one family member, claims for that individual will be paid at 100%. Once the family’s combined expenses reach the family out-of-pocket maximum, claims will be paid at 100 percent for all covered family members’ eligible non-preventive expenses for the remainder of the calendar year.
ORANGE

The ORANGE Plan option out-of-pocket maximums are (individual/family):

In-network - $4,800/$9,600

Out-of-network - $7,800/$15,600

Once the individual out-of-pocket maximum is reached, claims for that individual will be paid at 100%.

Once the individual out-of-pocket maximum is reached by one family member, claims for that individual will be paid at 100%. Once the family’s combined expenses reach the family out-of-pocket maximum, claims will be paid at 100 percent for all covered family members’ eligible non-preventive expenses for the remainder of the calendar year.

Certain medical services require precertification for you to receive benefits. To precertify, contact Anthem Blue Cross and Blue Shield at 855.285.4212. Note: If precertification is not required, it does not mean that a service will necessarily be covered by the Assurant Health Plan. Please see the Resources page for a list of services requiring prior authorization. 

The Anthem Blue Cross and Blue Shield member website, Anthem.com, enables you to search for in-network providers in your area and does not require you to log in. The Anthem network for Assurant is based upon where you live, not where your doctor is located. Go to anthem.com and do not sign in. Select "Providers", then select "Find a Doctor". Search as a Guest by Selecting a Plan or Network, enter Medical for type of care, enter your state. Under Medical (Employer-Sponsored), select the plan/network, then follow these steps:

  • If you live in the state of Florida, scroll down to the Medical (Employer Sponsored) section and choose the NetworkBlue (Select Network) as the Plan Type.
  • If you live in the state of Georgia, scroll down to the Medical (Employer Sponsored) section and choose the Blue Open Access POS (Select Network) as the Plan Type.
  • If you live in the greater Kansas City service area, scroll down to the Medical (Employer Sponsored) section and choose the Preferred-Care Blue (KC) (Select Network) as the Plan Type.
  • If you live in the state of Wisconsin, scroll down to the Medical (Employer Sponsored) section and choose the Blue Preferred POS (Select Network) as the Plan Type.
  • All other employees will scroll down to the Medical (Employer Sponsored) section and choose National PPO (BlueCard PPO).

     

  • Click Continue.
  • Choose the type of provider you want (e.g., a doctor, hospital, lab) and location.
  • Click Search.

* The greater Kansas City service area includes doctors and hospitals in 30 Missouri and 2 Kansas counties: Missouri: Andrew, Atchison, Bates, Benton, Buchanan, Caldwell, Carroll, Cass, Clay, Clinton, Daviess, Dekalb, Gentry, Grundy, Harrison, Henry, Holt, Jackson, Johnson, Lafayette, Livingston, Mercer, Nodaway, Pettis, Platte, Ray, Saline, St. Clair, Vernon, and Worth; Kansas: Johnson and Wyandotte.

Coverage for mental health and substance abuse treatment is provided by Anthem Blue Cross and Blue Shield. Anthem has a large, nationwide behavioral care network utilizing credentialed and qualified national providers. For information or assistance with mental health or substance abuse benefits, please call Anthem’s Blue Care Consultants at 855-285-4212.

 

Coverage for prescription drugs for all three Assurant Health Plan options is administered by CVS Caremark, one of the largest providers of pharmacy benefits with more than 64,000 participating retail pharmacies nationwide (including Target/CVS locations). Most major drug chains and many small, independent pharmacies are part of the CVS Caremark network. Mail-order services are also available for maintenance medications. If you choose to utilize a nonparticipating pharmacy, you will be responsible for your regular coinsurance plus any difference between the amount charged by the pharmacy and CVS Caremark's discounted price. Certain drugs, including compound prescription medications, may require prior authorization from CVS Caremark to confirm medical necessity. To obtain information on a particular medication(s), log on to caremark.com.

Preventive Drugs
Preventive drugs can help keep you healthy and prevent serious complications down the road. The Plan covers generic preventive drugs at 100 percent. If you take a preferred brand name preventive drug, you will pay 50 percent of the cost up to a maximum of $75 per prescription for a 30-day supply. If you take a non-preferred brand name preventive drug, you will pay 50 percent of the cost up to a maximum of $100 per prescription for a 30-day supply. Certain over-the-counter preventive drugs prescribed by your doctor (based on age and gender eligibility requirements) are covered at no cost, such as vitamin D, aspirin, folic acid and iron supplements. Coverage for preventive drugs is not subject to the deductible, which means that you don’t need to satisfy your deductible before these benefits begin.

Non-Preventive Drugs
Regardless of which Health Plan option you elect, you will pay the full discounted cost of any eligible non-preventive drug until your deductible is met. The cost of these drugs will apply to your Health Plan deductible.

After you meet your deductible, you will pay 50 percent of the cost of your prescription drug up to a maximum of $100, for a 30-day supply, or up to $200 for a 90-day supply of maintenance medications. Even before your deductible is met, you will get the benefit of the discounted rates CVS Caremark negotiates with participating pharmacies.

Maintenance Medications
If you take medications on a regular basis to treat a chronic condition (such as high cholesterol or high blood pressure), you must fill them through a 90-day supply instead of a 30-day supply. You can fill 90-day maintenance medication prescriptions filled at CVS Caremark pharmacy only (including Target/CVS locations) or you can order them via CVS Caremark’s mail order service. This will save you time and money.

The Plan allows for two 30-day fills of maintenance medications at any pharmacy in the CVS Caremark network. After that, the Plan will cover maintenance medications only if you have 90-day supplies filled through mail-order or at a CVS Caremark pharmacy. You can call CVS Caremark to discuss payment options. If you continue to have 30-day supplies of maintenance medications filled (regardless of whether the pharmacy is in the CVS Caremark network), you will be responsible for the entire cost of the medication.

CVS Caremark’s Mail-Order Service
CVS Caremark’s mail-order service can save you money and time. When you order maintenance medications via CVS Caremark’s mail-order service, you’ll get a 90-day supply for 50 percent of the cost up to a maximum of $200. It’s easy and convenient to participate - you can order refills online and standard shipping is always free. Visit caremark.com or call CVS Caremark at 866.587.4799 for more information.

Dispense as Written Guidelines
To encourage the use of cost-effective FDA-approved generic equivalents, when a prescribed brand name drug has a generic equivalent, you'll receive the generic equivalent unless your physician specifies Dispense as Written, or DAW, on the prescription. If your physician does not specify DAW and you select the brand name drug, you'll pay your share of the cost plus the difference in price between the brand name drug and the generic drug. You will never pay more than the actual cost of the drug, but you may pay more than the $75 maximum (preferred brand name drug) and $100 maximum (non-preferred brand name drug) for a 30-day supply or the $150 maximum (preferred brand name drug) and $200 maximum (non-preferred brand name drug) for a 90-day supply.

CVS Caremark’s Formulary
Coverage for prescription drugs under all three Assurant Health Plan options is administered by CVS Caremark. The prescription plan has a wide variety of safe and effective generic and brand medications, covering treatments for all types of injuries and illnesses.

Caremark periodically reviews their formulary or covered drug list. Certain formulary medications may be excluded from coverage from time to time and impacted members will be notified directly by CVS Caremark. The Health Plan includes three tiers of prescription coverage: generic, preferred brand and non-preferred brand. The cost you pay per prescription is based on the tier your medication is in.

By using generic or preferred brand medicines, you can help make sure you get better value based on your plan and individual needs. Click here to view the specialty formulary and click here to view the non-specialty formulary. You can also visit caremark.com to review your preferred drug list, updated quarterly, to find out which therapeutic medicines provide you with greater savings. Here are definitions of each of the three tiers:

Tier 1: Generic - generic drugs must have the same active ingredients as the original brand name drug.
Tier 2: Preferred brand - brand name drugs listed on the CVS formulary/covered drug list.
Tier 3: Non-preferred brand - brand name drugs not listed on the CVS formulary/covered drug list.

See the chart below for coverage by each tier.

 Retail (30-day supply) Mail order prescriptions or retail maintenance prescriptions at a CVS pharmacy (90-day supply)
Type of Medication
Coinsurance Minimum per prescription Maximum per prescription Coinsurance Minimum per prescription Maximum per prescription
Generic* 50% $0 $50 50% $0 $125
Preferred brand 50% $10 $75 50% $20 $150
Non-preferred brand 50% $40 $100 50% $80 $200

*Please note that generic preventive drugs are 100% covered.

Note: What you pay will never exceed the total cost of the medication.

Here is a chart explaining what you might expect to pay based on the below illustrative medication costs:

Type of medication Member cost-share after deductible, before out-of-pocket maximumDrug costsYou pay
Retail Generic (30-day supply) 50% max $50$25$12.50
Retail Non-Preferred (30-day supply)50% min $40 max $100$201$100
Preferred Mail order (90-day supply)50% min $20 max $150$19$19

Filling Your Prescription at a Non-Participating Pharmacy If you choose to go to a non-participating (out-of-network) pharmacy, you'll pay the full prescription price at the point of sale and will need to send CVS Caremark a paper claim. You should submit a paper claim form along with the original prescription receipt(s) to CVS Caremark for reimbursement of covered expenses. You can download and print a claim form when you log in to caremark.com. If you fill your prescription at a non-participating pharmacy, you will be responsible for your regular coinsurance plus any difference between the amount charged by the pharmacy and CVS Caremark’s discounted price.