2022 benefit updates

For renewing members

If you had 2021 coverage you can view your online renewal in your secure member portal.

Renewing medical coverage

On exchange plans purchased through Pennie.com

Gold Simple PPO 0/0/25

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Gold PPO Choice 2000/0/30

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Gold PPO 2150/10/20

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Gold Valley Advantage EPO 2150/10/20

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Silver PPO Choice 4000/20/35

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Silver PPO 6000/20/40

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Silver Valley Advantage EPO 6000/20/40

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Bronze PPO Choice 7100/0/50

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Bronze PPO 8000/0/60

Below are the benefit changes for 2022

  • In-network annual deductible - $7,450 single/$14,900 family
  • Diagnostic lab services when performed at a facility/hospital owned lab - $75 copayment after deductible
  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Bronze Valley Advantage EPO 8000/0/50

Below are the benefit changes for 2022

  • In-network annual deductible - $7,450 single/$14,900 family
  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Catastrophic PPO 8550/0/75

Below are the benefit changes for 2022

  • In-network annual deductible - $8,700 single/$17,400 family
  • In-network annual maximum out of pocket limit -$8,700 single/$17,400 family
  • Outpatient office visits and consultations when provided by a family practitioner, general practitioner, or pediatrician (PCP visits) - paid in full for first 4 visits; paid in full after deductible starting at 5th visit
  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Zero/Limited Plans

Below are the benefit changes for 2022

  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Off exchange plans purchased directly through Capital Blue Cross

Gold Simple PPO 0/0/25

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Gold PPO Choice 2000/0/30

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Gold PPO 2150/10/20

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Gold Valley Advantage EPO 2150/10/20

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Silver PPO Choice 4000/20/35

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Silver PPO Choice 3950/20/35

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Silver PPO Choice 4000/20/35

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Silver PPO 5950/20/40

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Silver PPO 6000/20/40

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Silver Valley Advantage EPO 5950/20/40

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Silver Valley Advantage EPO 6000/20/40

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Bronze PPO Choice 7100/0/50

Below are the benefit changes for 2022

  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Bronze PPO 8000/0/60

Below are the benefit changes for 2022

  • In-network annual deductible - $7,450 single/$14,900 family
  • Diagnostic lab services when performed at a facility/hospital owned lab - $75 copayment after deductible
  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Bronze HMO 8000/0/60

Below are the benefit changes for 2022

  • In-network annual deductible - $7,450 single/$14,900 family
  • Diagnostic lab services when performed at a facility/hospital owned lab - $75 copayment after deductible
  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Bronze Valley Advantage EPO 8000/0/50

Below are the benefit changes for 2022

  • In-network annual deductible - $7,450 single/$14,900 family
  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Catastrophic PPO 8550/0/75

Below are the benefit changes for 2022

  • In-network annual deductible - $8,700 single/$17,400 family
  • In-network annual maximum out of pocket limit -$8,700 single/$17,400 family
  • Outpatient office visits and consultations when provided by a family practitioner, general practitioner, or pediatrician (PCP visits) - paid in full for first 4 visits; paid in full after deductible starting at 5th visit
  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Catastrophic HMO 8550/075

Below are the benefit changes for 2022

  • In-network annual deductible - $8,700 single/$17,400 family
  • In-network annual maximum out of pocket limit -$8,700 single/$17,400 family
  • Outpatient office visits and consultations when provided by a family practitioner, general practitioner, or pediatrician (PCP visits) - paid in full for first 4 visits; paid in full after deductible starting at 5th visit
  • Virtual Care visits delivered through our Virtual Care app when provided by a family practitioner, general practitioner, internist or pediatrician - paid in full
  • Enhanced preventive medication list and new insulin saver program

Visit the prescription drug benefits page to view the Value formulary (list of drugs) and other important information for 2022.

Pharmacy changes

Visit the prescription drug benefits page to view plan formularies and other important information for 2022.

Enrollment

Open enrollment timeline

Open enrollment is from November 1st, 2021- January 15th, 2022.

Applications for coverage effective January 1st, 2022 must be submitted between November 1st-December 15th, 2021.

Applications for coverage effective February 1st, 2022 must be submitted between December 16th, 2021- January 15th, 2022.

Any applications submitted outside of the above timeline will fall into the Special Enrollment Period and must have a qualifying event to enroll.

Ready to enroll or make a change

You can apply for medical with Rx included, dental or vision plans if you live in our service area.

Visit our individual and family plans to get started.

Enrollment details

Current member

If you’re a current member and you would like to keep your current plan, you do not need to take any action. We will enroll you in the plan outlined in your renewal packet.

On Pennie members

Visit Pennie to review your application for any changes, including any changes to your financial help.

New member

If you are a new member, you’ll receive a declaration page after you enroll. The page provides the effective date of coverage, covered members and expected premium amounts.

ID cards

You will receive a new ID card in mid-December. Please keep and be ready to use beginning January 1st.

Billing

Invoices for January enrollment will be generated on December 10, 2021.

Estimated subsidies in renewal package (On Pennie members only)

Reminder that the declaration page in your renewal packet may show you a premium different than your bill for 2022.

These estimates were based on your 2021 rebalanced Advanced Premium Tax Credit (APTC) instead of your 2022 APTC. Your final 2022 premium may be higher or lower than the amount estimated in your renewal packet.

To confirm that your tax and income information is correct, please visit Pennie. Review your application to make sure the information is still current and accurate and to see if you qualify for more or less financial help than in 2021. Report changes in your expected income, changes to your household or individual members or changes in your healthcare (Medicare or Medicaid eligible).

Or call us at the number on the back of your member ID card to confirm your monthly premium.

Payment options

  • Credit card/eCheck

    Make payments by logging into your secure member account or by calling 833.496.7321. Select a single payment or setup recurring payment options.

  • Check it Out

    You will receive a notice when Check It Out is processed. Payment will be deducted from the selected account on the first day of each month.

  • Paper bill

    Invoices are mailed to the address on the enrollment application.

  • Bill payer

    Payments can be made through a financial institution’s bill payer program.

You can now view your invoices and payment history here.

Visit the Welcome page for more information about your plan.