Health Insurance
State employees eligible for the health benefits program may enroll in a statewide health plan, regional plan, or if living or working in the Northern Virginia area only, a regional health maintenance organization (HMO). Full-time employees pay the employee portion of the total monthly premium, with the state paying the remainder of the cost, and their premiums are deducted from paychecks before taxes are paid. For current monthly premiums, visit the DHRM Rates page. A side-by-side comparison of available plan features can be found in the current Benefits at a Glance.
Coverage for new employees begins on the first day of the month following the hire date (except for those employees hired on the 1st of the month). New employees must make their health insurance elections within 30 days of their date of hire, whether or not they are enrolling or waiving. Changes to health plans may be made outside of the 30-day initial enrollment period; this time is known as Open Enrollment. Open Enrollment is usually held in April or May each year, and changes become effective on July 1st. In addition to the initial enrollment and Open Enrollment periods, employees may make changes within 60 days of a Qualifying Mid-Year Event (QME). Information on what constitutes a QME and what documentation is required can be found on DHRM's Health Coverage website.
Statewide PlansThe Commonwealth of Virginia offers the following plans:
They are administered on a plan year that begins on July 1 and ends on June 30 of the following year. For in-depth descriptions of each plan including optional buy-ups documentation can be found on DHRM's Health Coverage website. Note: All health plan deductions are mandatory pre-tax. This is accomplished by deducting the premiums before taxes are calculated, thus reducing the amount of Federal, State, and Social Security withholding. |
COVA CareThe COVA Care plan has four separate benefit components: medical, dental, outpatient prescription drug, and behavioral health with the Employee Assistance Program (EAP), each administered by Anthem Blue Cross and Blue Shield with the exception of dental which is administered by Delta Dental. Some covered services are subject to a plan year deductible, co-insurance, or co-payments. At an extra cost to you, you may also select additional options that offer enhanced coverage for dental, out-of-network, vision, and hearing services.
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COVA HealthAwareThe COVA HealthAware plan includes a Health Reimbursement Arrangement (HRA) to help you pay for plan expenses. The Commonwealth will place $600 in an HRA for an employee or $1,200 for an employee and spouse enrolled in the plan. The funds can be used to pay your deductible and other plan costs for all covered family members. You may also earn more HRA funds by completing health activities, called “Do Rights,” designed by the plan to earn up to $150 in your HRA, and your spouse can do the same. “Do Rights” include having an annual physical exam, a dental exam, a flu shot, and using one of the MyActiveHealth (www.myactivehealth.com/cova) portal trackers at least three times a month for each month in a quarter. Simply pick three of the four “Do Rights” and earn $50 for each one. Note: The funds for “Do Rights” are placed in your HRA during the quarter after you complete the activity. |
Optional Benefits for COVA Care and HealthAwareCertain optional health insurance coverage may be added to the COVA Care (CC) plan and the COVA HealthAware (HA) plan as follows:
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COVA HDHP (High Deductible Health Plan)The COVA HDHP is a special type of health care plan that allows you to set up a Health Savings Account (HSA). Use the tax-deductible funds you put into the HSA to help pay for medical expenses. Your HSA goes wherever you go and you are not required to “use it or lose it.” The COVA HDHP has a higher plan year deductible that must be met before the plan pays for your medical, behavioral health and prescription drug benefits. Once the deductible is met, you pay 20% coinsurance for most covered services. When two or more people are covered, the entire deductible must be met before the plan pays any expenses for any one person covered under the plan. Under the HDHP, you pay no more out of pocket for in-network services than $5,000 for one person and $10,000 for two or more people. The deductible applies to this limit. The COVA HDHP includes basic dental benefits. However, there is no out-of-network coverage for medical or behavioral health benefits. All components of this plan are administered by Anthem. Go to www.anthem.com to access the online Provider Directory. |
Premium RewardsCOVA Care and HealthAware members may be able to reduce your monthly premiums by completing an online health assessment. The reward amount is $17 per month, and if your covered spouse participates you can double your monthly reward. To complete or update your online health assessment, please follow the steps below:
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Kaiser Permanente Regional HMOAvailable only to employees who live or work in Northern Virginia, the Kaiser Permanente regional HMO has a service area that includes Northern Virginia, Washington, D.C., and parts of Maryland. There is no deductible for in-network services, but you must use HMO participating providers (except in an emergency) and choose a PCP for each enrolled family member. You may search by zip code on the Kaiser Web site to determine if your job location or home address is in the Kaiser Permanente service area. |