Medical and Prescriptions
Medical plans through Anthem
Stone Harbor Staffing Group is committed to helping you and your dependents maintain health and wellness by providing you with access to the highest levels of care. We offer you a choice of three medical plan options through Anthem: one PPO plan and two HDHP plans.
Overview: Copays for office visits and prescription drugs. Once the deductible is met, coinsurance applies. Coinsurance, copays and deductible apply toward out-of-pocket maximum. Embedded deductible — family deductible does not have to be met for coinsurance to apply.
Health Savings Account compatible? No
Office visit payment: Member pays copay at time of service.
Payment for prescription drugs: Member pays copay at time of service.
Preventive care is covered at 100% (in-network).
Overview: Member pays negotiated provider costs for all medical services and prescription drugs until deductible is met. Once the deductible is met, coinsurance applies. Coinsurance and deductible apply toward out-of-pocket maximum.
IMPORTANT: The $3,300 HSA has an embedded deductible meaning no individual family member will have to satisfy higher than their single deductible before coinsurance applies. The $1,650 HSA plan has an aggregate deductible meaning an individual member can satisfy the entire family deductible on the plan.
Health Savings Account compatible? Yes
Office visit payment: Member pays deductible and coinsurance due at time of service. Provider sends claim to Anthem. Member receives an Explanation of Benefits (EOB) in the mail or electronically following the visit. Member pays the provider from HSA funds or post-tax dollars.
Payment for prescription drugs: Member pays discounted cost of prescription drug at time of service. Certain preventive maintenance drugs are covered at no cost and are not subject to the deductible. Once deductible is met, coinsurance applies.
Preventive care is covered at 100% (in-network).
Anthem PPO Classic – with $500 Deductibles.It is atraditional PPO plan that offers fixed copays for office and urgent care visits and 80% coinsurance after deductible.
Anthem HDHP Tier 1 – with 1,700 Deductibles. HSA-eligible plan that covers 90% coinsurance fixed copays on Rx after the deductible is met. Non-embedded deductible.
Anthem HDHP Tier 2 – has 3,400 Deductibles. HSA-eligible plan that offers 80% coinsurance fixed copays on Rx after the deductible is met.
Do You Need a Quick Overview of Your Medical and Prescription Benefits?
Click below for a comparison of the medical plans Anthem offers you.
What is a Summary of Benefits and Coverage (SBC)?
The SBC is a federally mandated snapshot of your plan’s costs, covered services and other features that may be important to you and your family. SBC’s are provided in a standard format and contain the same plan level details to allow you to easily compare multiple benefit plan options (even when the plans are offered through different carriers).
PPO Classic Summary of Benefits (2026) CapitalRx Finding Best Pricing RPO Classic Pharmacy Plan Design (2026)
What is a Summary Plan Description (SPD)?
A Summary Plan Description provides in-depth description of the plan benefits, including coverages, limitations, eligibility, claims submission details, etc. Also included in the SPD are certain legally mandated notices and information. The SPD provides more detail than an SBC or the quick overview found above.
2026 SPDs Coming Soon
PPO Classic Summary Plan Description (2026) HDHP Tier 1 Summary Plan Description (2026) HDHP Tier 2 Summary Plan Description (2026)
Pharmacy plans through CapitalRx
CapitalRx will be our new Pharmacy Partner please view the below to learn more about this transition, helpful tools, how to find the best pricing, and for more information on specialty medications! To find what drugs are covered by CapitalRx and locate pharmacy near you, click here.
Welcome to CapitalRx CapitalRx Finding Best Pricing PPO Classic Pharmacy Plan Design (2026)
Transitioning to OptumRx through CapitalRx HDHP Tier 1 Pharmacy Plan Design (2026) HDHP Tier 2 Pharmacy Plan Design (2026)
Contact Information
Anthem provides anytime live customer service support – online or over the phone. For your medical benefit questions, claims information, or any other Anthem benefit-related inquiry contact: medical call 844-995-1741 or visit anthem.com.
Sign in to anthem.com to:
View current and past claims
View benefits information
Manage prescriptions.
Live chat
How-to-videosSetting up your online account. Use this collection of videos to learn more about setting up your account or accessing the app. How to Videos
24/7 NurseLine: 24/7 NurseLine serves as your first line of defense for unexpected health issues. You can call a trained, registered nurse to decide what to do about a fever, receive allergy relief tips, or get advice on where to go for care. A nurse is always available to answer your questions. For help, call 24/7 NurseLine at the customer service number on your ID card.
Download Anthem’s App
Find a doctor and check your costs: Search for doctors, hospitals, labs, and other health professionals in your plan. You can search by name, location, and type of care. You can even filter by gender or languages spoken, and then check costs before you go to find what’s best for you. View your claims: Check medical vision claims with one click. See all your health coverage benefits: Shows you essential information at a glance. Whether that’s an overview of your plan, health reminders, or suggestions for wellness programs. You also can find your deductible, copay, and share of costs. View and use your Anthem digital ID card. You’ll always have your most current Anthem ID card handy. And you can use it just like a paper one when you visit the doctor, pay for care, and more. Use the chat to find answers: Just type your questions in the app and receive the answers you’re looking for. Plus, Anthem’s Sydney app can suggest resources to help you understand your benefits, improve your health, and save money. Help manage your health: You can take better care of yourself with features that focus on your wellness. Community resources: helps you connect with organizations offering no-cost and reduced-cost programs to help with challenges such as food, transportation, and child care. Stay connected to healthy living: Put your wellness first. Sync your devices to your fitness tracker, monitor your nutrition, and set custom reminders to help you reach your goals. Check your health records: The My Health Records feature on the app gives you mobile access to your health data, including health history and electronic medical records, all in one place. Availability is based on your plan.
Virtual Care
Receive virtual care and support with the Sydney App
You can connect easily to the care you need and have a video visit with a doctor on your mobile device or computer with a camera, 24/7.
Visit with a doctor for common health concerns the doctors are available anytime, with no appointments or long wait times. They can help you with these types of conditions: Cold, fever, sore throat, flu, minor rashes or headaches. During your video visit, the doctor will assess your condition, provide a treatment plan, and send prescriptions to the pharmacy of your choice, if needed. Prescription availability is defined by physician judgment.
Here’s how to access the program through virtual care:
The app is available for both Apple and Android phones.
- Download the no-cost Sydney Health app.
- Register (if you haven’t yet) and log in.
- Once you register, your username and password are the same for our app and anthem.com/ca.
- Select Care and then select Video Visits.
Anthem Covered Infertility Services
To learn more about the covered services, click the button below to view frequently asked questions or if you have more specific questions if fertility services are covered, call Member Services at the number on your member ID card.
Frequently Asked Questions
Global Mobility Blue Cross Blue Shield Global® Core program
As a BCBS member, you may have the ability to take your healthcare benefits with you when you go abroad! Through the Blue Cross Blue Shield Global® Core program, you have access to doctors, hospitals, support tools, and resources around the world. Learn About Healthcare Coverage When Traveling Abroad
- Locate doctors and hospitals, or to obtain medical assistance services when outside the United States, by calling the BCBS Global Core Service Center at one of the following:
- Toll-free numbers: 1.800.810.BLUE (2583) / 1.877.547.2903
- Collect at 1.804.673.1177
- The BCBS Global Coreapp is available for Apple and Android devices. Visit the appropriate app store or www.bcbsglobalcore.com/home/mobileapp/ to download the latest app for your device.
- In an emergency, go directly to the nearest hospital.
For Hawaii residents only provided through Kaiser
If you are an employee living in the state of Hawaii, Stone Harbor Staffing Group provides you with access to a HMO plan option through Kaiser Permanente Contact Information Questions about this plan? Please visit: Kaiser customer service by calling 800.966.5955 or visiting the website:
kp.orgDo You Need a Quick Overview of Your Medical and Prescription Benefits?
Click below for the Kaiser HMO medical plan summary.
Click here What is a Summary of Benefits and Coverage (SBC)?The SBC is a federally mandated snapshot of your plan’s costs, covered services and other features that may be important to you and your family. SBC’s are provided in a standard format and contain the same plan level details to allow you to easily compare multiple benefit plan options (even when the plans are offered through different carriers). Kaiser HMO SBC What is a Benefit Summary? A benefit summary provides a more in-depth description of the plan benefits, including coverages, limitations, etc. A benefit summary provides more detail than an SBC or the quick overview found above. Kaiser HMO Benefit Summary
Minimum Essential Coverage (MEC) provided through Apex
Apex MEC Plus Advantage
Minimum Essential Coverage (MEC) is designed to meet the basic health insurance requirements but is not a major medical plan. It provides limited benefits and should not be relied upon for comprehensive healthcare needs, as it does not include the extensive coverage typically associated with major medical insurance.
Loomis
For information on eligibility, member cards, or MEC claims adjudication, please visit loomisco.com or call 877-959-9952.
CitizenRx is in partnership with APEX. To find what drugs are covered under this plan, see below.
Do You Need a Quick Overview of the MEC Plus Plan?
Click below for the Apex MEC medical plan summary we’ve created for you.
The summary below from the vendor explains what services are covered under our Apex MEC plan, how to find a provider, additional benefits and more.
Important Notes About this Plan
Selection of the Apex MEC Plus Advantage medical plan includes hospital indemnity benefits which may not be independently elected, or independently continued after employment ends, in accordance with California’s insurance regulations.
The State of Massachusetts requires its residents to maintain medical coverage that meets certain minimum creditable coverage (MCC) guidelines in order to avoid a tax penalty. These penalties vary depending on your income, age and family size. Apex maintains that its MEC Plus Advantage plan does not meet Massachusetts MCC guidelines so if you enroll in this plan without coverage in another plan that meets the state’s guidelines, you may be at risk for this tax penalty.
New Jersey and individual mandate requires most individuals in the state (and their family members) to be covered under minimum essential coverage for each month of the year, beginning in 2019. Individuals that don’t obtain acceptable health insurance coverage will be penalized. Notably, the new law provides that the state individual mandate penalty will not be enforced for any tax year in which the ACA’s federal premium tax credits become unavailable. Additional information on this mandate is included within the benefit summary provided below.
Fixed Indemnity Consumer Protection Notice
IMPORTANT: This is a fixed indemnity policy, NOT health insurance
This fixed indemnity policy may pay you a limited dollar amount if you’re sick or hospitalized. You’re still responsible for paying the cost of your care.
Looking for comprehensive health insurance? Visit HealthCare.gov or call 800-318-2596 (TTY: 855-889-4325) to find health coverage options. To find out if you can get health insurance through your job, or a family member’s job, contact the employer.
Questions about this policy?
- The payment you get isn’t based on the size of your medical bill.
- There might be a limit on how much this policy will pay each year.
- This policy isn’t a substitute for comprehensive health insurance.
- Since this policy isn’t health insurance, it doesn’t have to include most Federal consumer protections that apply to health insurance.
- For questions or complaints about this policy, contact your State Department of Insurance. Find their number on the National Association of Insurance Commissioners’ website (naic.org) under “Insurance Departments.”
- If you have this policy through your job, or a family member’s job, contact the employer.
Where do I go for the best care?
Knowing where to go for medical care can save you lots of time and money! It can also help get you the best care for your situation. Here are some general guidelines to assist you in determining the best option for you.
DOCTOR’S OFFICE
When you have any medical concern, your primary doctor can oversee your care, provide routine services and refer you to specialists, if necessary:
- Routine checkups
- Immunizations
- Preventive services
- Manage your overall health
URGENT CARE
When you need care quickly, your primary doctor is not available and your condition is not life-threatening, go to urgent care. Some examples include:
- Sprains/strains
- Minor broken bones
- Rash
- Flu and fever (below 104°)
- Earache/sore throat
EMERGENCY ROOM
When you need immediate treatment of a serious or critical condition, go to the ER:
- Severe/life-threatening symptoms
- Severe head injury
- Excessive bleeding
- Extreme pain
- Shortness of breath
- Broken bones
Fixed Indemnity Consumer Protection Notice
Traditional Drugs Specialty Drugs Helpful Cost Saving Tips
- Generic drugs offer the lowest copay: You pay the lowest copay for generics, making these drugs the most cost-effective option for treatment.
- Brand drugs are a higher copay: This category includes preferred, brand name drugs that don’t yet have a generic equivalent. These drugs are more expensive than generics, and a higher copay.
- Non-preferred drugs are the highest copay: In this category are nonpreferred brand name drugs for which there is either a generic alternative or a more cost-effective preferred brand. These drugs have the highest copay. Make sure to check for mail order discounts that may be available.
- Preferred drugs offer the lowest specialty drug copay: Specialty drugs are generally more effective and less expensive than nonpreferred specialty drugs.
- Non-preferred drugs are the highest specialty drug copay: These drugs have the highest copay for specialty drugs, usually because there may be a more cost-effective generic or preferred brand available.
- Generic preferred drugs: Save money with generic preferred drugs. Ask your doctor if it’s appropriate to use a generic drug rather than a brand. Generic drugs are less expensive, and according to the FDA, they contain the same active ingredients as a brand name.
- Mail order: Many drugs are available in a 90-day supply, rather than the 30-day retail supply. The Mail order cost is 2.5x the preferred copay.
- Good Rx: You can save on prescription costs by utilizing online tools like GoodRx.com. This platform provides an Rx database to help you find the most affordable pharmacy for your specific prescription. You may also find coupons directly from the drug manufacturers via their websites that may reduce your expenses. Keep in mind that some coupons can only be used outside of your prescription plan and will not count towards your annual out-of-pocket maximums.
Benefits+ Hotline
Available Monday to Friday, 8am – 8pm EST.