Share:

Benefit Details

ACA SUMMARIES OF BENEFITS & COVERAGE (SBC) / BENEFITS AT A GLANCE (BAAG)

Blue Cross Community Blue PPO Plans
Active Employees of Legislative Branch Exempt (including Elected Officials & Judges), 3rd Circuit GAA, JAASBCBAAG
Pre-Medicare Retirees of Legislative Branch Exempt (including Elected Officials & Judges), 3rd Circuit GAA, JAASBC BAAG
Medicare-Eligible Retirees of POAM, Legislative Branch Exempt (including Elected Officials & Judges), 3rd Circuit GAA, JAANot RequiredBAAG
Blue Cross Simply Blue High Deductible Health Plans (HDHP) PPO
Active Employee of Legislative Branch Exempt (INCLUDING Elected Officials & Judges), 3rd Circuit GAA, JAASBCBAAG
All Other Benefit-Eligible Active EmployeesSBCBAAG
Pre-Medicare Retirees of Legislative Branch Exempt (INCLUDING Elected Officials & Judges), 3rd Circuit GAA, JAASBCBAAG
Medicare-Eligible Retirees of Legislative Branch Exempt (INCLUDING Elected Officials & Judges), 3rd Circuit GAA, JAANot RequiredBAAG
All Other Pre-Medicare-Eligible Retirees (EXCLUDES retirees eligible under Retiree Stipend Program)SBCBAAG
All Other Medicare-Eligible Retirees (EXCLUDES retirees eligible under Retiree Stipend Program)Not RequiredBAAG
Blue Care Network (BCN) Full Provider Network HMO Plans
Active Employees of Legislative Branch Exempt (INCLUDING Elected Officials & Judges), 3rd Circuit GAA, JAASBCBAAG
All Other Benefit-Eligible Active EmployeesSBCBAAG
Pre-Medicare Retirees of Legislative Branch Exempt (INCLUDING Elected Officials & Judges), 3rd Circuit GAA, JAASBCBAAG
Medicare-Eligible Retirees of Legislative Branch Exempt (INCLUDING Elected Officials & Judges), 3rd Circuit GAA, JAANot RequiredBAAG
All Other Pre-Medicare Benefit-Eligible Retirees (EXCLUDES retirees eligible under Retiree Stipend Program)SBCBAAG
All Other Medicare-Eligible Retirees (EXCLUDES retirees eligible under Retiree Stipend Program)Not RequiredBAAG
Blue Care Network (BCN) PCP Focus HMO Plans
All Active Employees EXCLUDING Legislative Branch Exempt (INCLUDING Elected Officials & Judges), 3rd Circuit GAA, JAA EmployeesSBCBAAG
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)SBCBAAG
Medicare-Eligible Retirees EXCLUDING Retirees of Legislative Branch Exempt (INCLUDING Elected Officials & Judges), 3rd Circuit GAA, JAA and retirees eligible under Retiree Stipend ProgramNot RequiredBAAG
ACA Minimum Value Plan- Blue Cross Simply Blue HDHP
Plan for Employees Working 30 or More Hours Per Week on AverageSBCBAAG
Delta Dental Plans
Delta Dental PPO Standard Plan (Active Employees Only)BAAG / Fee Schedule
Delta Dental EPO Plan (Active Employees Only)BAAG / Fee Schedule
Golden Dental Plans
Golden Dental Radiant DHMO Plan (Active Employees Only)BAAG / Fee Schedule
Golden Dental Smile Guard DHMO Plan (Active Employees Only)BAAG / Fee Schedule
Golden Dental DHMO Voluntary Retiree Dental PlanBAAG / Fee Schedule
Heritage Vision Plans
Heritage Vision Plan (Active Employees Only)BAAG

Heritage Vision Plan Supplemental Retiree Vision Plan

This plan does NOT replace retiree Optical Reimbursement benefits.

BAAG