The Affordable Care Act imposes a number of requirements on self-insured health plans maintained by employers. Failure to comply with certain of these ACA requirements (for example, the prohibition against having annual or lifetime limits on essential health benefits) can subject an employer to significant monetary penalties (up to $100 per violation per day). Despite guidance issued by the federal agencies responsible for enforcing the ACA, there remain significant uncertainties about the ACA.

Solely as an accommodation to its membership, Elevanta Health is offering employers an opportunity to adopt plan designs known as MEC plans (Basic and Choice). The MEC plans provide less coverage than a traditional major medical program and may not be suitable for everyone. The MEC plans provide minimum essential coverage that allows an individual to satisfy the individual mandate requirement under the Affordable Care Act.

Elevanta Health makes no representations regarding whether or not the MEC plans comply with the employer responsibilities under the ACA and/or whether adopting the MEC plans could subject an employer to significant monetary penalties under the ACA. Elevanta Health requires each employer that offers an MEC plan to its full-time employees to offer it as an alternative choice in conjunction with a minimum Bronze level major medical plan. Each employer that is considering the adoption of an MEC plan is urged to consult with its legal counsel and/or other adviser regarding whether, and to what extent, the MEC plan complies with the ACA and the effect adopting the MEC plans may have on the employer and its employees.

Click the appropriate link for the type of provider you are seeking in the Find a Provider menu of this site. Each link will take you to a dedicated page where you can enter additional information to locate an in-network provider in your area.

No. You are free to visit any specialist whenever you like. If you choose a non-preferred specialist, your out-of-pocket costs will be higher than if you visit a preferred provider. If you need help selecting a specialist, the physician providing your primary care can probably make some helpful suggestions.

No. When you visit an in-network provider, the physician’s office will submit all claims. You will need to pay the co-pay and any additional fees for services rendered. However, if you visit an out-of-network provider, you will need to submit a claim.

If you are enrolled in one of our Major Medical PPO plans, you can visit magellanrx.com to learn more about your prescription drug coverage.

We provide overviews of each plan as well as more detailed Summary Plan Descriptions under Member Reources. You can also access your accounts online for information on processed claims (you will need your subscriber information to log on) or contact the Elevanta Health Service Center.

You can change your coverage each year during the open enrollment period. However, if you experience a qualifying life event, you can change your coverage at that time. View the requirements for a qualifying event below.

If a qualifying event occurs and you want to make a change to your benefit, you are required to make the change with 30 days of the event by notifying your employer and providing supporting documentation. These special circumstances are referring to as Qualifying Life Events, and you can view them here.

We offer a paperless system, so there are no identification cards to track. When making your appointment, simply give the provider the subscriber’s unique identification number, along with the patient’s name and date of birth, and identify the patient as a vision plan member. The provider will verify the patient’s eligibility and coverage with us prior to the scheduled appointment. Have more questions about your vision plan? View the UnitedHealthcare Vision FAQs.

The Patient Protection and Affordable Care Act (PPACA) has many regulations regarding your rights and responsibilites concerning health insurance. One of them is the individual mandate, which requires citizens to have insurance coverage that meets minimum standards set as part of health insurance exchanges, including guaranteed access to affordable coverage, essential benefits and other consumer protections. The legislation imposes a tax penalty on individuals—with some exceptions—who do not purchase coverage. Learn more here.