The Open Enrollment window (active NOW through November 15 in ADP) is the perfect time to review your benefits options and assess whether you might want to make a change for next year. Over the next few days, we’re going to focus on the major benefits that you’ll see in the ADP Open Enrollment module. Today’s benefit is MEDICAL.

We offer two plan options:

1. Albemarle Select: a traditional medical plan that has higher monthly premiums and lower out-of-pocket costs (copays and coinsurance); and
2. Albemarle Choice: a consumer-driven high-deductible plan that comes with lower monthly premiums and features a monthly employer contribution to a Health Savings Account (HSA).

Both plans cover the same services; what varies are the monthly premiums and out-of-pocket costs for services rendered. Each plan has an annual maximum that limits your out-of-pocket costs if you have significant health care expenses during the year.

Tip: Needs change as we move through life, so it’s always a good idea to look at your medical plan options annually, and choosing the plan that best meets your needs and that of your family doesn’t have to be difficult. First, think about how you and your covered family members typically use medical benefits: A little? More than a little? Then, understand the plan options and compare the out-of-pocket costs, including the monthly premium rates. You can view this information on our Open Enrollment info page.

Do you know that our plans offer a mail-order pharmacy option?

If you take prescription drugs on a regular basis, you can save time and money with Anthem’s mail-order pharmacy service. You get a 90-day supply of most drugs at less cost than filling them monthly at a retail pharmacy, plus free standard shipping to your home. You can also set up automatic refills that will arrive before your current 90-day supply runs out.

Who is eligible for coverage on our medical plans?

• Employees in regular positions who work at least 50% part-time
• Eligible dependents:
  • Your spouse (to whom you are currently and legally married) who does not have access to affordable medical coverage through their own employer
    • Please review our Spousal Eligibility (Medical Insurance) page.
    • Note: The rules pertaining to spousal eligibility do NOT apply to our dental plan or to spouses who are Medicare-eligible and do not have employer coverage.
  • Your natural children, children of your current spouse, legally adopted children, or those for whom you have legal custody/guardianship (including eligible foster children) under the age of 26
  • Certain disabled dependents over the age of 26 (subject to eligibility criteria)

Please review the eligibility criteria thoroughly before adding new dependents onto the plan or before confirming your covered dependents for next year. If any dependent you currently have on the medical plan does not meet the eligibility criteria, you are required to remove that dependent from the medical plan during the Open Enrollment window (or as soon as that dependent becomes ineligible). Dependents on the medical plan are subject to a dependent eligibility review. Important: Failure to comply with an eligibility review will result in the removal of your dependent from the medical plan.

Need help?

Whether you have a quick question or you’d like to schedule a virtual consultation with a member of our benefits team, we’re here to help! You can reach us by email at benefits@k12albemarle.org or give us a call at 434-296-5827.