Active Health Summary Plan Description
As of July 1, 2022
En Español (PDF)
                    Article 2: Plan Benefits Available to You  >>
2.1 Inside Wireman, Intelligent Transportation, Inspector, Railroad Agreements, Master Turf and Master Maintenance
This section modified by Amendment 5. View old language.
  2.1 Inside Wireman, Intelligent Transportation, Inspector, Railroad Agreements
  
    - Hospital/Medical/Prescription Drug Benefit Options (Choice of One)
      
        - Blue Shield PPO Plan Plan 
 
        - Kaiser Permanente HMO Plan
 
        - UnitedHealthcare HMO Plan
 
      
     
    -  Dental Benefit Options (Choice of One)
      
        - United Concordia Preferred Provider Organization (PPO) Plan
 
        - DeltaCare USA Dental Health Maintenance Organization (DHMO) Plan 
 
        - United Concordia Dental Health Maintenance Organization (DHMO) Plan
 
      
     
    -  Vision Care Benefit Options
      
        - Vision Service Plan (VSP)
          (Available to UnitedHealthcare HMO and Blue Shield PPO Plan Plan Participants) 
        - Kaiser Permanente Vision Plan
          (Except prescription safety glasses, which are provided through VSP for Employees only)  
      
     
    -  Body Scan Benefits
      
    
 
    -  Orthotic Benefits
     
    -  Advocacy and Assistance Benefit
      
    
 
    -  Member Assistance Program (MAP)
     
    -  Life Insurance/AD&D Benefits
      
        - Anthem Blue Cross Life and Health Insurance Company
 
      
     
  
 
    
      - Hospital/Medical/Prescription Drug Benefit Options (Choice of One)
        
          - Blue Shield PPO Plan Plan 
 
          - Kaiser Permanente HMO Plan
 
          - UnitedHealthcare HMO Plan
 
        
       
      -  Dental Benefit Options (Choice of One)
        
          - United Concordia Preferred Provider Organization (PPO) Plan
 
          - DeltaCare USA Dental Health Maintenance Organization (DHMO) Plan 
 
          - United Concordia Dental Health Maintenance Organization (DHMO) Plan
 
        
       
      -  Vision Care Benefit Options
        
          - Vision Service Plan (VSP)
            (Available to UnitedHealthcare HMO and Blue Shield PPO Plan Plan Participants) 
          - Kaiser Permanente Vision Plan
            (Except prescription safety glasses, which are provided through VSP for Employees only)  
        
       
      -  Body Scan Benefits
        
      
 
      -  Orthotic Benefits
       
      -  Advocacy and Assistance Benefit
        
      
 
      -  Member Assistance Program (MAP)
       
      -  Life Insurance/AD&D Benefits
        
          - Anthem Blue Cross Life and Health Insurance Company