Page 10 - NickCo Hospitality_2017 EE Benefits Guide_Hourly Associates_12.08.16
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YOUR MONTHLY CONTRIBUTIONS
Medical
Medical Elements HMO
Associate Only $115.00
Associate + Spouse $445.44
Associate + Child(ren) $335.29
Associate + Family $693.28
Dental
Dental PPO
Associate Only $18.50
Associate + Spouse $56.12
Associate + Child(ren) $56.12
Associate + Family $109.73
Vision
Vision PPO
Associate Only $7.72
Associate + Spouse $15.06
Associate + Child(ren) $15.83
Associate + Family $22.01
RESOURCES AND CONTACTS
Below is a list of insurance carrier contacts should you require assistance with your benefit ques ons following open enrollment. If
you are unable to resolve your issues or ques ons with the insurance carriers, please contact the Home Office.
Anthem Blue Cross
Medical
Select Elements Choice HMO Member Services (279103H007)….....…………………………... (800) 227‐3560
Carrier Website ………………………………………………………………….………………….…………………… www.anthem.com/ca
Dental
Dental Complete PPO Member Services (2791030001)……………..………….…………………… (877) 567‐1804
Carrier Website ………………………………………………………………….………………….…………………… www.anthem.com/ca
Vision
Blue View Vision Member Services (2791030003)…….…..……………………….…………………… (866) 723‐0515
Carrier Website ……………………………………………………………….…………………….…………………… www.anthem.com/ca
Educational Video
Benefits terminology can get confusing. Click here to watch a quick video to learn the basics of how our
medical plans work.
Deduc bles, Copays, Coinsurance, and Out‐of‐Pocket Maximums
h p://video.burnhambenefits.com/terms/
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