Medical & Prescription Drug

We offer you three medical plan options. Each plan has a different premium (monthly contributions that come out of your paycheck) and out-of-pocket costs (what you pay when you receive care throughout the year).

Here are key things to know about your medical plan options:

They are administered by Anthem Blue Cross Blue Shield (BCBS).

Preventive care is free when you receive services in-network.

All three plans have a deductible.

Our two HDHP options come with a Health Savings Account (HSA).

Read on to learn about your options and determine what is best for you and your family. View eligibility guidelines here.

Use Anthem’s Care & Cost Finder to search in-network providers, see quality ratings, and get personalized cost estimates.

Get Care Anytime, Anywhere

With Anthem’s Sydney Health app, you can see doctors from anywhere.

Need urgent care? Choose LiveHealth Online for 24/7 visits without an appointment.
Need ongoing care? Choose Virtual Primary Care for regular check-ups and ongoing health needs.

Lower Your Premiums with One Simple Step

Complete your annual preventive care exam by October 15, 2025 to avoid a medical premium increase in 2026. It’s a quick, proactive way to stay healthy and save money. Learn more about the SMP Wellness Program here.

Schedule your exam between October 16, 2024 and October 15, 2025
Log in to anthem.com or use the Sydney Health app
Go to My Health Dashboard > My Rewards

Note: If you were hired on or after July 15, 2025, you do not have to complete the program to lower your premiums.

Plan Comparisons

Features	PPO Plan	HDHP Base Plan	HDHP Value Plan
In-Network Benefits
Deductible (individual/family)*	$1,300 / $2,400	$2,200 / $4,200	$4,000 / $8,000
Coinsurance after deductible	You pay 10%	You pay 10%	You pay 20%
Out-of-pocket max (individual/family)	$2,400 / $4,600	$3,950 / $7,700	$6,350 / $12,700
Preventive care	You pay $0	You pay $0	You pay $0
Office visit (primary/specialist)	$25 / $40	10%, after deductible	20%, after deductible
Virtual Visits – General Health	$0	$50, after deductible	$50, after deductible
Virtual Visits – Dermatology	$40	$40, after deductible	$40, after deductible
Virtual Visits – Mental Health (psychiatrist)	$0	$200 first, $100 ongoing	$200 first, $100 ongoing
Virtual Visits – Mental Health (psychologist or therapist)	$0	$90, after deductible	$90, after deductible
Urgent care	10%, after deductible	10%, after deductible	20%, after deductible
Emergency room	$250 copay	10%, after deductible	20%, after deductible
Inpatient hospital care	10%, after deductible	10%, after deductible	20%, after deductible
Outpatient hospital care	10%, after deductible	10%, after deductible	20%, after deductible
Labs, X-rays, and imaging**	10%, after deductible	10%, after deductible	20%, after deductible
Prescription Drug Coverage***
Retail pharmacy (30-day)		All non-preventive prescriptions are subject to deductible and coinsurance. There are several preventive drugs available for free under the following categories: Birth Control, Diabetes, Heart Health, High Blood Pressure, High Cholesterol, and Smoking Cessation. A complete list of covered drugs can be found here.
Generic (Tier 1)	$5 copay
Preferred Brand (Tier 2)	$30 copay
Non-Preferred Brand (Tier 3)	$60 copay
Specialty Medication (Tier 4)	$75 copay
Mail order (90-day)
Generic (Tier 1)	$7.50 copay
Preferred Brand (Tier 2)	$45 copay
Non-Preferred Brand (Tier 3)	$90 copay
Specialty Medication (Tier 4)	$112.50 copay

*Under both HDHP options, the family deductible is a combined deductible. That means if you cover any dependents, all collective claims under the plan must meet the full deductible before coinsurance begins. Once the total member responsibility exceeds the deductible, the entire family begins to pay coinsurance.
** If your doctor recommends a high-tech imaging service, such as an MRI/CT scan, you must get prior authorization for these services, or you will be subject to a $50 penalty. If you need a high-tech imaging service, have your doctor call 1-888-953-6703 (the same number on the back of your Medical ID card).
*** There is a Tiered Pharmacy Surcharge for using a Level 2 Pharmacy (see Prescription Drug)

Plan Premiums

Monthly, pre-tax employee contributions for medical coverage are based on salary bands.

Note: If you were hired prior to July 15 and/or had a spouse covered under our medical plan, but did not complete the wellness program, $50 per month will be added to your monthly medical plan contribution in the following year.

1. First, find your salary band:

Band	Minimum	Maximum
1	–	$30,000
2	$30,001	$35,000
3	$35,001	$40,000
4	$40,001	$50,000
5	$50,001	$60,000
6	$60,001	$70,000
7	$70,001	$80,000
8	$80,001	$90,000

Band	Minimum	Maximum
9	$90,001	$100,000
10	$100,001	$110,000
11	$110,001	$120,000
12	$120,001	$130,000
13	$130,001	$140,000
14	$140,001	$150,000
15	$150,001	$1,000,000

2. Then, find your band in the rate charts for each medical plan option:

Band	Plan	EE Only	EE + Spouse	EE + Children	Family
1	PPO HDHP Base HDHP Value	$113 $68 $32	$251 $182 $86	$243 $177 $84	$318 $227 $107
2	PPO HDHP Base HDHP Value	$145 $99 $47	$300 $230 $109	$287 $220 $104	$382 $290 $138
3	PPO HDHP Base HDHP Value	$150 $104 $49	$307 $237 $113	$297 $229 $109	$393 $300 $142
4	PPO HDHP Base HDHP Value	$160 $113 $54	$321 $251 $119	$314 $246 $117	$411 $319 $151
5	PPO HDHP Base HDHP Value	$171 $124 $59	$339 $269 $127	$332 $263 $125	$435 $341 $162
6	PPO HDHP Base HDHP Value	$184 $137 $65	$361 $288 $137	$350 $279 $133	$465 $369 $175
7	PPO HDHP Base HDHP Value	$197 $148 $71	$380 $307 $145	$368 $298 $141	$489 $392 $186
8	PPO HDHP Base HDHP Value	$208 $160 $75	$398 $324 $154	$382 $312 $148	$514 $416 $197
9	PPO HDHP Base HDHP Value	$220 $172 $81	$418 $344 $163	$399 $328 $155	$540 $441 $209
10	PPO HDHP Base HDHP Value	$234 $184 $87	$437 $362 $172	$413 $342 $162	$566 $466 $220
11	PPO HDHP Base HDHP Value	$243 $193 $92	$453 $379 $179	$427 $357 $168	$586 $487 $231
12	PPO HDHP Base HDHP Value	$254 $205 $97	$468 $393 $186	$441 $370 $175	$607 $508 $240
13	PPO HDHP Base HDHP Value	$267 $217 $103	$489 $413 $195	$455 $383 $181	$634 $533 $253
14	PPO HDHP Base HDHP Value	$277 $227 $107	$504 $428 $203	$468 $398 $188	$654 $553 $263
15	PPO HDHP Base HDHP Value	$282 $232 $110	$511 $437 $207	$482 $411 $195	$665 $565 $268

Prescription Drugs

When you enroll in an Anthem BCBS medical plan, you have prescription drug coverage through CareIonRx. CareIonRx has programs in place to help you and the company better manage drug costs.

Prior Authorization: Your doctor must get approval from Anthem when prescribing certain medications to be sure drugs are being used as recommended by the FDA.
Preferred Generic: Members must buy the generic equivalent of a brand-name drug unless your doctor received prior authorization for the drug to be filled as a brand name. If you choose a brand name when a generic is available without prior authorization, you will pay the difference between the brand name cost and the generic cost.

Important Documents

View a list of drugs by tier, preferred generics, and get answered to frequently asked questions in the Document Library.

Step Therapy: If your doctor prescribes a specific medication, you may need to try one or more other drugs before Anthem will cover the medication your doctor ordered.
Exclusive Specialty Program: You must fill specialty medication prescriptions through CareIonRx Specialty Pharmacy.
Tiered Pharmacy Surcharge: Members can fill prescriptions at Level 1 and Level 2 pharmacies. If you go to a Level 2 pharmacy, you will pay a surcharge (PPO: $10 / HDHPs: 10%). Log on to anthem.com to find a Level 1 pharmacy near you.
Quantity Limits: Members may not exceed the covered amount of medication (number of pills) filled in a certain time period.
Mail Order Program and 90-Day Supply Options at Retail Pharmacies: SMP requires that you fill maintenance drugs using CareIonRx home delivery mail order, which will save you and the company money! You receive a 90-day supply of maintenance medications at home instead of going to the pharmacy every 30 days. With mail order, you may save approximately 33% on the cost of the medications.1 In addition, with the Carelon Retail 90 Network, you can get a 90-day supply of maintenance medication for the same cost as the mail order program at more than 26,000 retail pharmacies nationwide (including Walmart and CVS).
Cost Relief: This feature combines an innovative specialty copay plan design strategy with an improved member experience to help optimize savings from available manufacturer assistance programs—reducing member and company specialty drug costs. Call 877-638-4008 to learn more about eligibility.

Save with 90-Day Prescriptions

Get a 90-day supply of your maintenance medications through CarelonRx Mail Order or at 26,000+ retail pharmacies (like Walmart & CVS) — all at the same low cost!

You could save up to 33% compared to monthly refills.

Mail order is required for ongoing prescriptions.

Health Savings Account

The HDHP Base Plan and HDHP Value Plan both come with an HSA. If you enroll in one of the two HDHP medical options, SMP will contribute to your HSA.

You can enroll in an HDHP and contribute to the HSA if you are:

Not covered by any other health plan, including a Health Care Flexible Spending Account (FSA) provided through Standard Motor Products or your spouse’s employer
Not enrolled in Medicare (A, B, or D)
Not claimed as a dependent on another individual’s tax return

Learn more on the Tax-Advantaged Accounts page.

Advantages of an HSA

It offers a triple tax advantage. Even more tax advantages than a 401(k) plan!

Money is tax-free when it goes in, through the convenience of payroll contributions, lowering your taxable income.
It’s tax-free as it grows, as any interest or investment earnings aren’t subject to taxes.
It’s tax-free when you spend it on qualified health care expenses. That means you’re saving money on things like your medical, dental, and vision coinsurance and deductibles.

Your contributions are flexible.

You choose the tax-free amount you want to contribute for 2025 when you enroll, but you’re not locked into that decision. In fact, unlike an FSA, you can change this amount at any time during the year as often as you’d like as your needs and budget change. You can even transfer funds directly from your checking account! The more you can save, the more your money will grow over time, but you don’t have to make any minimum contribution.

It’s easy to use.

In addition to being able to manage your account online, there are multiple ways to use your HSA to pay for expenses. You can use the HSA debit card, use the website to send money to your provider electronically, or reimburse yourself from your HSA for claims paid in cash earlier in the year.

It’s always your money.

Just like a bank account, you own your HSA, so it’s yours to keep and use even if you change medical plans, leave SMP, or retire. There’s also no “use it or lose it” rule like a Flexible Spending Account (FSA). What’s more, you’re in complete control of how you spend the money in your HSA. You can use the funds each year to help cover today’s costs, or save for the future, building your account balance over time. You can even use your HSA to pay premiums for medical coverage in retirement.

Medical & Prescription Drug

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