Medical
Medical
Medical
Medical
anthem

Medical coverage is one of the most important benefits we provide to you and your family.

We understand that our Benesch family has different health care needs and preferences, so we give you a choice of two types of medical plans. With both plans, you have access to Anthem’s vast network of providers and receive prescription coverage as part of Express Scripts.

Please note: If you enroll in coverage, it is effective on the first of the month following hire date.

Health Care Savings Medical Plan

  • Higher deductible in exchange for lower premium
  • Opportunity to save pre-tax dollars in a Health Savings Account (HSA) for qualified medical expenses

Preferred Provider Organization Plan (PPO)

  • Lower deductible in exchange for higher premium
  • Predictability of costs—you know before you go because there are set copays for services

Discover the best medical plan for you and your family with our new online medical cost calculator! This easy to-use tool will help you find the right fit for your unique healthcare needs.

Health Care Savings Medical Plan

This medical plan has higher deductibles but lower premiums. Once you reach your annual deductible, copays will apply. You have access to the same network of providers and high level of care. Note: in-network preventive care is paid at 100% and the deductible does not apply.

Important Note: Prescriptions are applied to the deductible first. Once you meet your deductible, a copay will apply.

By enrolling in this medical plan, you are eligible to enroll in a Health Savings Account (HSA) which provides a triple-tax advantage. The funds you contribute to your HSA is yours to keep and can be used not only for medical expenses, but for retirement expenses as well.

You are also eligible to contribute to a Limited Purpose Flexible Spending Account, (LFSA), which can be used to cover dental and vision expenses. It also provides an additional level of tax-advantage.

In-Network Out-of-Network
Plan Design
Deductible $3,200 individual / $6,400 family $4,000 individual / $8,000 family
Maximum Out-of-Pocket $4,000 individual / $8,000 family $8,000 individual / $16,000 family
Primary Care and Mental Health and
Substance Abuse Disorder Services Visits
$25 copay after deductible 50% after deductible
Preventive Care No Charge 50% after deductible
Specialist Visits $35 copay after deductible 50% after deductible
Emergency Room $250 copay and 20% after deductible $250 copay and 20% after deductible
Urgent Care $75 copay after deductible 50% after deductible
Rx Retail Copays
Generic $10 copay after deductible 50% coinsurance after deductible
Preferred Formulary $30 copay after deductible
Non-Preferred Formulary/Specialty $50 copay after deductible
Maintenance Rx 90 Day Supply through Smart 90 Pharmacies
Generic $25 copay after deductible Not covered
Preferred Formulary $75 copay after deductible
Non-Preferred Formulary/Specialty $125 copay after deductible
Express Scripts Rx Home Delivery
Generic $20 copay after deductible Not covered
Preferred Formulary $60 copay after deductible
Non-Preferred Formulary/Specialty $100 copay after deductible

Plan Monthly Rates

Coverage Tier 1 Medical Plan Monthly Rates
Base Salary < $100,000
Tier 2 Medical Plan Monthly Rates
Base Salary = > $100,000
Tier 3 Medical Plan
Monthly Rates Equity Partner
Employee $142.00 $236.68 $826.03
Employee + Spouse $312.41 $520.70 $1,817.27
Employee + Child(ren) $269.81 $449.69 $1,569.46
Employee + Family $454.41 $757.38 $2,643.30

PPO Medical Plan

This medical plan allows you to visit any physician or healthcare provider you wish without first requiring a referral from a primary care physician. No matter which healthcare provider you choose, in-network healthcare services will be covered at a higher benefit level than out-of-network services. It's important to check if your provider accepts your health plan so you receive the highest level of benefit coverage. For a list of in-network doctors, click here.

For most services, a deductible will apply. Once you've met your deductible, a copay will apply thereafter.

Prescriptions are covered at a copay. In-network pharmacies will be covered at a higher level of benefit than out-of-network pharmacies.

You are also eligible to contribute to the Medical Flexible Spending Account (FSA) that provides tax advantages and can be used to cover the costs of your deductible and copays.

In-Network Out-of-Network
Plan Design
Deductible $500 individual / $1,000 family $2,500 individual / $5,000 family
Maximum Out-of-Pocket $2,000 individual / $4,000 family $5,000 individual / $10,000 family
Primary Care and Mental Health and
Substance Abuse Disorder Services Visits
$25 copay 50% after deductible
Preventive Care No copay 50% after deductible
Specialist Visits $35 copay 50% after deductible
Emergency Room $250 copay $250 copay
Urgent Care $75 copay 50% after deductible
Rx Retail Copays
Generic $10 copay 50% coinsurance
Preferred Formulary $30 copay
Non-Preferred Formulary/Specialty $50 copay
Maintenance Rx 90 Day Supply through Smart 90 Pharmacies
Generic $25 copay Not covered
Preferred Formulary $75 copay
Non-Preferred Formulary/Specialty $125 copay
Express Scripts Rx Home Delivery
Generic $20 copay Not covered
Preferred Formulary $60 copay
Non-Preferred Formulary/Specialty $100 copay

Plan Monthly Rates

Coverage Tier 1 Medical Plan Monthly Rates
Base Salary < $100,000
Tier 2 Medical Plan Monthly Rates
Base Salary = > $100,000
Tier 3 Medical
Plan Monthly Rates
Equity Partner
Employee $299.48 $424.26 $972.94
Employee + Spouse $658.85 $933.37 $2,140.47
Employee + Child(ren) $569.01 $806.09 $1,848.59
Employee + Family $958.33 $1,357.62 $3,113.41

My Health Dashboard

Download the Sydney Health App and use your Anthem login to find everything you need to know about your medical and wellness benefits all in one place.

In addition to being able to find a doctor matched to your preferences and manage your medical/pharmacy care, you have access to My Health Dashboard under the Menu on the app: your hub for personalized health and wellness. You can sync your devices and find resources and programs that interest you including:

  • WebMD Health Risk Assessment – to help build an action plan based on your personalized needs
  • Action Plans – reduce stress, sleep better, increase energy, get active, eat healthy, or achieve a healthy weight in digitally curated action plans with five easy steps
  • Well-being Coach – digital and phone coaching programs to transform your health
  • Emotional Wellbeing Resources – digital tools and programs to improve emotional well-being
  • Weight Management Center – digital playbook to lose weight
  • ConditionCare – programs specifically for cancer, diabetes, asthma and heart disease
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