Benefits Forms and Details for 2022
2022 New Hire Benefits Booklet
2022 Active Working Spouse Form
2022 New Anthem Group Number Sample Cards
2022 Sample of Anthem Gold PPO Card
2022 Sample of Anthem Blue PPO Card
About the Provider: Anthem
Anthem's website: www.anthem.com
Anthem's Customer Service Phone Number:1-844-653-7397
Provider Search
- To determine if a physician is in the network, you should search the Anthem provider network
- Once you go to www.anthem.com you will click on the "Find Care" button
- Search as a Guest, click on "Guests" icon
- "What type of care are you searching for?" select Medical
- "What State do you want to search with?" select your state
- "What type of plan do you want to search with?" select Medical (Employer-Sponsored)
- "Select a plan/network", for members in Oho select Blue Access PPO or out of state members select National PPO (BlueCard PPO) and click on "Continue" button
- Select your search criteria
Anthem Informational Flyers
- Anthem Complex Care Flyer
- Anthem Cancer Support Flyer
- Anthem LiveHealth Online Member Flyer
- Anthem Substance Abuse Anyone Can Become Addicted
- Anthem Substance Abuse Misuse Truth Flyer
- Anthem Substance Abuse Extra Support
- Anthem Preventative Care Flyer
- Anthem Special Offers/discounts flyer
- Anthem Blue Cross Blue Shield Global Care
Information for Active Employees
- Gold Medical Plan Rates 2022
- Blue Medical Plan Rates 2022
- Anthem General Plan Summary
- SBC Glossary of Health Coverage and Medical Terms
- 2022 Anthem SBC Active Gold PPO
- 2022 Anthem SBC Active Blue PPO
- Working Spouse Form 2022 - Must be completed each year if electing spousal coverage
- Gold Plan: Summary Plan Document
- Blue Plan: Summary Plan Document
- Anthem Claim Form
About the Provider: Delta Dental
Delta Dental's website: www.deltadentaloh.com
Delta Dental's Customer Service Phone Number: 1-800-524-0149
| Rates shown are annual pre-tax full time employee contributions. | |
| Employee | $57.00 |
| Employee + Spouse | $117.48 |
| Employee + Child(ren) | $110.28 |
| Employee + Spouse + Child(ren) | $169.80 |
Information for Employees
About the Provider: VSP - Vision Service Plan
VSP's website: www.vsp.com
VSP's Customer Service Phone Number: 1-800-877-7195
| Rates shown are annual pre-tax full time employee contributions. | |
| Employee | $118.08 |
| Employee + 1 | $236.16 |
| Family | $345.48 |
Information for Employees
VSP - The Importance of an Eye Exam
About the Provider: CVS Caremark
CVS Caremark's website: www.caremark.com
CVS Caremark's Customer Service Phone Number: 1-888-202-1654
Prescription Gold Card Prescription Blue Card
Participating pharmacies
Beyond CVS, these pharmacies will accept your prescription ID card.
Mandatory generic policy
If the member or the physician wishes to use a brand name drug when the U.S. Food and Drug Administration has determined a therapeutically equivalent (“AA” or “AB” rated) generic is available, the member will pay the difference in the brand name and generic medication price, plus the generic co-payment. Members may still elect to use brand name medications if they choose, but they will be required to pay the difference in the brand name and generic medication price, plus the generic co-payment.
From the FDA: Understanding generic medications
Plan Summary
To view the Summary of the Prescription Drug plan, click here.
Affordable Care Act - Smoking Cessation
To view Tobacco Cessation coverage, click here.
Paper Claim Forms
To view and/or edit and print a Paper Claim Form, click here
Finding low-cost Rx Options
To view flyer of the CVS Caremark Check Drug Cost tool, click here
About the Provider: UNUM
UNUM's website: www.unum.com
UNUM's Customer Service Phone Number: 1-800-421-0344
About the Coverage
| Salary replacement | 60%, $1,400 maximum weekly benefit. Must exhaust leave |
| Waiting period | 14 Days for Injury, 28 Days for Illness, including pregnancy |
| Employee cost | Varies by age and salary, 100 percent employee funded |
| Limitation | Plan is subject to a 12/12 pre-existing condition limitation |
Information for Employees
UNUM Short-term Disability Plan Document
About the Provider: UNUM
UNUM's website: www.unum.com
UNUM's Customer Service Phone Number: 1-800-421-0344
About the Coverage
| University Provided | 60% Salary Replacement, $5,000 Monthly Benefit Maximum. The elimination period before benefits are paid is the later of any accumulated sick leave or 180 days. |
| Supplemental Option | 70% Salary Replacement, $6,000 Monthly Benefit Maximum. The elimination period before benefits are paid is the later of any accumulated sick leave or 180 days. |
| Employee Cost | 60% Option: $0, 100% University Funded. 70% Option: Varies. Employee pays difference between 60% and 70% option. Cost varies by salary. |
| Limitation | Plan is subject to a 3/12 pre-existing condition limitation. |
Information for Employees
About Provider: UNUM
UNUM's website: www.unum.com
UNUM's Life Insurance Customer Service Phone Number: 1-800-445-0402
About the Coverage
| University Provided | Two times your annual salary. Maximum $100,000 |
| Accelerated Benefit | Available if diagnosed as terminally ill (12 months or less life expectancy). Contact UNUM for details |
| Supplemental Options | Employee may purchase 1 to 5 times their annual salary up to $500,000 without an "evidence of insurability" medical exam. Costs varies by age and salary |
Information for Employees
Beneficiary Election Form - Please return to Office of Benefit Administration, +0602
UNUM Evidence of Insurability Form
UNUM Life Active Plan Document
UNUM Life and Accident Claim Form
UNUM Life Planning Financial and Legal Resources Flyer
Please use these forms if you sustain a work-related injury. Completion of these forms does not assure the allowance of the claim in accordance with the Ohio Bureau of Workers’ Compensation.
About the Provider: Chard Snyder
Chard Snyder website: www.chard-snyder.com
Chard Snyder Customer Service Phone Number: 1-800-982-7715
Information for Active Employees
FSA Reimbursement Online Job Aid
Verification of Medical Expenses
Why Your Benny Might Stop Working And What to Do About It
FSA Account Summary Plan document
Flexible Spending Accounts are a smart way to pay for your out-of-pocket qualified healthcare and/or dependent care expenses. You can enjoy tax savings and a convenient debit card for your eligible expenses.
Flexible spending accounts allow employees to set aside money on a pre-tax basis to pay for eligible out-of-pocket medical and dependent care expenses, therefore reducing taxable income. The monies set aside for these accounts must be used for expenses not reimbursed by other coverage.
The Health Care Spending Account allows you to be reimbursed for non-covered and medically necessary medical, dental or eye care expenses. Employees can contribute a maximum of $2,850 in into a health care flexible spending account. Participants will receive a debit card for easy FSA withdrawals for eligible items. The plan will continue to have a grace period for claim submissions. For all claims incurred prior to December 31, 2021, the claims must be submitted to Chard Snyder no later than March 31, 2022. In addition, FSA funds up to $570 may be carried over to the 2022 plan year. This change applies to Health FSAs only and does not apply to Dependent Care FSAs.
The Dependent Care Spending Account allows you to be reimbursed for child and dependent care expenses for dependent up to the age of 13(e.g., daycare etc.) that are required for you or your spouse to work. Employees can contribute a maximum of $2,500 or $5,000 if married and filing a joint tax return
Information for Retirees
Healthcare Reimbursement Account (HRA) Summary
HRA Reimbursement Online Job Aid
Healthcare Reimbursement Account (HRA) Summary Plan Description
About the Provider: AllOne Health/Impact Solutions
IMPACT Solutions is the administrator of the University’s confidential employee-assistance program.
The IMPACT Employee Assistance (EAP) & Work/Life Program offers access to confidential professional support 24 hours a day, 365 days a year. The IMPACT program includes access to unlimited phone consultation, six complimentary face-to-face counseling sessions per person per occurrence, plus an expansive collection of resources.
The IMPACT Employee Assistance (EAP) & Work/Life Program is available 24 hours a day, 7 days a week by calling 800-227-6007.
For additional information, log on to Impact Solutions’ site for access to articles, resources and interactive features. The member logon is UAkron.
AllOne Health has provided a live webinar schedule for the remainder of the year. If you are interested in learning how to manage your time while working remotely, the art of active listening, prioritizing numerous responsibilities and more, you can register here: AllOne Health Annual Live Webinar Schedule.
EAP Overview
IMPACT MyLifeExpert Flyer.
Guide to setting up your MyLifeExpert account.
IMPACT Employee Assistance and Work/Life Program
IMPACT Quit Center for Tobacco Addiction
IMPACT Website on Smart Phone
IMPACT Identity Theft Protection Benefit
IMPACT Saving Center
IMPACT Online Service Request
IMPACT Mental Health and Suicide Awareness National Resources
Impact Summary Plan Description
Mailing address:
The University of Akron
Human Resources, Benefits Administration
Akron, Ohio 44325-0602
Building location:
Administrative Services Building
185 E. Mill St
Send us an e-mail.
Phone: 330-972-7381
Fax: 330-972-2336