Anthem Health Insurance

**Life Event Changes must be submitted to the Payroll Office within 30 days of the event with documentation**
[Life Event Changes include: Birth of Child, Marriage, Divorce, Loss of Coverage]

2022 - 2023 MCPS Benefit Booklet

Want to know which benefits would work best for you? 
Try ALEX, an interactive guide to employee benefits!

Anthem Enrollment Application

Lumenos Detail Benefit Description
HMO Detail Benefit Description
PPO Detail Benefit Description




*If you are a New Hire, you must enroll with Gallagher unless otherwise instructed.
Please contact the Payroll & Benefits Office at 540-382-5100 if you have any questions or concerns.*

Forms:

• Family Status Change Form
• Anthem Member Change Form
• Anthem Enrollment Application
• HSA - UMB Bank Enrollment Form
• HSA Payroll Deduction Form
• Health Insurance Pre-Tax Conversion Form

Retiree Forms:

• Retiree Anthem Enrollment Application
• Retiree ACH Debit Authorization Form

Information on the Health Savings Account (HSA):

• HSA FAQ
• HSA Myths & Facts
• HSA Web Access
• HSA Mobile App
• HSA Eligible Expense List
• HSA - UMB Bank Investment Options 
• HSA - UMB Bank Beneficiary Designation Form

Visit Flexible Benefit Administrators web page for more information.
Forms can be found here as well.

General Information:

• How to Find a Doctor - Anthem
• Anthem Machine-Readable Files
• Anthem Anywhere App
• For information on prescription drugs follow this link: Anthem Prescription Drug Listsand select "National Drug Lists/3 tier" 
• Information on Marketplace Coverage Options
• COBRA General Notice