Active Health Summary Plan Description
As of July 1, 2022
En Español (PDF)
Article 2: Plan Benefits Available to You >>
This section modified by Amendment 4. View old language.
2.2 Residential Agreement
- 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
- Alternate Kaiser Permanente HMO Plan Only
- Health Reimbursement Arrangement
- Advocacy and Assistance Benefit
- Member Assistance Program (MAP)
- Life Insurance/AD&D Benefits
- Anthem Blue Cross Life and Health Insurance Company