ROANOKE COLLEGE QUALIFYING EVENT GUIDE
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EMPLOYEES
HEALTH SAVINGS CONTRIBUTION FOR PLAN 7 HDHP ENROLLMENT
VIRGINIA PRIVATE COLLEGES BENEFITS CONSORTIUM
AFFIDAVIT NOTICE FOR SPOUSAL HEALTH INSURANCE
Employee spouses who have access to affordable, minimum essential coverage that provides minimum value are not eligible for coverage on our health plans. If your spouse is not employed, is employed but does not have access to coverage, or is employed by a VPCBC member school, including Roanoke College, they are eligible for coverage. To be eligible to participate in our health plans, employees must be legally married.
This eligibility change helps the VPCBC maintain affordable coverage for our employees, dependent children, and their spouses who do not have access to coverage.
Three populations of spouses will continue to be eligible for enrollment as a dependent. Those populations are as follows:
1. Spouses who are not employed.
2. Spouses who ARE EMPLOYED but do not have access to minimum essential coverage.
3. Spouses who are employed by a VPCBC member school, including Roanoke College.
To be eligible to participate in the VPCBC health plan, employees must be LEGALLY married.
HEALTH PLAN DESIGNS
Benefit plan provisions are subject to change from time to time at direction of the Virginia Private Colleges Benefits Consortium (VPCBC) Board of Directors. For maximum benefits, use in-network providers.
DENTAL INSURANCE PREMIUMS
2026
EMPLOYEES PAID BIWEEKLY – 20 PAY PERIODS
DENTAL PLAN DESIGNS
For the services listed below, Delta Dental will pay the stated percentage of the plan allowance based on the dentist's participation with Delta Dental.
IN-NETWORK OVERVIEW
Deductible
$50 Single
$150 Family
$50 Single
$150 Family Annual Benefit
Orthodontic Lifetime
$1,000 Per Person $2,000 Per Person
$2,000 Per Person
Prevention First Visits To The Dentist For Diagnostic And Preventive Services Will Not Count Against The Annual Maximum
Diagnostic and Preventive Services Covered at 100% - No Deductible
▪ Oral Exams And Cleanings - Twice In A Calendar Year.
▪ Periodontal Cleanings - Twice In A Calendar Year.
▪ Fluoride Applications - Twice In A Calendar Year For Enrollees Under Age 19.
▪ X-Rays - Bitewing X-Rays Are Limited To Once In A Calendar Year; Limited To
Covered at 100% - No Deductible
▪ A Maximum Of Four Films Or A Set (Seven To Eight Films) Of Vertical Bitewings. Full-Mouth X-Rays Are Limited To Once In A Five-Year Period.
▪ Sealants - One Per Tooth In A Five-Year Period For Members Under Age 16 On Non-Carious, Non-Restored First And Second Permanent Molars.
▪ Space Maintainers- Once Per Quadrant Per Arch For Enrollees Under The Age Of 14.
Basic Services
Covered At 80% Covered at 100% For Dependents Under Age 13
▪ Fillings- One Per Surface In A 24-Month Period.
▪ Stainless Steel Crowns - Primary (Baby) Teeth For Enrollees Under The Age Of 14.
▪ Endodontic Services - Root Canal Therapy.
▪ Periodontic Services -Treatment For Gum Disease.
▪ Simple Extractions
▪ Oral Surgery - Surgical Extractions And Other Surgical Procedures.
▪ Denture Repair And Recementation
▪ Occlusal Guards For Bruxism
Major Services
Covered at 80% Covered at 100% For Dependents Under Age 13
None
▪ Crowns - One Per Tooth In An 84-Month Period For Members Age 12 And Older.
Covered at 50% Covered at 100% For Dependents Under Age 13
▪ Prosthodontics/Dentures And Bridges - Once In An 84-Month Period For Members Age 16 And Older.
▪ Implants- One Per Site For Members Age 16 And Older
Orthodontic Services None Covered at 50%
Orthodontic Lifetime Maximum N/A
▪ Treatment For The Proper Alignment Of Teeth - For Subscriber And Covered Dependents.
Disclaimer: The plan document will govern the final claim payment process for the benefits.
$2,000
2026 Plan Year
Voluntary Vision Coverage Provided by Blue View Vision
EMPLOYEES PAID MONTHLY – 12 PAY PERIODS
EMPLOYEES PAID BIWEEKLY – 26 PAY PERIODS
EMPLOYEES PAID BIWEEKLY – 20 PAY PERIODS
VOLUNTARY VISION PLAN DESIGNS
As a Blue View Vision plan member, you have access to one of the nation’s largest vision networks. You may choose from many private practice doctors, local optical stores, and national retail stores including LensCrafters®, Target Optical®, and most Pearle Vision® locations. You may also use your in-network benefits to order eyewear online at Glasses.com and ContactsDirect.com.
Out-of-Network – If you choose to, you may instead receive covered benefits outside of the Blue View Vision network. Just pay in full at the time of service, obtain an itemized receipt, and file a claim for reimbursement up to your maximum out-of-network allowance
Eye Examination – Every 12 Months
Eyeglass Frames – Every 24 Months
$130 Allowance, Then 20% Off Any Remaining Balance Up To $100
Standard Plastic Lenses – Every 12 Months $15
- $100
Members Can Receive Both Eyeglasses And Contact Lenses In The Same Plan Year – Each Have $130 Allowance
Elective Conventional Contacts
Disposable Contacts
$130 Allowance, Then 15% Off Any Remaining Balance
$130 Allowance
$130 Allowance
$130 Allowance
Medically Necessary Contacts Covered In Full $210 Allowance
Eyeglass Lens Upgrades
When obtaining eyewear from a Blue View Vision provider, you may choose to upgrade your new eyeglass lenses at a discounted cost. Eyeglass lens copayment applies.
Disclaimer: The plan document will govern the final claim payment process for the
HEALTH SAVINGS ACCOUNTS
Connecting Health and Wealth With Health Savings Accounts
2026 HSA CONTRIBUTION LIMITS
Annually
Catch-Up Limit (Age 55 & Older)
If you enroll in the high-deductible health plan you can also open a Health Savings Account (HSA) to help pay for eligible medical expenses
USE YOUR HSA FOR ELIGIBLE EXPENSES:
✓ Medical
✓ Dental
✓ Vision
✓ Over-The-Counter Medicines
See The Complete List Of Qualified Expenses: https://www.irs.gov/publications/p502/index.html
HSA ELIGIBILITY
Federal regulations require you to meet all the following eligibility requirements in order to open and contribute to an HSA:
▪ Covered under a qualified high-deductible health plan on the first day of the month.
▪ Not covered by any other health plan, including your spouse’s health insurance.
▪ Not covered by your own or spouse’s medical flexible spending account (FSA).
▪ Not enrolled in any part of Medicare or Tricare.
▪ Not claimed as a dependent on another person’s tax return.
ADVANTAGES OF AN HSA
▪ Decide how much to set aside for health care costs
▪ Control how to spend the money
▪ Receive tax benefits, including maximizing your tax savings and carrying over your money tax-free each year
▪ Any unused money stays in your account
▪ Account balance rolls over from year to year
▪ You own your account and the money is yours even if you switch jobs
▪ Grow your money by saving and/or investing
INVESTMENT OPTIONS
Our members have the option to access the money via a debit card or invest in a portfolio of funds whereby the money can potentially grow tax free, or both.
No-Load Mutual Funds
▪ Choose from Vanguard® mutual funds offered
▪ No minimum contribution required
▪ No transaction or redemption fees
▪ Not FDIC insured Debit Card
▪ APY varies based on account balance
▪ FDIC insured
▪ No monthly low-balance fee eligible.
FLEXIBLE SPENDING ACCOUNTS
Healthcare and Dependent Care Flexible Spending Accounts
2026 FSA CONTRIBUTION LIMITS
Benefit Plan
Health Care FSA/Limited Purpose FSA
Dependent Care FSA
Health Care FSA/Limited Purpose FSA Rollover
CONTRIBUTION LIMITS
$3,300
$7,500 ($3,750 if married and filing separately)
$660
MAKE THE MOST OUT OF YOUR FLEXIBLE SPENDING PLANS - SAVE ON TAXES
Our Flexible Spending Accounts provide participants with an important tax advantage that can help you pay for eligible health care and dependent care expenses on a pre-tax basis. By paying for certain expenses on a pretax basis, you can lower your taxable income and increase your take-home pay.
HEALTH CARE FSA
▪ Allows you to save for qualified medical, dental and vision expenses incurred by you and your dependents.
LIMITED PURPOSE FSA
▪ Allows employees participating in the HDHP plan to pay for qualified dental and vision expenses only incurred by you and your dependents.
THE DEPENDENT CARE FSA
▪ Can be used to pay childcare expenses for your dependent children up to age 13 and adult day care for a disabled spouse, or for senior dependents so that you, and your spouse are able to work.
HEALTHEQUITY WEBSITE
On the HealthEquity website, www.healthequity.com participants can check their accounts and submit claims.
Download the mobile app and find more information about flexible spending accounts.
RUN-OUT PERIOD
Employees have a run-out period to turn in expenses for the Health Care FSA after the end of the plan year: 3 months (until March of the new plan year). Unused funds remaining in the Dependent Care Account after the end of the 3 run-out period will be Forfeited
Participants who enroll in the HDHP w/HSA and have balances in the FSA at the end of the plan year will have those funds (up to the rollover limit) roll into a Limited Purpose FSA account automatically to be used for dental and/or vision expenses. Any monies remaining in your health care FSA at the end of the plan year – up to rollover maximum – will rollover into the new plan year if the traditional FSA is elected for the new upcoming plan year
FLEXIBLE SPENDING FACTS
Health Care FSA
Funding Account Used With →
Eligible Expenses →
Receipts →
Limited Purpose FSA
Funding Account Used With →
Eligible Expenses →
Receipts →
Dependent Care FSA
What →
Eligible Expenses →
Non-HSA eligible medical plan
Medical, Dental, Vision, Prescriptions, and OTC medicines
Receipts Keep your receipts in case the IRS asks to confirm use of funds
HDHP HSA eligible medical plan
Dental and Vision only
Receipts Keep your receipts in case the IRS asks to confirm use of funds
Helps with child or elder care while you and your spouse work Babysitter inside or outside household; before and after school care, day or summer camps, daycare centers, nanny expenses, preschool/nursery school, plus more
OPEN ENROLLMENT & QUALIFYING EVENTS
The Roanoke College Annual Open Enrollment period is an employee’s opportunity each year to review their benefits and make changes for the upcoming calendar year. The Open Enrollment usually takes place during the fall semester and benefit changes are effective for January 1st of the new calendar year.
Benefit election changes can only be made during the plan year if an employee experience a qualifying event such as:
▪ Birth of a child or adopting a child
▪ Change in marital status
▪ Employee or dependent loses eligibility for membership (e.g., exceeding the age limit, divorce, etc.)
▪ New dependent becomes eligible (e.g., newborns, adoptions)
▪ Change in subscriber's employment
▪ Change in hours from part-time to full-time and vice versa
▪ Member assumes permanent residence outside the service area
▪ Death of a member
▪ Availability of other health coverage
▪ Employee or dependent become eligible for state-granted health premium assistance
▪ Employee or dependent loses health coverage under Medicaid or a State Children's Health Insurance Program (SCHIP)
Any requested benefit change must be consistent with the status change, and status changes must be requested within 30 days of the qualifying event.
To report a qualifying event, please contact Human Resources at 540-375-2442 or visit our office on the second floor of College Hall.
AFFIDAVIT NOTICE FOR SPOUSAL HEALTH INSURANCE
Virginia Private Colleges Benefits Consortium
Effective January 1, 2021, employees’ spouses who have access to affordable, minimum essential coverage that provides minimum value1 through another employer will no longer be eligible for medical coverage in the Virginia Private Colleges Benefits Consortium (“VPCBC”) medical plan. This eligibility change helps VPCBC maintain affordable coverage for employees, their spouses who do not have access to another employer’s medical coverage, and dependent children.
Three (3) populations of spouses will continue to be eligible for enrollment as your dependent;
▪ Spouses who are not employed;
▪ Spouses who are employed, but do not have access to affordable, minimum essential coverage that provides minimum value through their employer; and
▪ Spouses who are employed by a VPCBC Member Institution, including the school where you are employed.
To be eligible to participate in the VPCBC medical plan, you and your spouse must be currently legally married.2
If your spouse is employed, and any medical coverage other than (i) COBRA coverage, (ii) Medicare, or (iii) a medical flexible spending account (“FSA”) under a cafeteria plan (funded solely by your spouse’s contributions), is available to him/her through their current employer (whether or not your spouse actually enrolls in such coverage) then your spouse is not eligible to participate in the VPCBC medical plan.
IMPORTANT REMINDERS
1 Affordable, minimum essential coverage that provides minimum value as defined by the Affordable Care Act means health coverage that is affordable (for 2021, the employee portion of the Employee Only premium for the employer’s lowest-cost coverage does not exceed 9.83 percent of the employee’s income) and provides minimum value (plan pays at least 60 percent of the total allowed costs of benefits provided under the plan).
2 Certain VPCBC Member Institutions have extended coverage to unmarried domestic partners. Please check with your Human Resources Department for additional information.
* Note: All employers must provide information to their employees in one of their health plan documents, the Summary of Benefits and Coverage, informing them whether their employer-sponsored coverage meets the minimum value standard. In addition, all employers must provide notice to all employees beginning October 1, 2013, regarding coverage options available through the Health Insurance Marketplace or Exchange. In that notice, employers may indicate if the employer-sponsored coverage meets the minimum value standard and the cost of the coverage is intended to be affordable, based on employee wages. Consult your spouse’s employer if you have questions regarding the affordability or minimum value status of their employer-sponsored coverage.
**Note: Example affidavit, please see full affidavit for full language
ADDITIONAL EMPLOYEE RESOURCES
Vendor Contact Information
VENDOR CONTACT INFORMATION
Virginia Private Colleges Benefits Consortium
Benefits Consortium (540) 682-4480
Email: info@vpcbc.org www.vpcbc.org
Medical Anthem Health Guides 1-833-597-2358 www.anthem.com
Prescription Drug Services
Pharmacy Member Services
1-833-389-1968
Help for Pharmacists 1-833-296-5039 www.anthem.com/pharmacyinformation
Virtual Visits
Anthem
1-888-548-3432 (support only) www.anthem.com or Sydney App
Blue View Vision
Anthem 1-866-723-0515 www.anthem.com
Medical Travel - International
Anthem BlueCross BlueShield Global Core 1-800-810-2583 (BLUE) www.bcbsglobalcore.com
Dental
Delta Dental 1-800-237-6060 www.deltadentalva.com
VENDOR CONTACT INFORMATION
Blue View Vision (Buy Up Vision) Blue View 1-866-723-0515 www.anthem.com
Employee Advocacy Program Health Advocate 1-866-695-8622
Email: answers@HealthAdvocate.com www.healthadvocate.com/VPCBC
COBRA Administration
Empyrean COBRA Service Center 1-833-874-1600 (7:00 am – 7:00 pm) www.cobraandbillingservices.com
FSA and HSA Assistance HealthEquity
HSA Help: 1-866-346-5800
FSA Help: 1-877-924-3967 www.healthequity.com
EAP
Anthem 1-844-451-1579 www.anthemeap.com/vpcbc
Life Insurance
The Hartford 1-866-547-4205 www.employeenavigator.com www.myhealthhub.app/thehartford
Benefits Mobile Apps
ADDITIONAL EMPLOYEE RESOURCES
Put your smartphone to work for you! Download these free apps from Google Play or Apple store
Anthem Sydney Health Mobile App
Find Complete Care Support, On Your Time, Through The Sydney Health App
FEATURES: ▪ Virtual Care
▪ Symptom Checker
▪ Live Chat
▪ Find Care Provider
▪ Compare Cost
▪ See Your Claims
▪ Check Benefits
▪ View & Use ID Card
Health Advocate Mobile App Free | Convenient | On-the-Go Help
FEATURES: ▪ Review Member Benefits
▪ Confidential Support
▪ One-Touch Calling
▪ Personalized Help Finding Doctors
▪ Quick Email Contact
▪ 24/7 Member Website
Delta Dental Mobile App
The Delta Dental Mobile App Makes It Easy To Make The Most Of Your Dental Benefits Right From Your Mobile Devise!
FEATURES: ▪ Mobile ID Card
▪ Find A Dentist
▪ Cost Estimator
▪ Quick Contact Access
▪ View Claims
The HealthEquity Mobile App
EASY ACCESS TO Your HealthEquity Account WHEREVER YOU ARE
FEATURES: ▪ On-The-Go Access
▪ Photo Documentation
▪ Send Payments & Reimbursements
▪ Manage Debit Card Transactions
TIAA Mobile App
▪ View Claims Status
▪ Make Claims
Your Money | Your Future | Your Options
FEATURES: ▪ Digital Registration
▪ Contribution Overview
▪ Manage Contributions
▪ Beneficiary Designations
▪ “How am I doing?” Tracker
▪ Retirement Allocations
▪ 6-Minute Planning Checkup
