Your Medical HMO Plan Benefits
Anthem Blue Cross
833-913-2236
Carrier Website: https://www.anthem.com/ca
Find A Provider: Search for Anthem providers
Eligibility
All active, regular full-time employees scheduled to work 30 hours or more per week are eligible the first of the month following your date of hire or coinciding with the current month in the Green Dot Public Schools’ benefits program.
Anthem Contributions
*Contributions are per pay period
| Anthem Vivity HMO | Anthem Full HMO | |
|---|---|---|
| Employee | $0 | $49.36 |
| Employee + Spouse | $0 | $108.59 |
| Employee + Child | $0 | $88.85 |
| Employee + Family | $0 | $153.02 |
Anthem Vivity HMO
Anthem Full HMO
Anthem Plan Documents
Kaiser Permanente
800-464-4000
Carrier Website: www.kaiserpermanente.org
Find A Provider: Search for Kaiser providers
Eligibility
All active, regular full-time employees scheduled to work 30 hours or more per week are eligible the first of the month following your date of hire or coinciding with the current month in the Green Dot Public Schools’ benefits program.
Kaiser Contributions
*Contributions are per pay period
| Kaiser HMO | |
|---|---|
| Employee | $49.36 |
| Employee + Spouse | $108.59 |
| Employee + Child | $88.85 |
| Employee + Family | $153.02 |
Kaiser Traditional HMO
Kaiser Plan Documents
Your Medical PPO Plan Benefits
Anthem PPO (Premier $300)
Anthem PPO (Exclusive Classic $100)
Plan Details
Carrier Information
Anthem Blue Cross
800-888-8288
Carrier Website: https://www.anthem.com/ca
Find a Provider: Anthem network providers
Eligibility
All active, regular full-time employees scheduled to work 30 hours or more per week are eligible the first of the month following your date of hire or coinciding with the current month in the Green Dot Public Schools’ benefits program.
Anthem PPO Contributions
| Anthem Premier PPO | Anthem Exclusive Classic PPO | |
|---|---|---|
| Employee | $269.76 | $119.77 |
| Employee + Spouse | $593.47 | $263.49 |
| Employee + Child | $485.57 | $215.59 |
| Employee + Family | $836.26 | $371.29 |
Legal Notices
Your FSA Benefits
Plan Information
Carrier Information
HealthEquity
Carrier Website: https://info.healthequity.com/Member/FSA
877-924-3967
Eligibility
All active, regular full-time employees scheduled to work 30 hours or more per week are eligible the first of the month following your date of hire or coinciding with the current month in the Green Dot Public Schools’ benefits program.
Your DCFSA Benefits
Plan Information
Carrier Information
HealthEquity
Carrier Website: https://info.healthequity.com/Member/FSA
877-924-3967
Eligibility
All active, regular full-time employees scheduled to work 30 hours or more per week are eligible the first of the month following your date of hire or coinciding with the current month in the Green Dot Public Schools’ benefits program.
Your Dental Benefits
MetLife Dental
Green Dot Public Schools offers a choice of dental plans through MetLife so you can select the level of coverage that best fits your needs.
- DHMO plan: you choose a primary care dentist and receive all of your care within the plan’s network — there is no out-of-network coverage. There is also no deductible or annual maximum benefit under the DHMO plan.
-
High and Low plans: you can see any dentist you want, but you must first meet a deductible before coverage begins. These plans also include an annual maximum benefit. The differences between the High and Low plans is in the deductibles, annual maximums, out-of-network coverage, and orthodontic lifetime maximums.
MetLife Dental HMO
MetLife Dental PPO Low ($50) and High ($25)
MetLife Plan Flyers
Carrier Information
MetLife
Carrier Website: www.metlife.com
Provider Network Website: MyBenefits.com
800-438-6388
Eligibility
All active, regular full-time employees scheduled to work 30 hours or more per week are eligible the first of the month following your date of hire or coinciding with the current month in the Green Dot Public Schools’ benefits program.
MetLife Dental HMO Contributions
MetLife Dental HMO (MET150A) Rates Per Pay Period
| Dental HMO | |
|---|---|
| Employee | $0 |
| Employee + Spouse | $0 |
| Employee + Child | $0 |
| Employee + Family | $0 |
MetLife Dental PPO Contributions
MetLife Dental PPO Low ($50) and High ($25) Rates Per Pay Period
| Dental PPO Low($50) | Dental PPO High($25) | |
|---|---|---|
| Employee | $9.85 | $21.87 |
| Employee + Spouse | $17.95 | $38.94 |
| Employee + Child | $26.32 | $57.07 |
| Employee + Family | $35.03 | $71.21 |
Benefits 101
Your Vision Benefits
Plan Details
Carrier Information
VSP Vision
Carrier Website: visionbenefits.vsp.com
Find a Provider: www.vsp.com/eye-doctor
800-877-7195
Eligibility
Vision Rates Per Pay Period
| Vision | |
|---|---|
| Employee | $0 |
| Employee + Spouse | $0 |
| Employee + Child | $0 |
| Employee + Family | $0 |
Contributions
All active, regular full-time employees scheduled to work 30 hours or more per week are eligible the first of the month following your date of hire or coinciding with the current month in the Green Dot Public Schools’ benefits program.
Find a Network Provider
You’ll get the best value by using a provider in the VSP network.
Benefits 101
Your Prescription Drug Benefits
Prescription Drugs
All of the medical plans include retail and mail-order prescription drug coverage. Benefits are provided by:
- Anthem if you enroll in an Anthem medical plan. See how drugs are covered by Anthem. (To view the Essential Formulary, click on “Essential Drug List 4-Tier (Searchable).”)
- Kaiser Pharmacy if you enroll in a Kaiser medical plan. See how drugs are covered by Kaiser.
Your Telehealth Benefits
LiveHealth Online (for Anthem members only)
With our convenient LiveHealth Online benefit, you and your covered family members can see the doctor without leaving the house! It’s an affordable, easy alternative to urgent care and ER visits when you need non-emergency medical care.
Use it for:
- Sinus problems
- Urinary track infections
- Behavioral health needs
- Pink eye
- Bronchitis and flu/cough
- Upper respiratory infections
- Ear infections
- Much more
LiveHealth Online gives you 24/7/365 access to board-certified physicians who will consult with you by phone or via live video on your mobile phone or computer. LiveHealth Online physicians can provide fast, convenient diagnosis and treatment for many common conditions. To get started, simply set up an account on the LiveHealth Online website and you’ll be ready the next time you need care in a hurry!
Use it when:
- The doctor’s office is closed
- Your child has a fever at 2 AM
- You’re traveling or on vacation
- It’s after business hours or on weekends
- Your medical situation is not life-threatening
- You think you have the flu but feel too ill to leave the house
Telehealth (for Kaiser members only)
If you enroll in the Kaiser HMO plan, telehealth services are provided directly through Kaiser.
Your Health Advocate Benefits
Health Advocate
Member Services: 866-695-8622
E-mail: answers@HealthAdvocate.com
Website: www.healthadvocate.com/greendotpublicschoolsca
Smartphone App: Health AdvocateSM
Plan Documents
Eligibility
All active, regular full-time employees scheduled to work 30 hours or more per week are eligible the first of the month following your date of hire or coinciding with the current month in the Green Dot Public Schools’ benefits program.
Contributions
To perform at your best, you need a whole-person approach that provides physical, emotional, relational, and financial support.
This Health Advocate plan is complimentary; there is no cost to you!
Your STD Benefits
Plan Information
Carrier Information
Lincoln Financial
https://www.mylincolnportal.com (first-time users register with code: GreenDot)
Contributions
Lincoln STD is 100% employer paid.
Eligibility
All active, regular full-time employees scheduled to work 30 hours or more per week are eligible the first of the month following your date of hire or coinciding with the current month in the Green Dot Public Schools’ benefits program.
Benefits 101
Your LTD Benefits
Plan Information
Carrier Information
Lincoln Financial
https://www.mylincolnportal.com (first-time users register with code: GreenDot)
Contributions
Lincoln LTD is 100% employer paid.
Eligibility
All active, regular full-time employees scheduled to work 30 hours or more per week are eligible the first of the month following your date of hire or coinciding with the current month in the Green Dot Public Schools’ benefits program.
Benefits 101
Your Life and AD&D Benefits
Plan Information
Carrier Information
Lincoln Financial
https://www.mylincolnportal.com (first-time users register with code: GreenDot)
Contributions
Lincoln Life is 100% employer paid.
Eligibility
All active, regular full-time employees scheduled to work 30 hours or more per week are eligible the first of the month following your date of hire or coinciding with the current month in the Green Dot Public Schools’ benefits program.