Medical
You have a choice of three BlueCross BlueShield (BCBS) PPO Plans. California employees also have a Kaiser Permanente HMO option.
All three PPO Plans use the same national BCBS network of physicians, hospitals and pharmacies. You can go to any doctor or hospital you want, but you save money by using providers in the network.
Kaiser offers in-network only coverage. You will select an in-network primary care physician (PCP) who will make sure you receive the best possible care at the lowest possible out-of-pocket cost.
For complete details like information about copays, coinsurance and more, download a copy of your Top Shelf Benefits Guide on SGNN.
Stay In-Network*
When choosing a doctor or hospital at myhealthtoolkitfl.com or using the BCBS app, be sure to look for providers in the BlueCard network. You can find BlueCard providers in all 50 states. By using network providers, you’ll always benefit from the negotiated — lower — in-network rate.
Health Management Programs
If you’re enrolled in a Southern Glazer’s medical plan, Health Advocate can help you:
· Find in-network doctors and hospitals.
· Schedule second opinions.
· Resolve claims issues.
· Negotiate out-of-network medical or dental costs.
· Get detailed medical or lab cost estimates.
· Answer questions about your medical plan.
Learn more at healthadvocate.com/sgws or 866-611-8299.
You or your covered spouse can receive free, unlimited support for egg freezing, fertility, adoption, surrogacy, preconception, pregnancy, postpartum, return-to-work, breast milk shipping, parenting, pediatrics and menopause care. Video chat or message 24/7 with providers in 35 different specialties.
Ready to start a family? We provide a fertility assistance benefit to help pay for fertility treatments, procedures and prescription medications.
If your doctor offers virtual visits, our SGWS medical plans cover them at a lower cost than an in-person visit.
Primary360 lets you take care of your annual wellness visit and other preventive care needs virtually, through Teladoc.
With Primary360 you can:
· Establish a primary care physician
· Book your annual visits within days
· Access a dedicated Care Team to answer any health-related questions
· Receive clear guidance to achieve your health goals with confidence
· Get help coordinating additional health care services, if needed
Get physician-based board certified care 24/7 for non-emergency conditions like cold and flu, skin conditions, sinus infections, allergies and more. Or, schedule a visit with a therapist or psychiatrist, 7 days a week for challenges like depression, anxiety, stress, not feeling like yourself and many others. All care is delivered via secure video chat, phone or via mobile app.
With Kaiser Online Care, you can connect with your provider via phone, in-person visit, email or video visit.
Care Connected is a free program that can help you make informed health care decisions.
Get help:
· Understanding your insurance plan
· Choosing the right care
· Navigating the system and your bills
· Dealing with difficult physical and mental health issues
Livongo, a Teledoc company, can help you keep your diabetes in check. Get smart touch blood glucose meters, unlimited free test strips, coaching and 24/7 expert support.
Prescription Drugs
CVS Caremark provides prescription drug benefits to BCBS medical plan members. You can fill your prescriptions two ways: through a retail pharmacy or the mail order program. You’ll pay a copay or percentage of the cost after you meet the annual deductible.
Prescription drugs have a separate deductible and out-of-pocket maximum for the 90 Proof and 80 Proof options. The HD Split medical deductible and out-of-pocket maximum apply to both medical and prescription drug expenses.
You must purchase from a CVS Caremark network pharmacy to receive prescription drug benefits. The network includes more than 67,000 pharmacies nationwide, including many independent pharmacies, most chain pharmacies (such as Walgreens and Walmart) and all CVS Pharmacy locations.
Prescription Drug Benefits
CVS Caremark covers certain tobacco cessation drugs at 100%.
If you take a specialty drug, you may qualify for a $0 copay through the PrudentRx Specialty Drug Program. You’ll be automatically enrolled, but you must speak with PrudentRx to approve your enrollment. You can opt out, but you will pay 30% of the cost.
If you take maintenance medications for a chronic condition, the Maintenance Choice program can save you money. You’ll receive a 90-day supply at a discounted price via the mail-order pharmacy or a CVS-owned retail pharmacy.
Accordant provides health care management services if you suffer from a rare and chronic condition – for example epilepsy, cystic fibrosis, lupus, rheumatoid arthritis and more. Accordant provides 24/7 access to care teams that will personalize your care. If you’re eligible, Accordant will contact you.
Virtual PrEP care is a convenient, cost-effective way to get your HIV preventive care. You’ll save by using generics first and accessing convenient, stigma-free virtual care. Get easy access to PrEP meds, labs, testing and support – anytime anywhere.
If you enroll in the Kaiser Permanente HMO Plan, your prescription drug benefits will be covered through your Kaiser HMO Plan.
Dental
Dental benefits are provided through two Aetna options. You can visit any dentist but will pay less when you use a network dentist. Both include 100%-paid preventive care and coverage for basic services, major services and orthodontics. If you live in certain states***, you may also have a Dental Maintenance Organization (DMO) option.
Vision
Vision benefits are available through VSP. Keep your eyes healthy and save money when you visit a VSP doctor, whether an individual practitioner or in a retail chain store.
Hawaii
SGWS offers three medical plan options through HMSA and Kaiser Permanente – one PPO option and two HMO options.
If you’re enrolled in one of the HMSA plans, the Online Care mobile app connects you to a doctor 24/7 and costs less than an office visit.
When you enroll in a medical option, you automatically receive prescription benefits for yourself and your enrolled eligible dependents.
When you enroll in a medical option, you automatically receive prescription benefits for yourself and your enrolled eligible dependents.
You automatically get dental coverage when you elect medical coverage. If you select an HMSA Plan for your medical coverage, you have two HMSA dental options. If you select the Kaiser Permanente HMO, Kaiser will provide an in-network-only dental plan.
The HMSA PPO dental plan provides coverage whether you visit an in-network or out-of-network provider, but you will save money by using in-network dentists. The HMSA HMO and Kaiser Permanente HMO dental plans cover in-network care only. There is no out-of-network benefit with these programs. Kaiser Permanente HMO does not include orthodontic coverage.
* These services apply to the BCBS 90 Proof, 80 Proof and HD Split plans.
** These services apply to the Kaiser HMO only.
*** DMO is available if you live in AZ, CA, CO, FL, GA, KY, MD, NJ, NY, PA, TX or Washington, D.C.
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Nothing on this website or in any other benefits document or oral presentation should be construed as an employment contract or a guarantee of benefits. Southern Glazer’s Wine & Spirits reserves the absolute and unconditional right to terminate or change any benefit Plan (including employee premiums, contributions, copays, deductibles, and other costs) at any time. Southern Glazer’s Wine & Spirits as the Plan Administrator of the Plans, has sole discretion to interpret the terms of coverage, eligibility and availability for any benefits provided.
