medical PPO plan
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.
Important: Chevron will suspend the monthly premium for employees enrolled in the Chevron Medical PPO who currently have premiums taken from their pay from May through September 2021. This means that the cost for medical coverage under these plans will be $0 during this premium holiday period. Your first May 2021 paycheck is the first paycheck with no premium deduction. Your normal deductions (if any) will be reinstated on your first October 2021 paycheck. Learn more about the premium holiday here.
care a lot, get a shot ... and points
- You can enroll in the Medical PPO Plan 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 Medical PPO Plan is a preferred provider organization (PPO) health plan, so you can choose to see any provider you want. However, remember that you pay more out-of-your pocket if you visit an out-of-network provider.
- The Medical PPO Plan 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 Medical PPO Plan, you're also automatically enrolled in the Vision Program for basic vision coverage with VSP.
- The Medical PPO Plan generally covers the same services as the HDHP and the HDHP Basic. But the Medical PPO monthly premium, deductible, copayment and coinsurance amounts are different. And there are important differences in how the Medical PPO deductible works.
- The Medical PPO Plan is not compatible with a health savings account (HSA). However, the Health Care Spending Account (HCSA) – a flexible spending account plan – is available to help you save money for qualified health expenses you incur during the calendar year.
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.
- COVID-19 immunization coverage under the Prescription Drug Program (February 15, 2021)
- Temporary extension of coverage for out-of-network COVID-19 immunizations under 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)
- Update to Infertility Services (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)
- Medical PPO Deductibles (January 1, 2018)
- New coverage for adult hearing aids (January 1, 2018)
- Prescription Drugs: Condition-specific prescription drug programs (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.
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.
get in the know
Preventive care is an investment in your health. All Chevron medical plans include 100 percent coverage with no copayment, coinsurance or deductible for certain preventive care services when you see a network provider.
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.
Participate in health rewards to save up to $750 annually on your Chevron medical premium.
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.