Administrative Information

 
 

Benefits Summary Plan Description

Administrative Information

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Administrative Information

Important administrative information for each Leidos benefit plan is described in this section. For a comprehensive contact information list, go to Contact Information.

Medical
       
Dental
       
Vision
       
Life and AD&D Insurance
       
Business Travel Insurance
       
Short-Term Disability
       
Long-Term Disability
       
Flexible Spending Accounts

 


Medical Plans

Medical Plans Administrative Information

Leidos Benefit Plan

Healthy Focus Advantage and Healthy Focus Essential Plans

Type of Plan

Group health plans

Plan Sponsor

Leidos
Attn: Corporate Benefits
11955 Freedom Drive
Reston, VA 20190

Plan Sponsor Employer Identification Number

95-3630868

Participating Employers

  • Leidos
  • BD Systems, Inc.
  • The Benham Companies, LLC and Majority-Owned Subsidiaries
  • Eagan, McAllister Associates, Inc.
  • Hicks & Associates, Inc.
  • MEDPROTECT LLC
  • Varec Holdings, Inc

Plan Administrator

Leidos
Attn: Corporate Benefits
11955 Freedom Drive
Reston, VA 20190

Group Number

Aetna – 698685
Anthem – 17010

Plan Number

501

Agent for Service of Legal Process

Legal process may be served on the Plan Administrator at the address specified above.

Plan Year

January 1 – December 31

Funding

The plans are self-funded and self-administered by Leidos. Leidos and participants share the cost of coverage.

Claims Administrators:

Employees who live in these states are administered under the Aetna Inc:

Alabama, Arkansas, California, Delaware, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Vermont, Virginia, West Virginia, Wisconsin, Wyoming

Aetna
P.O. Box 14089
Lexington, KY 40512-4089
800-843-9126

Express Scripts
P.O. Box 14711
Lexington, KY 40512
877-223-4721

Claims Administrators:

Employees who live in these states are administered under Anthem BC Life and Health with claims administered by Anthem Blue Cross:

Alaska, Arizona, Colorado, Connecticut, Florida, Georgia, Louisiana, Massachusetts, Mississippi, New Mexico, North Carolina, Rhode Island, South Carolina, Texas, Utah, Washington state, and Puerto Rico.

Anthem
P.O. Box 60007
Los Angeles, CA 90060
866-403-6183

Express Scripts
P.O. Box 14711
Lexington, KY 40512
877-223-4721


Dental Plans

Dental Plan Administrative Information

Leidos Benefit Plan

Leidos Dental PPO Plan

Type of Plan

Group health plan

Plan Sponsor

Leidos
Attn: Corporate Benefits
11955 Freedom Drive
Reston, VA 20190

Plan Sponsor Employer Identification Number

95-3630868

Participating Employers

  • Leidos
  • BD Systems, Inc.
  • The Benham Companies, LLC and Majority-Owned Subsidiaries
  • Eagan, McAllister Associates, Inc.
  • Hicks & Associates, Inc.
  • MEDPROTECT LLC
  • Varec Holdings, Inc

Plan Administrator

Leidos
Attn: Corporate Benefits
11955 Freedom Drive
Reston, VA 20190

Group Number

698685

Plan Number

501

Agent for Service of Legal Process

Legal process may be served on the Plan Administrator at the address specified above.

Plan Year

January 1 – December 31

Funding

The plans are self-funded and self-administered by Leidos. Leidos and participants share the cost of coverage.

Claims Administrators

(2017) Aetna PPO Dental
P.O. Box 14027
Lexington, KY 40512-4027
800-843-9126

(2018) Delta Dental
4818 Starkey Road
Roanoke, VA 24018
800-237-6060


Vision Plans

Vision Plan Administrative Information

Leidos Benefit Plan

Vision Plan

Type of Plan

Group health plan

Plan Sponsor

Leidos
Attn: Corporate Benefits
11955 Freedom Drive
Reston, VA 20190

Plan Sponsor Employer Identification Number

95-3630868

Participating Employers

  • Leidos
  • BD Systems, Inc.
  • The Benham Companies, LLC and Majority-Owned Subsidiaries
  • Eagan, McAllister Associates, Inc.
  • Hicks & Associates, Inc.
  • MEDPROTECT LLC
  • Varec Holdings, Inc

Plan Administrator

Leidos
Attn: Corporate Benefits
11955 Freedom Drive
Reston, VA 20190

Plan Manager

Process Works, Inc.
P.O. Box 1470
Brookfield, WI 53008-1470
800-599-7546 or 262-797-7010

Group Number

12180678

Plan Number

514

Agent for Service of Legal Process

Legal process may be served on the Plan Administrator at the address specified above.

Plan Year

January 1 – December 31

Funding

Participants pay the full cost of coverage. To be covered by benefits, participants make pre-tax contributions.

Claims Administrators

Vision Service Plan
3333 Quality Drive
Rancho Cordova, CA 95670
800-852-7600


Life and AD&D Insurance Plans

Life and AD&D Insurance Plans Administrative Information

Leidos Benefit Plan

Basic Term Life InsuranceSupplemental Term Life Insurance/Group Universal Life (GUL) InsuranceBasic AD&D Insurance, and Voluntary AD&D Insurance

Type of Plan

Group Term Life Insurance
Accidental Death & Dismemberment
Group Universal Life Insurance (2018)

Plan Sponsor

Leidos
Attn: Corporate Benefits
11955 Freedom Drive
Reston, VA 20190

Plan Sponsor Employer Identification Number

95-3630868

Participating Employers

  • Leidos
  • BD Systems, Inc.
  • The Benham Companies, LLC and Majority-Owned Subsidiaries
  • Eagan, McAllister Associates, Inc.
  • Hicks & Associates, Inc.
  • MEDPROTECT LLC
  • Varec Holdings, Inc

Plan Administrator

2017 Life & AD&D Insurance
Life Insurance Company of North America
1601 Chestnut
Philadelphia, PA 19192-2235

2018 Life Insurance
Prudential Insurance Company of America
  P.O. Box 8517
Philadelphia, PA 19176

2018 AD&D Insurance
Life Insurance Company of North America
1601 Chestnut
Philadelphia, PA 19192-2235

Policy Number

Cigna - FLX-050953; COA-004005; and OK 819515
Prudential - Control 52844

Agent for Service of Legal Process

Legal process may be served on the Plan Administrator at the address specified above.

Plan Year

January 1 – December 31

Funding

Leidos pays the full cost of Basic Term Life Insurance and Basic AD&D Insurance. Participants pay the full cost of coverage for Supplemental Term Life Insurance (in 2017), Group Universal Life (GUL) Insurance (in 2018) and Voluntary AD&D Insurance. The Leidos employer paid life and employee paid life plans are combined for rating purposes. At any time, the cost of one plan may subsidize the cost of the other plan.

Claims Administrators

2017 Life & AD&D Insurance
Cigna Life Insurance
1601 Chestnut
Philadelphia, PA 19192-2235

2018 Basic Life & GUL Insurance
Prudential
P.O. Box 8517
Philadelphia, PA 19176

2018 AD&D Insurance
Cigna Life Insurance
1601 Chestnut
Philadelphia, PA 19192-2235

Claim Forms

Claim forms are available from your Benefits POC. Completed claim forms, along with supporting documentation, should be submitted directly to Leidos Employee Services:
P.O. Box 2502
Oak Ridge, TN  37831


 

Business Travel Accident Insurance

Business Travel Accident Insurance Administrative Information

Leidos Benefit Plan

Business Travel Accident Insurance

Type of Plan

Group term life insurance plans

Plan Sponsor

Leidos
Attn: Corporate Benefits
11955 Freedom Drive
Reston, VA 20190

Plan Sponsor Employer Identification Number

95-3630868

Participating Employers

  • Leidos
  • BD Systems, Inc.
  • The Benham Companies, LLC and Majority-Owned Subsidiaries
  • Eagan, McAllister Associates, Inc.
  • Hicks & Associates, Inc.
  • MEDPROTECT LLC
  • Varec Holdings, Inc

Plan Administrator

Life Insurance Company of North America
1601 Chestnut
Philadelphia, PA 19192-2235

Policy Number

ABL-65 86 41

Agent for Service of Legal Process

Legal process may be served on the Plan Administrator at the address specified above.

Plan Year

January 1 – December 31

Funding

Leidos pays the full cost of Business Travel Accident Insurance.

Claims Administrators

CIGNA Life Insurance
1601 Chestnut
Philadelphia, PA 19192-2235

Claim Forms

Claim forms are available from your Benefits POC. Completed claim forms, along with supporting documentation, should be submitted directly to:

Leidos
Employee Services
P.O. Box 2502
Oak Ridge, TN 37831


 

Short-Term Disability Plan

Short-Term Disability Plan Administrative Information

Leidos Benefit Plan

Voluntary Short-Term Disability Insurance (VSDI)

Type of Plan

Disability plan

Plan Sponsor

Leidos
Attn: Corporate Benefits
11955 Freedom Drive
Reston, VA 20190

Plan Sponsor Employer Identification Number

95-3630868

Participating Employers

  • Leidos
  • BD Systems, Inc.
  • The Benham Companies, LLC and Majority-Owned Subsidiaries
  • Eagan, McAllister Associates, Inc.
  • Hicks & Associates, Inc.
  • MEDPROTECT LLC
  • Varec Holdings, Inc

Plan Administrator

Leidos
Attn: Corporate Benefits
11955 Freedom Drive
Reston, VA 20190

Plan Manager

Sedgwick CMS
3280 E. Foothill Blvd., Suite 250
Pasadena, CA 91107
800-939-4911

Plan Number

515

Agent for Service of Legal Process

Legal process may be served on the Plan Administrator at the address specified above.

Plan Year

January 1 – December 31

Funding

Employees pay the full cost of Voluntary Short-Term Disability Insurance (VSDI).

Claims Administrators

Sedgwick CMS
3280 E. Foothill Blvd., Suite 250
Pasadena, CA 91107
800-939-4911


 

Long-Term Disability Plan

Long-Term Disability Plan Administrative Information

Leidos Benefit Plan

Long-Term Disability Insurance

Type of Plan

Disability plan

Plan Sponsor

Leidos
Attn: Corporate Benefits
11955 Freedom Drive
Reston, VA 20190

Plan Sponsor Employer Identification Number

95-3630868

Participating Employers

  • Leidos
  • BD Systems, Inc.
  • The Benham Companies, LLC and Majority-Owned Subsidiaries
  • Eagan, McAllister Associates, Inc.
  • Hicks & Associates, Inc.
  • MEDPROTECT LLC
  • Varec Holdings, Inc

Plan Administrator

Life Insurance Company of North America
1601 Chestnut
Philadelphia, PA 19192-2235

Plan Number

LK-980003

Agent for Service of Legal Process

Legal process may be served on the Plan Administrator at the address specified above.

Plan Year

January 1 – December 31

Funding

Employees pay the full cost of Voluntary Long-Term Disability Insurance.

Claims Administrators

Life Insurance Company of North America
1601 Chestnut
Philadelphia, PA 19192-2235


 

Flexible Spending Accounts

Flexible Spending Accounts Administrative Information

Leidos Benefit Plan

Health Care FSA and Dependent (Day) Care FSA

Type of Plan

Group health plans

Plan Sponsor

Leidos
Attn: Corporate Benefits
11955 Freedom Drive
Reston, VA 20190

Plan Sponsor Employer Identification Number

95-3630868

Participating Employers

  • Leidos
  • BD Systems, Inc.
  • The Benham Companies, LLC and Majority-Owned Subsidiaries
  • Eagan, McAllister Associates, Inc.
  • Hicks & Associates, Inc.
  • MEDPROTECT LLC
  • Varec Holdings, Inc
Plan Manager

HealthEquity
15 W. Scenic Pointe Drive
Suite 100
Draper, UT 84020
Customer Service: 1-844-373-6981 
HealthEquity

 

Agent for Service of Legal Process

Legal process may be served on the Plan Administrator at the address specified above.

Plan Year

January 1 – December 31

Funding

Benefits are funded with voluntary pre-tax contributions made by enrolled participants.

Claims Administrators

HealthEquity
15 W. Scenic Pointe Drive
Suite 100
Draper, UT 84020
Customer Service: 1-844-373-6981 
HealthEquity