View Your Benefits
Qualified Life Event
OPEN Enrollment
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YEAR-ROUND ADVOCACY
REVIEW YOUR BENEFIT OPTIONs
New Hire Enrollment:
What You Need to Do
Schedule Your
Enrollment Appointment
QLE Process
Schedule Your QLE Appointment
Eligible Changes by Event
Required Documentation
Enroll Yourself
Schedule Your Enrollment Appointment
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Understanding Rewards
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Your benefit needs are unique to you and your family.
ARHA is pleased to offer year-round support with electing,
understanding, and using your benefits.
Benefits Questions
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Enroll
YOUR HEALTH.
YOUR PROTECTION.
YOUR FUTURE.
OPEN ENROLLMENT:
JUNE 20 - JULY 22
Your Benefits.
GET YOUR QUESTIONS ANSWERED
COMPLETE PARTICIPATING EMPLOYER AGREEMENT
For a complete list of Documents & Forms available to you, click the link above.
Important Enrollment Documents
2023 Benefits Booklet
HEALTH PLAN OVERVIEW BROCHURE
Coming
Soon!
Coming
Soon!
BCBS Wellness Tools
ARHA has chosen benefits that we feel offer the best care for you and your family. To make your benefits enrollment easy and personalized, and to help you fully understand your options, Benefits Educators will be available during Open Enrollment to walk you through the process and help you enroll.
Schedule your session beginning Monday, March 20th to get the best date and time that works for you. All you need to do is:
OR • Call the Optavise Benefits Service Center at 877-884-2928.
About This Year’s Enrollment:
• Open Enrollment is from March 28th – April 14th. Your elections will be effective May 1st, 2023.
Open Enrollment begins March 28th!
Schedule your one-on-one, confidential phone appointment with a Benefits Educator starting Monday, March 20th!
OpEN ENROLLMENT
Click Here
ELIGIBILITY
VISION BENEFITS OVERVIEW
KEY DATES AND TIMING
DENTAL BENEFITS OVERVIEW
VISION
DENTAL
MEDICAL
BENEFITS
MEDICAL BENEFITS OVERVIEW
DENTAL MONTHLY RATES
To find a dentist in the Access Plus Dental network, visit AlabamaBlue.com and click on “Find a Doctor” then select “Dentist” as the healthcare provider type, enter your zip code or city/state and choose “Access Plus Dental."
VISION RATES (MONTHLY)
The ARHA is pleased to offer our members medical plan coverage through BlueCross BlueShield, dental coverage through Delta Dental, and vision coverage through VSP. As a member of the association, you have the opportunity to purchase health insurance for you and your family.
Coverage Tier
RATES
Employee Only
$11.42
Employee + Spouse
$16.47
Employee + Children
$16.75
Family
$25.17
Coverage Tier
Delta Basic PLAN
Employee Only
$25.24
Employee + Spouse
$45.60
Employee + Children
$52.62
Family
$80.62
Delta enhanced PLAN
$30.40
$56.97
$73.16
$109.73
Coverage Tier
Premier PLAN
Employee Only
Employee + Spouse
Employee + Children
Family
Value PLAN
$585.13
$1,130.27
$1,048.49
$1,593.63
$623.86
$1,211.60
$1,119.77
$1,713.76
Premier PLAN
$1,000/$2,000
$3,000/$6,000
80% after deductible
80% after deductible
$35/$50
$15/$60/$100/$425
Value PLAN
$5,000/$10,000
$7,000/$14,000
80% after deductible
80% after deductible
$35/$50
$15/$60/$100/$425
Inpatient Facility
Single/Family
Deductible
Single/Family
Out-of-Pocket
Single/Family
Outpatient Facility
Single/Family
Prescriptions
MEDICAL RATES (MONTHLY)
In-Network
Bronze PLAN
$552.66
$1,065.32
$988.43
$1,501.09
$4,000/$8,000
$6,000/$12,000
60% after deductible
60% after deductible
60% after deductible
$15/$50/$75/$395
Bronze PLAN
Office Visit Copays
Preventive Care/Specialists
$25/$75
$2,500
$1,500
Enhanced PLAN
Basic PLAN
$50/$150
$1,000
$1,500
Orthodontic Services
In-Network
Lifetime Orthodontia Maximum
19 and under
Annual Deductible
Single/Family
Annual Maximum
Per Individual
Diagnostic & Preventive Services
Exams, Cleanings, Flouride Treatment, Space Maintauners, X-Rays, Sealants
Major Services
Crowns, Inlays, Onlays, Bridges, Dentures
Basic Services
FIllings, Simple Extractions, General Anesthesia, Oral Surgery, Endodontics, Periodontics
Covered 80% / Subject to deductible
Covered 100%
Covered 50% / Subject to deductible
Covered 50% (Child)
Covered 100% / Subject to deductible
Covered 80% / Subject to deductible
Covered 50% (Child)
Covered 100%
Primary Care
Subscription
UNLIMITED VIRTUAL CARE
River Health Virtual care is more than telemedicine:
• 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.
Coverage Tier
Rates
Employee Only
$49
$69
$124
$149
Employee + Spouse
Employee + Children
Employee + Family
RATES (MONTHLY)
$5,000/$10,000
$7,000/$14,000
Covered 80% / Subject to deductible
Covered 80% / Subject to deductible
$35/$50
$15/$60/$100/$425
Value PLAN
Premier PLAN
$1,000/$2,000
$3,000/$6,000
Covered 80% / Subject to deductible
Covered 80% / Subject to deductible
$35/$50
$15/$60/$100/$425
$4,000/$8,000
$6,000/$12,000
Covered 60% / Subject to deductible
Covered 60% / Subject to deductible
Covered 60% / Subject to deductible
$15/$50/$75/$395
Bronze PLAN
Prescriptions
In-Network
Inpatient Facility
Single/Family
Deductible
Single/Family
Out-of-Pocket Max.
Single/Family
Outpatient Facility
Single/Family
Office Visit Copays
Preventive Care/Specialists
$0 OFFICE VISITS
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 in 47 states
*subsequent visits are only $99 per visit
DIAGNOSTICS & LABS
River Health offers $0 lab testing at over 3000+ partner labs including Quest Diagnostics.
• Members can also request at-home lab testing at no additional cost
Prescriptions
River Health members enjoy $0 prescriptions from a formulary of over 700 medications.
• Prescriptions are mailed for free to the member’s doorstep.
Mental Health & Wellness
River Health members can see a therapist virtually at no additional cost. Therapists include licensed clinical social workers, psychiatric NPs, psychologists, and more.
• Wellness: All River Health Plans come with free wellness services like Yoga passes and a free Headspace Premium Meditation
Subscription.
Employee + 4
River Health Primary Care OVERVIEW
This is not major medical
Primary Care
Subscription
What are the ARHA Health Plans?
The ARHA Health Plan is a high deductible plan with BlueCross BlueShield. There is a secondary insurance option offered through TransAmerica that can be elected to increase the benefit of the BCBS plan. Combining primary and secondary insurance creates maximum savings for the plan’s participants.
What is secondary insurance?
Secondary insurance pays most deductibles and out-of-pocket expenses up to the policy limit after your primary medical plan has paid its covered expenses. For the ARHA Health Plan, your secondary coverage pays a total of $4,000 toward your deductible and out-of-pocket maximum, meaning you only have pay $3,000 of your own money. To receive full benefits, be sure to give your doctor both your primary insurance card and your secondary insurance card. Click here to watch a video presentation explaining secondary insurance in more detail.
Who is Eligible for the ARHA Health Plan?
All ARHA members who have at least one common law employee are eligible for the ARHA Health Plan. Sole proprietors without at least one common law employee are not eligible to participate in the plan. Member companies must have a direct affiliation with the restaurant and hospitality industries in order to be eligible. The company must be domiciled in the State of Alabama.
Employers must complete a participating employer agreement prior to open enrollment. Please contact Patrick Pittman for more information at arha@cobbsallen.com.
What if I’m already offering a small group health plan to my employees?
You may transfer to the ARHA Plan by submitting a Current Health Census to arha@cobbsallen.com. Please note that you must notify all impacted employees of this change and allow them the option to opt out. Employees who wish to change their benefit election must do so by scheduling an appointment with a Benefits Educator during Open Enrollment.
Could I elect Dental, without participating in the Medical Plan?
Yes. Both Dental and Medical can be elected separate of each other, or together if preferred.
What if I am currently enrolled in a different Health Plan, but want to elect the ARHA Health Plan?
Open enrollment is a Qualifying Life Event. If your employer decides to participate and you are enrolled in another health plan, you may still be eligible to enroll in the ARHA Health Plan. Credit can be given for the deductible that you and your family members have already reached on your current health plan. You may discuss credit for your deductible with the Benefits Educator during your scheduled appointment. If you are transferring from a BCBS plan, the deductible credit will happen automatically.
When and how do I enroll?
The ARHA Health Plan renews May 1, and our Open Enrollment is held in March each year. Open enrollment is the one time per year we are allowed to onboard new members to the plans. If your company is an existing plan member and has a new hire, you have the ability to schedule an appointment with a Benefits Educator by clicking here or by calling (877) 884-2928. During your scheduled appointment time, a Benefits Educator will assist you in enrolling in the plan.
What if an employee who elected the benefit gets fired or quits? How is the benefit offered to new hires?
Members will be responsible for submitting information of any employees who elected the plan who was terminated or hired each month. This will ensure each group is billed the appropriate amount each pay period. These census updates will be submitted to Cobbs Allen.
New Hires should schedule an appointment to enroll within 30 days of hire date by visiting the Qualified Life Event section.
How do I pay my premium?
Each member company will be assigned a login to our payment portal, www.paymyhealthinsurance.com. Employers are responsible for remitting payment for their employees who participate on the plan. Invoices will be sent via email on the 5th of each month. Payment will be due on the 15th and late on the 20th. After the second late payment, a $100 late fee will be assessed.
Who should I contact if I have questions?
Questions about the ARHA Health Plan and its benefits can be directed to a Cobbs Allen Benefits Consultant:
Patrick Pittman | 205-874-1268 | ppittman@cobbsallen.com
Matthew Cate | 205-874-1226 | mcate@cobbsallen.com
Questions about how to book your enrollment appointment can be directed to a DirectPath Benefits Educator at 877-884-2928.
Frequently Asked
Questions
We know that your benefits are important to you and your family. We also know that understanding how your benefits work can sometimes be confusing. That is why we offer assistance with your benefits-related questions and enrollment. This assistance is a 30-minute, confidential phone call with a Benefits Educator and an opportunity to make sure you understand all the Company has to offer you and your family. It's simple, quick, and our way of making this an easy process for you.
To schedule your appointment, click the button below:
Schedule Your New Hire
Appointment
New Hire Enrollment
Active employer members of ARHA who wish to participate in the ARHA Health Plan must sign and submit a Participating Employer Agreement prior to being eligible to enroll. If your company is already participating in the plan, there is no need to sign and submit another agreement.
Click the button below to view and sign the Participating Employer Agreement.
Once signed, please return to Patrick Pittman at ppittman@cobbsallen.com.
DOWNLOAD THE PARTICIPATING
EMPLOYER AGREEMENT
Participating Employer Agreement
ELIGIBILITY
EMPLOYEE ELIGIBILITY
Employees who work are eligible to participate in <2022> benefits.
DEPENDENT ELIGIBILITY
Eligible employees may also cover any legal* dependents, including:
• Your legally married spouse
• Your children, up to age 26, regardless of student or marital status
• Any children who have a mental or physical disability that meets the Social Security definition of “Disabled” and depend on you for
support
*A copy of a birth certificate or other applicable legal document may be required as proof of dependent eligibility.
KEY DATES AND TIMING
AS A NEW HIRE
Employees who work are eligible to participate in <2022> benefits.
AS PART OF OPEN ENROLLMENT
Coverage elected during the Open Enrollment period is effective . .
DESCRIPTION
• Change in coverage for you or your dependent
• Qualified Medical Child Support Order (QMSCO)
• Loss of coverage and/or eligibility under Medicare
• Medicaid or a Children’s Health Insurance Program
You cannot change your benefit elections during the plan year unless you have a Qualified Life Event in your immediate family.
Qualified Life Events include:
• Marriage, divorce, or legal separation
• Birth, death, or adoption of a dependent
• Dependent reaching age limit
• Change in employment status of you or your spouse
If you have a life status change event, you must report the change to your human resource department within 30 days of the event if you want to change coverage. Changes will be effective on the day of the event. If you do not make your changes during the 30-day change-in-status period, your changes cannot be made until the next Open Enrollment period.
1. Click the button below to download and complete the Qualifying Life Event Form..
2. Submit the completed form to saugustson@cobbsallen.com within 30 days from the date of the event.
PROCESS
DOWNLOAD THE QUALIFYING LIFE EVENT FORM
Qualified Life Event
DENTAL
DENTAL ENHANCED PLAN DOCUMENTS
BCBS DENTAL ENHANCED PLAN HIGHLIGHTS
DENTAL
VISION PLAN DOCUMENTS
VISION
ARHA BENEFITS GUIDE
OVERVIEW
Participating Employer Agreement
FORMS
QUALIFYING LIFE EVENT FORM
DENTAL BASIC PLAN DOCUMENTS
BCBS DENTAL BASIC PLAN HIGHLIGHTS
DENTAL BENEFIT HIGHLIGHTS
BCBS Value Plan SPD
BCBS Bronze plan SPD
BCBS Value PLAN SBC
BCBS Bronze Plan SBC
MEDICAL
VSP Benefit Summary
VISION
Delta DENTAL SBC
ARHA Electronic BENEFITS GUIDE
BCBS Value Plan Matrix
Delta DENTAL Low Plan SPD
Delta DENTAL High Plan SPD
BCBS Bronze Plan Matrix
MedPlus Secondary Summary
Participating Employer Agreement
Documents & Resources
ARHA Health PLan Overview
River health Care Flyer
Primary Care