Review Your Benefit Options

Medical

Medical Benefits

Overview

ARHA offers three medical plan options administered by Blue Cross Blue Shield of Alabama. All plans are Preferred Provider Organization plans.

All plans use the same network of providers who have agreed to charge discounted rates to plan members. The amount you pay for health care will vary depending on whether or not you use in- network providers and facilities. You always have the choice to go to any provider, but you’ll pay less if you stay within the Blue Cross Blue Shield of Alabama network.

	Premier Plan	Value Plan	Bronze Plan
	In-Network	In-Network	In-Network
Deductible
Individual	$1,000	$5,000	$4,000
Family	$2,000	$10,000	$8,000
Out-of-Pocket Max.
Individual	$3,000	$7,000	$6,000
Family	$6,000	$14,000	$12,000
Inpatient Services
Inpatient Facility	80% after deductible	80% after deductible	60% after deductible
Emergency Room	80% after deductible	80% after deductible	60% after deductible
Physician Office Visits
Preventive Care/ Specialists	$35/$50	$35/$50	60% after deductible Preventive Care: (no charge)
Outpatient Services
Outpatient Diagnostics	80% after deductible	80% after deductible	60% after deductible
Rehabilitative Services	80% after deductible	80% after deductible	60% after deductible
Home Health Care	80% after deductible	80% after deductible	60% after deductible
Prescription Drug
Tier 1	$15 Copay	$15 Copay	$15 Copay
Tier 2	$60 Copay	$60 Copay	$50 Copay
Tier 3	$100 Copay	$100 Copay	$75 Copay
Tier 4	$425 Copay	$425 Copay	$395 Copay

Employee Monthly Contributions

	Premier Plan	Value Plan	Bronze Plan
Employee Only	$654.17	$611.57	$577.70
Employee + Spouse	$1,284.61	$1,195.15	$1,127.41
Employee + Child	$1,188.27	$1,109.86	$1,047.21
Family	$1,825.58	$1,693.44	$1,596.92

Primary Care

Primary Care Benefits

River Health members can see a doctor in person up to (3) times a year for $0*

$0 office visits at over 2500+ locations across the country including urgent care.
Available at all CVS MinuteClinic Locations across the country
Available at all CVS MinuteClinic Locations across the country
Available in 47 states

River Health members enjoy $0 prescriptions from a formulary of over 700 medications.

Prescriptions are mailed for free to the member’s doorstep
Every member gets a dedicated primary care provider.
See the same provider every time you have a virtual visit.
Your dedicated provider manages chronic conditions like diabetes, etc.
Get at-home diagnostic kits, blood pressure cuffs, weight scale and more.
See your provider over text, audio, and video with no caps.

Employee Monthly Contributions


Employee Only	$54
Employee + Spouse	$74
Employee + Child	$134
Employee + Family	$164

Dental

Dental Benefits

Overview

ARHA offers dental coverage to you through Delta Dental. Your dental plan provides coverage to help with the cost of many dental services including routine cleanings, x-rays, restorative and prosthetic services. The plan includes an extensive network of dental providers. Maximize your benefits by selecting an in-network dentist to save more on all covered services and avoid balance billing.

	Dental Basic Plan	Dental Enhanced Plan
Benefits	In-Network	In-Network
Annual Deductible Single/Family	$50/$150	$25/$75
Annual Maximum Per Individual	$1,000	$2,500
Lifetime Orthodontia Maximum 19 and under	$1,500	$1,500
Diagnostic & Preventive Services Exams, Cleanings, Flouride Treatment, Space Maintauners, X-Rays, Sealants	Covered 100%	Covered 100%
Basic Services FIllings, Simple Extractions, General Anesthesia, Oral Surgery, Endodontics, Periodontics	Covered 80% / Subject to deductible	Covered 100% / Subject to deductible
Major Services Crowns, Inlays, Onlays, Bridges, Dentures	Covered 50% / Subject to deductible	Covered 80% / Subject to deductible
Orthodontic Services	Covered 50% (Child)	Covered 50% (Child)

Employee Monthly Contributions

Coverage Tier	Basic Plan	Enhanced Plan
Employee Only	$25.74	$30.90
Employee + Spouse	$49.65	$59.54
Employee + Child	$55.76	$73.62
Family	$85.10	$110.42

Vision

Vision Benefits

Overview

AGA offers vision coverage to you through VSP. Receive the maximum benefits and pay less out-of-pocket by visiting an in-network provider. The network includes provider access points nationwide. A comprehensive vision exam is available every 12 months and you may purchase eyewear in the form of an eyeglass frame and lenses, or contact lenses.

Class Description	Copay	Frequency
WellVision Exam
Focuses on your eyes and overall wellness	$20 Copay	Every 12 months
Essential Medical Eye Care
Retinal screening for members with diabetes and additional exams and services beyond routine care to treat immediate issues. Coordination with your medical coverage may apply.	$0 per screening $20 per exam	Available as needed
Prescription Glasses	$20 copay
Frames	$20 Copay
$150 featured frame brands allowance $130 frame allowance 20% savings on the amount over your allowance $130 Walmart®/Sam’s Club® frame allowance $70 Costco® frame allowance	Included in Prescription Glasses	Every 12 months
Lenses
Single vision, lined bifocal, and lined trifocal lenses Impact-resistant lenses for dependent children	Included in Prescription Glasses	Every 12 months
Lens Enhancements
Standard Progressive Lenses	$0	Every 12 months
Premium Progressive Lenses	$95-105	Every 12 months
Custom Progressive Lenses	$150-$175	Every 12 months
Average savings of 30% on other lens enhancements
Contacts (instead of glasses)
$130 allowance for contacts; copay does not apply Contact Lens exam (fitting and evaluations)	Up to $60	Every 12 months

Employee Monthly Contributions

Coverage Tier	Rate
Employee Only	$13.34
Employee + Spouse	$18.94
Employee + Child(ren)	$19.25
Employee + Family	$28.59

Complete Participating Employer Agreement

Get Your Questions Answered

Open Enrollment

Qualified Life Event

Documents and Forms