Medical Benefit Booklet - Healthy Focus Essential HSA Plan - Effective 01/01/2025

Sep 26, 2026

Uploaded by iuabcfuw

Medical Benefit Booklet for Leidos, Inc. outlining the Healthy Focus Essential HSA Plan effective 01/01/2025. Explains how benefits are provided to eligible Members through Anthem Blue Cross and Blue Shield as administrative claims processor, including coverage conditions, limitations, exclusions, deductibles, and coinsurance. Describes Provider network access, medical necessity terminology, language assistance services, verification of benefits guidance, and key plan administration topics such as precertification, benefits, claims payment, appeal rights, and coordination of benefits.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages208

Reading Time8 h 44 min

AccessFree to download

WELCOME

How to Obtain Language Assistance

Verification of Benefits

Schedule of Benefits

Total Health and Wellness Solution

Eligibility

How Your Plan Works

Healthcare/Medical Management – Precertification

Benefits

Limitations and Exclusions

Claims Payment

Your Right to Appeal

Coordination of Benefits (COB)

Medical Benefit Booklet Leidos, Inc. Healthy Focus Essential HSA Plan Effective 01/01/2025 WELCOME Welcome to Anthem Blue Cross and Blue Shield! Si necesita ayuda en español para entender este documento, puede solicitarla sin costo adicional, llamando al número de Servicio al Cliente que aparece en el reverso de su Tarjeta de Identificación. If You need assistance in Spanish to understand this document, You may request it for free by calling Member Services at the number on Your Identification Card. This Benefit Booklet provides You with a description of Your benefits while You are enrolled under the healthcare Plan (the Plan) offered by Your Employer. You should read this booklet carefully to familiarize yourself with the Plan’s main provisions and keep it handy for reference. A thorough understanding of Your coverage will enable You to use Your benefits wisely. If You have any questions about the benefits as presented in this Benefit Booklet, please contact Your Employer’s Group Health Plan Administrator, or call the Claims Administrator’s Member Services Department. The Plan provides the benefits described in this Benefit Booklet only for eligible Members. The healthcare services are subject to the Limitations and Exclusions, Deductible, and Coinsurance requirements specified in this Benefit Booklet. Any group plan or certificate which You received previously will be replaced by this Benefit Booklet. Your Employer has agreed to be subject to the terms and conditions of Anthem Blue Cross and Blue Shield’s Provider agreements, which may include Precertification and utilization management requirements, timely filing limits, and other requirements to administer the benefits under this Plan. Anthem Blue Cross and Blue Shield, or “Anthem” is an independent licensee of the Blue Cross and Blue Shield Association. Anthem Blue Cross and Blue Shield is a registered trademark of Anthem Insurance Companies, Inc., designated by Your Employer to provide administrative services for Your Employer’s Group Health Plan. These administrative services may include claims processing, care management, arranging a network of healthcare Providers whose services are covered by the Plan, and other services. Important: This is not an insured benefit Plan. The benefits described in this Benefit Booklet or any rider or amendments attached hereto are funded by the Employer who is responsible for their payment. Anthem provides administrative claims payment services only and does not assume any financial risk or obligation with respect to claims. Anthem is an independent corporation operating under a license from the Blue Cross and Blue Shield Association, permitting Anthem to use the Blue Cross and Blue Shield Service Marks. Although Anthem is the Claims Administrator, You will have access to Providers participating in the Blue Cross and Blue Shield Association BlueCard® PPO network across the country. Anthem has entered into a contract with the Employer on its own behalf and not as the agent of the Association. Many words used in this Benefit Booklet have special meanings, like Covered Services, Network Provider, and Medical Necessity. These words are capitalized and are described in the Definitions section. Please refer to these definitions for the best understanding of what is being stated. Throughout this Booklet there may be references to “we,” “us,” “our,” “You,” and “Your.” The words “we,” “us,” and “our”mean Anthem or any of its subsidiaries, affiliates, subcontractors, or designees. The words “You” and “Your” mean the Member, Subscriber, and each Covered Dependent. How to Obtain Language Assistance Anthem is committed to communicating with our Members about their health Plan regardless of their language. Anthem employs a language line interpretation service for use by all of our Member Services Call Centers. Simply call the Member Services phone number on the back of Your Identification Card, and a representative w

FAQs

What is the Healthy Focus Essential HSA Plan benefit booklet used for?

It describes the benefits available while enrolled in the healthcare Plan offered by the Member’s employer, including the plan’s main provisions and how benefits apply to eligible Members.

Who administers the plan and how does Anthem relate to the coverage?

Anthem Blue Cross and Blue Shield provides administrative claims payment services and does not assume financial risk. The Employer funds the benefits described in the booklet, and Anthem administers based on Provider agreements.

How can Members get language assistance or verify benefits?

Members can call the Member Services phone number on the Identification Card for language-line interpretation and can also use TTY/TDD via 711. Verification of benefits is available by calling Member Services and is not a guarantee of payment for a specific procedure.

Sep 26, 2026

Uploaded by iuabcfuw