Health Benefit Summaries & Details

Health Plans

Blue Cross Community Blue PPO Plans

Plan SBC BAAG
Active Employees of Legislative Branch Exempt (including Elected Officials & Judges), 3rd Circuit GAA, JAA Community Blue PPO $500 SBC(PDF, 665KB) Community Blue PPO $500 BAAG(PDF, 108KB)
Pre-Medicare Retirees of Legislative Branch Exempt (including Elected Officials & Judges), 3rd Circuit GAA, JAA Community Blue PPO $500 SBC(PDF, 665KB) Community Blue PPO $500 BAAG(PDF, 108KB)
Medicare-Eligible Retirees of POAM, Legislative Branch Exempt (including Elected Officials & Judges), 3rd Circuit GAA, JAA Not Required Medicare Plus Blue Group PPO (Option 3) BAAG(PDF, 872KB)

Blue Cross Simply Blue High Deductible Health Plans (HDHP) PPO

Plan SBC BAAG
Active Employee of Legislative Branch Exempt (Including Elected Officials & Judges), 3rd Circuit GAA, JAA Simply Blue HDHP PPO 10% SBC(PDF, 653KB) Simply Blue HDHP PPO 10% BAAG(PDF, 215KB)
All Other Benefit-Eligible Active Employees Simply Blue HDHP PPO 20% SBC(PDF, 654KB) Simply Blue HDHP PPO 20% BAAG(PDF, 215KB)
Pre-Medicare Retirees of Legislative Branch Exempt (Including Elected Officials & Judges), 3rd Circuit GAA, JAA Simply Blue HDHP PPO 10% SBC(PDF, 653KB) Simply Blue HDHP PPO 10% BAAG(PDF, 215KB)
Medicare-Eligible Retirees of Legislative Branch Exempt (Including Elected Officials & Judges), 3rd Circuit GAA, JAA Not Required BAAG
All Other Pre-Medicare-Eligible Retirees (Excludes retirees eligible under Retiree Stipend Program) Simply Blue HDHP PPO 20% SBC(PDF, 654KB) Simply Blue HDHP PPO 20% BAAG(PDF, 215KB)
All Other Medicare-Eligible Retirees (Excludes retirees eligible under Retiree Stipend Program) Not Required Medicare Plus Blue Group PPO (Option 1) BAAG(PDF, 892KB)

Blue Care Network (BCN) Full Provider Network HMO Plans

Plan SBC BAAG
Active Employees of Legislative Branch Exempt (Including Elected Officials & Judges), 3rd Circuit GAA, JAA Blue Care Network HMO $500 SBC(PDF, 1MB) Blue Care Network HMO $500 BAAG(PDF, 259KB)
All Other Benefit-Eligible Active Employees Blue Care Network HMO HDHP 20% Full Net SBC(PDF, 1MB) BAAG(PDF, 821KB)
Pre-Medicare Retirees of Legislative Branch Exempt (Including Elected Officials & Judges), 3rd Circuit GAA, JAA Blue Care Network HMO $500 SBC(PDF, 1MB) Blue Care Network HMO $500 BAAG(PDF, 259KB)
Medicare-Eligible Retirees of Legislative Branch Exempt (Including Elected Officials & Judges), 3rd Circuit GAA, JAA Not Required Blue Care Network HMO-POS (Legislative) BAAG(PDF, 321KB)
All Other Pre-Medicare Benefit-Eligible Retirees (Excludes retirees eligible under Retiree Stipend Program) Blue Care Network HMO HDHP 20% Full Net SBC(PDF, 1MB) BAAG(PDF, 821KB)
All Other Medicare-Eligible Retirees (Excludes retirees eligible under Retiree Stipend Program) Not Required BAAG

Blue Care Network (BCN) PCP Focus HMO Plans+

Plan SBC BAAG
All Active Employees Excluding Legislative Branch Exempt (Including Elected Officials & Judges), 3rd Circuit GAA, JAA Employees Blue Care Network HDHP with PCP SBC(PDF, 666KB) Blue Care Network HDHP with PCP BAAG(PDF, 115KB)
Pre-Medicare Benefit-Eligible Retirees Excluding Retirees of Legislative Branch Exempt (Including Elected Officials & Judges), 3rd Circuit GAA, JAA, and retirees eligible under Retiree Stipend Program Blue Care Network HDHP with PCP SBC(PDF, 666KB) Blue Care Network HDHP with PCP BAAG(PDF, 115KB)
Medicare-Eligible Retirees Excluding Retirees of Legislative Branch Exempt (Including Elected Officials & Judges), 3rd Circuit GAA, JAA, and retirees eligible under Retiree Stipend Program Not Required Blue Care Network HMO-POS (Full Panel) BAAG(PDF, 322KB)

Blue Care Network (BCN) PCP Focus Copay HMO Plans

Plan SBC BAAG
Active Employees Excluding Legislative Branch Exempt (Including Elected Officials & Judges), 3rd Circuit GAA, JAA BCN PCP Focus Copay HMO SBC(PDF, 667KB) BCN PCP Focus Copay HMO BAAG(PDF, 462KB)
All Other Benefit-Eligible Active Employees BCN PCP Focus Copay HMO SBC(PDF, 667KB) BCN PCP Focus Copay HMO BAAG(PDF, 462KB)
Pre-Medicare Benefit-Eligible Retirees Excluding Retirees of Legislative Branch Exempt (Including Elected Officials & Judges), 3rd Circuit GAA, JAA and retirees eligible under Retiree Stipend Program HMO PCP Focus Copay SBC(PDF, 1MB) BCN PCP Focus Copay HMO BAAG(PDF, 462KB)
Medicare-Eligible Retirees Excluding Retirees of Legislative Branch Exempt (Including Elected Officials & Judges), 3rd Circuit GAA, JAA Not Required Blue Care Network HMO-POS (Focus Copay) BAAG(PDF, 323KB)

ACA Minimum Value Plan-Blue Cross Simply Blue HDHP

Plan SBC BAAG
Plan for Employees Working 30 or More Hours Per Week on Average SBC BAAG

 

Dental Plans

Delta Dental Plans

 

DENCAP Dental Plans

 

 

Vision Plans

Heritage Vision Plans

 

Wayne County Optical Plan

 

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