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In an emergency, will my out-of-network hospital stay be covered?

In a true life-threatening emergency, emergency services provided by an out-of-network hospital emergency room will be processed at the in-network level. In a non-emergency or urgent care situation, check to see if the hospital is in network by calling Anthem before receiving care. If you use an out-of-network hospital for a non-emergency, the charges will be processed at the out-of-network benefit level. Keep in mind that you would be responsible for any charges above the maximum allowed amount established by Anthem. For more information, see the Summary of Benefits and Coverage.

My spouse or domestic partner is eligible for coverage through his or her employer. Can I enroll him or her under the Hess Medical Plan or is there a penalty?

You can enroll your spouse or domestic partner in a Hess Medical Plan regardless of whether he or she has coverage available through his or her employer’s plan. Unlike many other companies, Hess does not charge a penalty or higher premium rates for spouses or domestic partners if they are eligible under their employer plan.

Are there any pre-existing limitations under the Hess Medical Plan?

No. Pre-existing conditions are covered under the Hess Medical Plan.

Can I enroll in the Hess dental or vision plan if I’m not enrolled in the medical plan?

Yes, you can enroll in dental if you’re not enrolled in medical since dental is a separate election. However, vision is included with medical, so you would need to elect medical to get vision coverage through Hess.

What are all the network names?

Medical: National BlueCard PPO
Vision: Blue View Vision
Pharmacy: National Plus
Delta Dental:
- Delta Dental PPO (generally offers lowest contracted rates and greatest cost savings)
- Delta Dental Premier (offers contracted rates that help you save).

What is the name of the Anthem medical and vision network for Hess?

Hess uses the National BlueCard PPO network for medical and Blue View Vision network for vision.

Where can I learn more about network providers and the differences in how benefits are paid?

Learn more about network providers online at anthem.com or by calling Anthem at 1-800-854-1834. You can find more information about how benefits are paid when you use in- and out-of-network providers here.

What happens if I use out-of-network providers?

When you use an out-of-network provider, the Hess Medical Plan administered by Anthem Blue Cross Blue Shield will pay co-insurance based on Anthem’s maximum allowed amount. You are responsible for any portion of the provider’s charge that exceeds this amount. For example, if you have met your deductible, the plan will pay 65 percent of the maximum allowed amount charge for out-of-network care. If your out-of-network provider charges $600 for a procedure and Anthem’s maximum allowed amount charge for the procedure is $500, you would pay 35 percent of the maximum allowed amount charge (35% x $500 = $175) plus the $100 that exceeds the maximum allowed amount, for a total of $275.

What are out-of-network services?

Out-of-network services are those performed by a provider who is not in the plan’s network. Out-of-network providers do not provide discounted pricing. You will spend more money using out-of-network providers compared to in-network providers.

What are in-network services?

In-network services are those performed by a provider (like a doctor or hospital) who is in the medical plan’s network. Network providers contract for discounted pricing. You save money using in-network providers compared to using out-of-network providers that do not offer discounts.