high deductible health plan basic
had a recent life event?
If you get married, have a baby, move or experience some other qualifying life event, you have 31 days to make changes to your benefits. If you miss this important deadline, you'll have to wait until the next open enrollment period to change your benefits.
save more on health
A second high-deductible health plan, the Chevron High Deductible Health Plan Basic (HDHP Basic), is available. Both the Chevron HDHP and the HDHP Basic cover the same services; only your out-of-pocket costs — the premiums, deductibles, and coinsurance — are different.
With the HDHP Basic you’ll get quality medical coverage, and the tax advantages and saving capabilities of a Health Savings Account (HSA). HDHP Basic coverage is much like a traditional PPO, so you can choose any doctor you want, in the network or out-of-network. But the high deductible part of the HDHP Basic means that compared to other plans Chevron offers, you’ll be responsible for paying a higher dollar amount before the plan shares costs with you. The trade-off for that higher deductible is the unique opportunity to participate in a Health Savings Account to help pay for current and future qualified health care expenses.
- You can enroll in the HDHP Basic if you're a U.S.-payroll employee and you're eligible for Chevron's health benefits. You can also enroll your eligible dependents, just as you can with Chevron's other health plans.
- U.S.-payroll expatriates cannot enroll in this plan while on expatriate assignment, but you'll have the option when you repatriate to the United States.
- The HDHP Basic is a preferred provider organization (PPO) health plan. This means you can choose to see any provider you want, but higher benefits are paid when you go to a network provider.
- The HDHP Basic includes medical coverage with Anthem Blue Cross (Anthem), prescription drug coverage with Express Scripts and mental health and substance abuse coverage with ValueOptions, a Beacon Health Company. In addition, if you enroll in the HDHP Basic, you're also automatically enrolled in the Vision Program for basic vision coverage with VSP.
- The HDHP Basic generally covers the same services as the HDHP and the Medical PPO Plan. But the HDHP Basic monthly premium, deductible, coinsurance amounts are different. And there are important differences in how the HDHP Basic deductible works.
- The HDHP and HDHP Basic are the only medical plans Chevron offers that are compatible with a health savings account (HSA). If you enroll in the HDHP or the HDHP Basic you are not eligible to participate in the Health Care Spending Account (HCSA) – a flexible spending account plan.
enrolling a new dependent?
plan facts at-a-glance
recent plan changes
Things change; be sure you're informed. The documents provided below are called a summary of material modification (SMM). An SMM explains recent updates to your plan that are not yet captured or updated in your summary plan description (SPD). Be sure to review the SMM for an understanding of important plan updates.
- Coverage for COVID-19 at-home test kits under the Prescription Drug Program (January 15, 2022)
- New coverage for weight loss class of prescription drugs (January 1, 2022)
- COVID-19 immunization coverage under the Prescription Drug Program (February 15, 2021)
- Temporary extension of coverage for out-of-network COVID-19 immunizations for medical coverage (December 11, 2020)
- Temporary coverage for flu shots under the Prescription Drug Program (September 15 - December 31, 2020)
- New address for benefits correspondence (June 1, 2020)
- COVID-19 testing and treatment, preventive services; Online visit coverage extended (Update to the March 19 document/March 27, 2020)
- COVID-19 testing and treatment coverage; Online visit temporary fee waiver (March 19, 2020)
- HDHP Deductible update (January 1, 2020)
- Update to Infertility Services (January 1, 2020)
- Preventive care for chronic conditions (January 1, 2020)
- Prescription Drugs: Preventive care for chronic conditions (January 1, 2020)
- Prescription Drugs: Managed prior authorization for Xyrem (January 1, 2020)
- Temporary Special Provision for Permian Basin Participants (March 1, 2019)
- Prescription Drugs: Advanced Opioid Management Program (January 1, 2019)
- New Dependent Verification Requirement (January 1, 2019) | Learn more
- New Qualifying Life Event (January 1, 2019)
- Employee after-tax contributions eliminated (January 1, 2019)
- New fee for insufficient funds (January 1, 2019)
- Prescription Drugs: Coverage for preventive medications (January 1, 2018)
- New coverage for adult hearing aids (January 1, 2018)
- Prescription Drugs: Condition-specific prescription drug programs (January 1, 2018)
- HDHP Basic deductibles and other updates (January 1, 2018)
prescription drug formulary & exclusions
- Prescription Drug administrative changes due to COVID-19
- Prescription Drug Plan Formulary (January 1, 2021)
summary plan description (SPD)
summary of benefits and coverage (SBC)
- Go to the SBC section of this website to locate the document for your plan.
services from a network provider
services from an out-of-network provider
- Anthem claim form (medical services)
- Express Scripts claim form (prescription drugs)
- VSP claim form (basic vision services)
- Claim forms are also available by calling the applicable claims administrator or accessing your account online.
One feature that makes the HDHP Basic special is that it's compatible with a health savings account. A health savings account – or HSA – is like a savings plan for your health care. An HSA is a personal account separate from your Chevron benefits. It works like a regular bank account, but you don't currently pay federal income taxes on money you deposit. Your savings grow from year to year. There is no use it or lose it rule. And you can take your money with you if you change plans or when you leave Chevron. You can use an HSA to pay for qualified medical expenses now or at any point in the future – even in retirement. There are a lot of rules about who can open and contribute to an HSA, how it's used, and how taxes work, so be sure to do your research before you take action. Learn more about HSAs, including the BenefitWallet HSA.
get up to $1,000 in an HSA
find a network provider
There are different coinsurance, copayment, deductible, and out-of-pocket maximum amounts depending on if you see a network or an out-of-network provider. Find a network provider here.
talk with a health professional from home
second opinion requirement
We request that you seek a second opinion through 2nd.MD — the Health Decision Support Program administrator — prior to receiving any of the four medical procedures (on a non-emergency basis) listed below. If you decline to use the service for these four procedures, that's your choice. But by doing so, you will be responsible for an additional $400 added to your total claim cost for the procedure, whether or not you've met the deductible.
- Knee surgery
- Hip surgery
- Back surgery
- Spine surgery
The second medical opinion service is free to eligible employees enrolled in a Chevron medical plan. It's always your decision whether to follow the second opinion, or stay the course on your original treatment plan. We're simply asking that you seek a second opinion through the 2nd.MD service to help you make informed decisions about your care before your knee, hip, back or spine procedure. This requirement currently only applies to eligible employees enrolled in the Chevron Medical PPO Plan, the Chevron HDHP and the Chevron HDHP Basic.
special services from your plan
With a virtual health visit service (also referred to telehealth), you can receive care for minor issues, right from home.
With Engage, you can see what's covered by your medical plan, compare the cost of services, and see where you've spent your medical care dollars.
Anthem Future Moms is a program that can answer your questions, help you make good choices and follow your health care provider’s plan of care. And it can help you have a safe delivery and a healthy child. Sign up as soon as you know you’re pregnant.
supplement your health coverage
The HR Service Center manages your enrollment in and eligibility for this benefit plan. For all other questions regarding your coverage, contact the claims administrator. A claims administrator manages the administration of your plan — for example, claims, account balances, ID cards, what's covered and what's not, provider networks, phone numbers, the administrator's website or mobile app, and more.
You can find key contact information for medical, prescription drugs, and basic vision services from the Contacts section of this website.
This web page provides only certain highlights about changes of benefit provisions. It is not intended to be a complete explanation. If there are any discrepancies between this communication and the legal plan documents, the legal plan documents will prevail to the extent permitted by law. There are no vested rights with respect to Chevron health care plans or any company contributions towards the cost of such health care plans. Rather, Chevron Corporation reserves all rights, for any reason and at any time, to amend, change or terminate these plans or to change or eliminate the company contribution toward the cost of such plans. Such amendments, changes, terminations or eliminations may be applicable without regard to whether someone previously terminated employment with Chevron or previously was subject to a grandfathering provision. Some benefit plans and policies described in this document may be subject to collective bargaining and, therefore, may not apply to union-represented employees.