Open Enrollment/Benefits Update

The open enrollment period for the health, dental and vision insurance plans ended on May 17th.  Changes made during open enrollment are effective July 1, 2019, provided that your application and required documentation (if applicable) was received by May 17, 2019.

Health Insurance

  • Updated premiums
  • Coverage enhancements
    • Carrum Health no cost surgery benefit for eligible procedures (e.g. bariatrics, hip/knee replacement, cardiac, spine)
    • Specialty Rx - Clinical Site of Care Program with Anthem for (non-cancer) infusion services will be provided at no cost to the member
    • LiveHealth Online copay reduced from $20 per visit to $0
    • Diabetic remote monitoring with Livongo (device and supplies provided at no cost to the member)
  • No changes will be made to the out-of-pocket maximums.  The copay amounts for in-person office visits, walk-in clinics, emergency room, and prescriptions* will remain the same.  *Note, the formulary (list of covered medications) will continue to be updated every July 1st and January 1st.

Dental Insurance

  • Updated premiums
  • Coverage changes
    • Orthodontics for adults age 19 and older will no longer be covered effective July 1st.  Note, for adults currently receiving orthodontia benefits, coverage will continue as-is until end of treatment.  
    • Posterior (rear) composite (white) fillings will be covered at 80% with a State of Maine PPO dentist, 70% with a Premier network dentist and 60% out of network.  
    • Calendar year deductible will be $25 individual/$75 family.  The deductible does not apply to preventive services (e.g. cleanings).  Please note, for the period of 7/1/19-12/31/19, the deductible will be $12.50 individual/$37.50 family.

Vision Insurance

  • Premiums (no changes for July 1st)
  • Coverage enhancements
    • Member cost for progressive lenses and anti-reflective coating has been reduced.  See Summary of Benefits July 1, 2019 (PDF) for specific coverage amounts.
    • The allowance for elective contact lenses will increase from $130 to $150.  If contacts are purchased from 1800 Contacts, the allowance will increase from $165 to $185.