CBIA Health Connections
Medicare plan from Anthem Blue Cross
& Blue Shield
CBIA Health Connections participants can take advantage of Anthem Blue Cross & Blue Shield's Medicare solution for medicare-eligible employees, dependents, and retirees.
CBIA Offers Plan F with an enhanced Part D prescription
drug rider (called Blue MedicareRxSM) with $10/25/40 copays for
only $331.05/month.
The premium reflects Plan F and the enhanced Part D prescription drug plan.
The enhanced Part D prescription drug plan is creditable according to CMS guidelines.
Note: The Medicare rate renews on January 1 regardless of a company's renewal
date.
Enrollment Policy
The Federal Government has very stringent policies pertaining to enrollment and disenrollment in Medicare. All requests for enrollment or disenrollment must be processed by the last business day of the month to be effective on the 1st of the month following. There will be no requests for enrollment or disenrollment processed retroactively. There will be no exceptions. Therefore, all CBIA must receive all forms at least 4 business days prior to the requested effective date.
Enrollment Instructions:
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Complete the Anthem Enrollment and Membership Change form.(includes Plan F Medical and Part D Prescription drug plan)
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Complete the Health Connections Enrollment/Change Form (choose one) HC, HC2, or 51+
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Make three copies of the Anthem forms.
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Return the original and one copy to CBIA. Employer retains the second copy. Employee retains the third copy.
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Remember to include a copy of the employee's
Medicare card showing active coverage in Parts A&B.
Please note: Qualified enrollees must submit their paperwork to CBIA prior to the requested
effective date of coverage.
All Information and Forms:
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