2023 AtlantiCare Benefits Booklet

Medical Plan FAQs

TABLE OF CONTENTS WELCOME.................2 WHAT’S NEW. ...........3 SERVICE CENTERS AND WEBSITES..........4 HOW TO ENROLL....5-6 MEDICAL..............7-14 PRESCRIPTION DRUG. ................15-17 ADDITIONAL MEDICAL PLAN RESOURCES........18-22 DENTAL...............23-24 VISION.....................25 LIFECENTER..............26 LIFE INSURANCE. .....27 DISABILITY...............28 VOLUNTARY OFFERINGS. ........29-32 SPENDING ACCOUNTS. ............33 RETIREMENT BENEFITS..................34 WELLNESS. .........35-38 LEGAL NOTICES...39-41 GLOSSARY..........42-43 FAQs...................44-46 CONTACTS.........47-48 FORMS................49-58

If I enroll in the Horizon Engaged Plan, does that mean my personal medical information will become part of my HR file? No, personal medical information is not part of your HR file. Neither HR staff nor your management team have access to your personal medical information. AtlantiCare Health Engagement, a separate company within AtlantiCare, collects data and administers the wellness program. Health Engagement is accountable under a number of federal and state laws to maintain any employee health information it obtains in separate, confidential files. Can I have my annual preventive care visit certification performed by a specialist such as an OB/GYN? No. All preventive care visits must be performed by a primary care provider. If I receive care at an AtlantiCare facility, are the doctors who treat me automatically considered AtlantiCare providers? No. For example, an anesthesiologist may not be covered even if they administer anesthesia at an AtlantiCare facility. Likewise, a physician who treats you at an AtlantiCare facility and then in another location, should not be automatically considered in- network. You are responsible for confirming network participation.

What should I do if I disagree with how a claim was paid? Contact Horizon directly at 1-800-355-2583 to file an Appeal.

What should I do if 10-14 business days have passed and I have not yet received my medical plan ID card? You can obtain a temporary card online. For assistance with this, please contact Horizon at 1-800-355-2583 to obtain your member ID to register online or through the Horizon Blue mobile app.

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