Plan Summaries

Medical & RX

• Summary of Benefits and Coverage (SBC)

  • VBA PPO 25 SBC (563 KB)

  • VBA PPO HRA SBC (567 KB)

  • VBA HK HMO 25 SBC (576 KB)

  • VBA HMO $3000 SBC (565 KB)

  • VBA PPO $2000 SBC (566 KB)

  • VBA PPO $3000 SBC (566 KB)

  • VBA PPO $4000 SBC (565 KB)

  • VBA PPO 20 SBC (565 KB)

  • PreventiveRX Drug List (427 KB)

  • Anthem COE Directory Transplant Providers (887 KB)

• Booklets

  • PPO 20 Booklet (1060 KB)

  • PPO 25 Booklet (1059 KB)

  • HMO 25 Booklet (1144 KB)

  • PPO HRA Booklet (1076 KB)

  • PPO 2000 Booklet (1079 KB)

  • HMO 3000 Booklet (1097 KB)

  • PPO 3000 Booklet (1079 KB)

  • PPO 4000 Booklet (1079 KB)

  • Blue View Vision HK Booklet (396 KB)

  • Blue View Vision PPO Booklet (394 KB)

• HK HMO Directories

  • HealthKeepers Central Directory (2119 KB)

  • HealthKeepers Eastern Directory (2004 KB)

  • Health Keepers Northern Directory (3323 KB)

  • HealthKeepers Western Directory (2132 KB)

                 

   

Dental

• Summaries

  • Basic 2019 (477 KB)

  • Comprehensive 2019 (485 KB)

  • Indemnity 2019 (485 KB)

• Booklets

  • Basic Booklet (301 KB)

  • Enhanced Indemnity Booklet (309 KB)

  • Delta Dental Comprehensive Booklet (1244 KB)

• VBA 2014 Dental Plan Comparisons (27 KB)

• Dental Plan Frequently Asked Questions (FAQ) (45 KB)

Vision  

• Summaries

  • VBA 2019 MBS (93 KB)

• VBA Evidence Certificate of Coverage Jan. 2018 (130 KB)

Life Insurance           

• Life Insurance Summary 10-2018 (91 KB)

• Life Insurance Booklet (868 KB)

Disability

• LTD Booklet (1582 KB)

• ERISA Summary Plan Description Update 4-1-18 (113 KB)

• MyLiberty Assist EAP Program (182 KB)

• MLA EAP COBRA Instructions (55 KB)

Voluntary Benefits

• Accident Brochure (1618 KB)

• VBA Accident Rates (199 KB)

• Critical Illness Brochure (1083 KB)

• VBA Critical Illness Rates (223 KB)

• Hospital Indemnity Brochure (767 KB)

• VBA Hospital Indemity Rates (275 KB)