Self-Insured Schools of California: Schools Helping Schools

Size: px
Start display at page:

Download "Self-Insured Schools of California: Schools Helping Schools"

Transcription

1 Schools Helping Schools SISC III SELF-INSURED SCHOOLS OF CALIFORNIA ACCESS+ HMO PLAN Self-Insured Schools of California: Schools Helping Schools 2012 Enrollment Guide 2012 Enrollment Guide

2 Schools Helping Schools SISC III SELF-INSURED SCHOOLS OF CALIFORNIA SISC is a Joint Powers Authority administered by the Kern County Superintendent of Schools Office Christine Lizardi Frazier, Superintendent Our philosophy Schools Helping Schools Pooling resources provides schools with a more stable long-term insurance solution than purchasing from commercial carriers that may be competitive today and out of reach tomorrow. SISC provides a very cost-effective rate environment which reflects its commitment to preventing losses and controlling costs. This keeps millions of dollars in the classroom that would have otherwise been paid out in premiums. Members in our board of directors are elected by member districts. All board members are employees of school districts. This ensures that SISC policies are set with the best interests of schools in mind. All SISC administrative personnel are employees of the school system. We do not receive sales commissions. Our fiduciary responsibility is to our members not a profit margin. Our ethics SISC believes ethically responsible organizations serve not only their members but all stakeholders: employees, employers, providers, vendors, and local communities. SISC s commitment is to demand standards of behavior which support professional practices. All decisions must take into account and reflect a concern for the interests of all stakeholders. Our goal SISC strives to provide the best coverage and service to our members while keeping costs affordable and stable. California-based, not-for-profit health plan Blue Shield offers the responsiveness and stability of an established, not-for-profit health plan. We have been part of California s healthcare landscape since 1939, and throughout our history, have sustained long-term, innovative relationships with our clients. We remain passionate about not only improving the health and wellness of our members, but also giving back to the communities where we live and work, as demonstrated by our continued support of the Blue Shield of California Foundation.

3 Schools Helping Schools SISC III SELF-INSURED SCHOOLS OF CALIFORNIA We re here to help If you have any questions, simply contact your dedicated Blue Shield Member Service team at (800) for personal assistance, from 7 a.m. to 7 p.m., Monday through Friday. Learn about the Blue Shield Access+ HMO plan Choosing a Personal Physician (Primary Care Physician) is one of the keys to using an HMO plan. HMO members must access covered services through a network of physicians and facilities as directed by their Personal Physician. Exceptions include emergencies and urgent care received outside of a member s Personal Physician s service area. The Access+ HMO plan may be a good choice and a cost-efficient way to maintain your health if you and your family go to the doctor often. Choosing a Personal Physician: When you enroll in the Access+ HMO plan for the first time, you will need to choose a Personal Physician for you and your enrolled dependents. If you are already a Blue Shield Access+ HMO member, your Personal Physician will not change. As a member, you have the option to choose a different Personal Physician and medical group for each enrolled family member. If you choose a Personal Physician you have already seen, please let Blue Shield know that you are an existing patient. When enrolling in the HMO plan, you will need your Personal Physician s provider number and medical group/ Independent Practice Association (IPA) number. See page 4 to learn how to find these numbers and search for a Personal Physician through the Blue Shield website. If you do not select a Personal Physician at the time of enrollment, Blue Shield will automatically assign a Personal Physician to you and your enrolled family members. You can change your Personal Physician by calling Member Services at (800) Key features of the Access+ HMO plan Choosing a doctor Access to specialists Out-of-pocket costs Select a Personal Physician to coordinate all your medical care. You cannot go outside the Blue Shield network except in emergencies. Get a referral from your Personal Physician or self-refer to specialists within your Personal Physician s medical group or IPA for a higher copayment.* Pay a copayment for covered services. * To use this option, members must select a Personal Physician who is affiliated with a medical group or IPA that is an Access+ provider group, which offers the Access+ Specialist feature. Members should then select a specialist within that medical group or IPA. Access+ SpecialistSM visits for mental health services must be provided by an MHSA network participating provider. Behavioral health Your behavioral health benefits include inpatient and outpatient mental health and substance abuse care for issues such as: Depression Alcohol/drug abuse Mental illness Marriage and family counseling The services are provided by Blue Shield s mental health service administrator (MHSA) network. HMO members only have access to MHSA network providers. Care away from home Through the BlueCard Program, Access+ HMO members can access emergency and urgent care services across the country and around the world. You can receive urgent care services from any provider; however, using the BlueCard Program can be more cost-effective and eliminate the need for you to pay for the services when they are rendered and submit a claim for reimbursement. You can locate a BlueCard provider at any time by calling (800) 810-BLUE or by going to the Find a Provider section of blueshieldca.com/sisc. The Away From Home Care program gives students, long-term travelers, workers on extended out-of-state assignments, and families living apart the convenience and flexibility of coverage for extended periods across the country. To learn more about Away From Home Care and whether your family is eligible, call your Blue Shield Member Services team at (800) Please note that Away From Home Care is not available in all areas and states, and benefits from the host plan may differ from the Access+ HMO plan. blueshieldca.com/sisc 3

4 Find a network provider Blue Shield s HMO network is one of the largest in California, with more than 35,000 physicians and 290 hospitals. If you don t have access to the Internet or need help, simply contact your dedicated Blue Shield Member Services team at (800) for personal assistance or to request a provider directory. It s easy to find a HMO network provider online Go to blueshieldca.com/sisc. Select Find a Provider. Under Find an Access+ HMO Network Provider, choose the provider you are looking for. You will be directed to the Blue Shield website where you can enter your city and state or ZIP code to find providers near a specific location. Find out your provider s quality of care rankings You can easily access quality scores, efficiency indicators, patient satisfaction scores, and cost information for many HMO medical groups and hospitals. To see a provider s performance profile, simply click on the name of the doctor, HMO medical group, or hospital from your search results. How to find the provider and medical group/ipa numbers for your Personal Physician (needed when you enroll in the Access+ HMO plan for the first time) Follow the steps above to find an HMO provider. Under Filter Results (to the left), select Doctors, then HMO Personal Physician. Click on the physician s name. On the next screen you can find the physician s provider and medical group/ipa numbers. 4 Blue Shield of California

5 Understand your pharmacy benefits Medco Pharmacy Benefits With the HMO plan, you can save on your long-term medications like those used to treat an ongoing condition such as high blood pressure or high cholesterol by ordering them through the Medco Pharmacy. Your plan can save you money when you fill your prescription by mail order instead of using a retail pharmacy. Get up to a 90-day supply delivered directly to you with free standard shipping! Multiple safety and advanced quality checks are in place to make sure you get the right medication. You have 24-hour phone access to pharmacists who are ready to help you and available to focus exclusively on your medications. You can easily order refills online, over the phone, or by mail. Medco Specialist Pharmacists at the Medco Pharmacy are available by phone 24/7 to help you understand and manage medications used to treat a wide variety of conditions. If you have any questions about your pharmacy benefits through Medco, call (800) MEDCO-MAIL or (800) , 24 hours a day, seven days a week. Save money on generic prescriptions at Costco SISC has partenered with Costco to offer HMO plan members the option to fill generic prescriptions at Costco for a $0 copayment. You do not need to be a Costco member to use the Costco pharmacy. It s simple to fill generic prescriptions at Costco; just follow the steps below: 1. Take your prescription for a generic medication to a Costco Pharmacy. 2. Present the pharmacist with your HMO member ID card. Note: Some narcotic pain medications and cough medications are excluded. blueshieldca.com/sisc 5

6 Discover more Helpful programs, services, and resources are available to you, over the phone and online, to help you and your family stay healthy. NurseHelp 24/7 To talk with registered nurses any time, day or night, and get answers to your health-related questions, or go online to have a one-on-one personal chat with a registered nurse anytime. The NurseHelp 24/7 SM phone number is conveniently located on the back of your Access+ HMO member ID card. Prenatal Program This program guides expectant parents from the first trimester to postnatal care and offers practical advice and useful information. Some materials are also available in Spanish. As an Access+ HMO member, you can enroll by logging in to blueshieldca.com or calling (877) Condition management programs The Access+ HMO plan is complemented by a wide range of helpful programs. These programs provide our members with chronic conditions with educational resources and strategies to help them manage their condition and feel better. Programs include the Asthma Program, Diabetes Program, Coronary Artery Disease (CAD) Program, Heart Failure Program, and the Chronic Obstructive Pulmonary Disease (COPD) Program. Members can apply to the programs by logging in to blueshieldca.com or calling (866) Blue Shield of California

7 Wellness discount program Your wellness is important to us. To make it easier for you to take better care of yourself, Blue Shield offers participants a variety of discounts on popular programs 1 that can help you save money and get healthier. Weight Watchers Get discounts on three- and 12-month subscriptions, monthly passes, and at-home kits. 24 Hour Fitness Enjoy waived enrollment fees and discounts on monthly membership dues. ClubSport and Renaissance ClubSport 2 Get a 60% discount on enrollments when joining with a month-to-month agreement. Enrollment fees are waived when joining with a 12-month agreement. (There is a one-time $25 processing fee when you enroll.) Drugstore.com Save on health and wellness products. Alternative care discount program 2 Save at least 25% on acupuncture, massage therapy, and chiropractic services, plus get discounts on health and wellness products. Vision services Get 20% off the published retail prices when you use a participating provider 3 in the Discount Vision Program network for exams, frames, lenses, and more. QualSight LASIK Members in California receive a 20% discount off providers usual and customary fees on traditional and custom LASIK surgery. TLCVision LASIK 4 Get 15% off providers usual and customary fees for LASIK and PRK correction surgery through a TLCVision or NVision network provider in California. Members who live outside California get a 10% discount off providers usual and customary fees from TLCVision providers. * Text4baby is a service mark of the National Healthy Mothers, Healthy Babies Coalition (text4baby.org). The National Healthy Mothers, Healthy Babies Coalition has an agreement with most carriers to waive applicable text charges. The networks of practitioners and facilities in the discount programs are managed by the external program administrators identified below, including any screening and credentialing of providers. Blue Shield does not review the services provided by discount program providers for medical necessity or efficacy. Nor does Blue Shield make any recommendations, representations, claims, or guarantees regarding the practitioners, their availability, fees, services, or products. Some services offered through the discount program may already be included as part of the Blue Shield plan covered benefits. Members should access those covered services prior to using the discount program. Members who are not satisfied with products or services received from the discount program may use Blue Shield s grievance process described in the Grievance Process section of the Evidence of Coverage. Blue Shield reserves the right to terminate this program at any time without notice. Discount programs administered by or arranged through the following independent companies: Alternative care discount program American Specialty Health Systems Inc. (ASH Networks) Discount Vision Program MESVision Weight control Weight Watchers North America Fitness facilities 24 Hour Fitness, ClubSport, and Renaissance ClubSport Health products (excluding prescription drugs) drugstore.com inc. LASIK Laser Eye Care of California, LLC, QualSight Inc., and TLCVision Corporation Note: No genetic information, including family medical history, is gathered, shared, or used from these programs. 1 These discount program services are not a covered benefit of Blue Shield health plans, and none of the terms or conditions of Blue Shield health plans apply. Discount program services are available to all members with a Blue Shield medical, dental, vision, or life insurance plan Hour Fitness, ClubSport/Renaissance ClubSport, and alternative care discount program are not available in all states. Members should contact their local 24 Hour Fitness or ClubSport gym, or American Specialty Health Systems (ASH) provider to determine whether a Blue Shield of California discount applies. To find an ASH provider, call (877) or go to blueshieldca.com/ findaprovider. 3 For Discount Vision Program providers in California, go to blueshieldca.com and search for Routine Care Discount Vision Program. For providers outside California, go to ecndiscount.com. 4 TLC Centers are not available in all states. To find a TLC Center near you, call (877) TLC Life insurance plans are underwritten by Blue Shield of California Life & Health Insurance Company. blueshieldca.com/sisc 7

8 Schools Helping Schools SISC III SELF-INSURED SCHOOLS OF CALIFORNIA SISC sisc.kern.org/hw (661) Health Smarts is SISC s health improvement program for members and their families. By providing customized resources and information in the areas of nutrition, fitness, preventive care, and condition management, Health Smarts helps you take charge of your health and well-being. Through Health Smarts, you and your family have access to tools and resources designed to provide the incentives and support needed to keep you in good health. These include: Onsite health screening* Health assessment* Digital health coaching* Condition management *If available in your District Blue Shield is here to help Member Services...(800) a.m. to 7 p.m., Monday through Friday. BlueCard Program... (800) 810-BLUE NurseHelp 24/7...(877) Prenatal Program... (877) Condition management programs...(866) Blue Shield of California Privacy Office...(888) Visit blueshieldca.com/sisc to access information on your plan benefits and health resources. An independent member of the Blue Shield Association A44288-SISC-HMO (6/12)

Self-Insured Schools of California: Schools Helping Schools

Self-Insured Schools of California: Schools Helping Schools Self-Insured Schools of California: Schools Helping Schools Blue Shield of California Access+ HMO Plan 2016/2017 Enrollment Guide Blue Shield of California offers health benefits to school districts that

More information

Self-Insured Schools of California: Schools Helping Schools

Self-Insured Schools of California: Schools Helping Schools Self-Insured Schools of California: Schools Helping Schools SISC PPO Plan for South Orange County Community College District Administered by Blue Shield of California 2016/2017 Enrollment Guide Blue Shield

More information

Self-Insured Schools of California: Schools Helping Schools

Self-Insured Schools of California: Schools Helping Schools Self-Insured Schools of California: Schools Helping Schools Blue Shield of California Access+ HMO SaveNet SM Plan 2016/2017 Enrollment Guide Blue Shield of California offers health benefits to school districts

More information

member handbook blueshieldca.com/bscbluegroove

member handbook blueshieldca.com/bscbluegroove member handbook blueshieldca.com/bscbluegroove With Main Groove, you get a Personal Physician from our medical provider network, and predictable, lower outof-pocket costs than with Basic Groove, plus access

More information

total health and wellness

total health and wellness total health and wellness Programs exclusively for our Blue Shield members total health and wellness Whether you want to ease stress, lose weight, or quit smoking we ll help you reach your goals. Our health

More information

total health and wellness Programs exclusively for our Blue Shield members For small businesses with 2 to 50 eligible employees

total health and wellness Programs exclusively for our Blue Shield members For small businesses with 2 to 50 eligible employees total health and wellness Programs exclusively for our Blue Shield members For small businesses with 2 to 50 eligible employees total health and wellness Whether you want to ease stress, lose weight, or

More information

Blue Shield Trio HMO Plan Frequently Asked Questions

Blue Shield Trio HMO Plan Frequently Asked Questions Blue Shield Trio HMO Plan Frequently Asked Questions If you have any questions about your health plan benefits, call your dedicated Shield Concierge team at (855) 747-5800. The team is available to assist

More information

when you feel great, you're unstoppable.

when you feel great, you're unstoppable. Enrollment Guide when you feel great, you're unstoppable. Health Plan Choices: Access+ HMO plan Trio HMO plan Effective: January 01, 2018 We want to help you better understand your health plan options.

More information

San Francisco Health Service System (SFHSS) Trio HMO Plan Frequently Asked Questions

San Francisco Health Service System (SFHSS) Trio HMO Plan Frequently Asked Questions San Francisco Health Service System (SFHSS) Trio HMO Plan Frequently Asked Questions Frequently Asked Questions (FAQs) If you have any questions about your health plan benefits, call your dedicated Shield

More information

when you feel great, you're unstoppable.

when you feel great, you're unstoppable. Enrollment Guide when you feel great, you're unstoppable. Health Plan Choices: Access+ HMO plan Trio HMO plan Effective: January 01, 2018 County of San Mateo We want to help you better understand your

More information

Blue Shield of California s PPO Plan

Blue Shield of California s PPO Plan Blue Shield of California s PPO Plan If keeping your relationship with your current doctors is important, our PPO plan may be a good choice for you. You can continue to see your doctors, even if they aren

More information

go with ^ Blue Shield PPO plan with Health Savings Account Blue Shield EPO plan Effective January 1, 2015 HIGHLIGHTS Plan overview 1

go with ^ Blue Shield PPO plan with Health Savings Account Blue Shield EPO plan Effective January 1, 2015 HIGHLIGHTS Plan overview 1 go with ^ Blue Shield PPO plan with Health Savings Account Blue Shield EPO plan Effective January 1, 2015 HIGHLIGHTS Plan overview 1 Pharmacy benefits 9 How to find a provider 10 Programs and services

More information

Blue Shield PPO Plan Frequently Asked Questions

Blue Shield PPO Plan Frequently Asked Questions Blue Shield PPO Plan Frequently Asked Questions If you have any questions about your plan benefits, call your dedicated Blue Shield Member Services team at (855) 724-7698. They are available to assist

More information

Effective Date 1/1/2014

Effective Date 1/1/2014 Effective Date 1/1/2014 1 Tufts Health Plan Overview Tufts Health Plan in business for 30+ years Headquartered in Watertown MA, with regional offices in Providence RI, Worcester and Springfield More than

More information

MEMBER HANDBOOK. Health Net HMO for Raytheon members

MEMBER HANDBOOK. Health Net HMO for Raytheon members MEMBER HANDBOOK Health Net HMO for Raytheon members A practical guide to your plan This member handbook contains the key benefit information for Raytheon employees. Refer to your Evidence of Coverage booklet

More information

working together for our members

working together for our members working together for our members Employer Guide for small businesses with 1 to 50 employees At Blue Shield of California, we ve put our powerful connections to work for your employees to create a new family

More information

Oxford Condition Management Programs:

Oxford Condition Management Programs: Oxford Condition Management Programs: Helping your employees learn, be encouraged and get support. Committed to helping improve the health and well-being of those we serve and improve the health care

More information

DDP: PPO, CDHP, and EPO (EPO for PA residents only) DDNY: PPO and CDHP. Effective January 1, plans: HIGHLIGHTS Medical benefits 11

DDP: PPO, CDHP, and EPO (EPO for PA residents only) DDNY: PPO and CDHP. Effective January 1, plans: HIGHLIGHTS Medical benefits 11 2016 plans: DDP: PPO, CDHP, and EPO (EPO for PA residents only) DDNY: PPO and CDHP Effective January 1, 2016 HIGHLIGHTS Medical benefits 11 How to find a provider 12 Programs and services 13 Benefit summaries

More information

CareFirst BlueChoice. District of Columbia

CareFirst BlueChoice. District of Columbia CareFirst BlueChoice District of Columbia Welcome We are pleased to offer you enrollment in our CareFirst BlueChoice Health Maintenance Organization (HMO) plan. Designed for today s health conscious and

More information

Blue Shield Gold 80 HMO

Blue Shield Gold 80 HMO Blue Shield Gold 80 HMO Uniform Health Plan Benefits and Coverage Matrix Blue Shield of California Effective January 1, 2017 THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND

More information

Blue Shield Gold 80 HMO 0/30 + Child Dental INF

Blue Shield Gold 80 HMO 0/30 + Child Dental INF Blue Shield Gold 80 HMO 0/30 + Child Dental INF Benefit Summary (For groups 1 to 100) (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Effective January 1, 2017 THIS MATRIX

More information

Blue Shield $0 Cost-Share HMO AI-AN

Blue Shield $0 Cost-Share HMO AI-AN Blue Shield $0 Cost-Share HMO AI-AN This plan is only available to eligible Native Americans 1 Uniform Health Plan Benefits and Coverage Matrix Blue Shield of California Effective January 1, 2017 THIS

More information

Gold Access+ HMO 500/35 OffEx

Gold Access+ HMO 500/35 OffEx An Independent Member of the Blue Shield Association Gold Access+ HMO 500/35 OffEx Benefit Summary (For groups 1 to 100) (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Effective

More information

Platinum Trio ACO HMO 0/20 OffEx

Platinum Trio ACO HMO 0/20 OffEx Platinum Trio ACO HMO 0/20 OffEx Benefit Summary (For groups 1 to 100) (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Effective January 1, 2017 THIS MATRIX IS INTENDED TO

More information

BETTER INFORMED. BETTER TOGETHER.

BETTER INFORMED. BETTER TOGETHER. BETTER INFORMED. BETTER TOGETHER. easy to get appointments free to focus on my patients excellent prenatal care test results online I can choose my doctor wide range of specialists I m part of the decision

More information

Foreign Service Benefit Plan

Foreign Service Benefit Plan Simple Steps to Living Well Together Foreign Service Benefit Plan 2018 Wellness Benefits and Incentive Rewards Health Plan Accredited by The FOREIGN SERVICE BENEFIT PLAN has Health Plan Accreditation from

More information

For fully insured groups of 100 or more eligible employees. HealthyOutcomes. A fully-integrated health management solution that works for you

For fully insured groups of 100 or more eligible employees. HealthyOutcomes. A fully-integrated health management solution that works for you For fully insured groups of 100 or more eligible employees HealthyOutcomes wellness case management condition care maternity A fully-integrated health management solution that works for you HealthyOutcomes

More information

Gold Access+ HMO $30 OffEx Benefit Summary (For groups 1 to 50) (Uniform Health Plan Benefits and Coverage Matrix)

Gold Access+ HMO $30 OffEx Benefit Summary (For groups 1 to 50) (Uniform Health Plan Benefits and Coverage Matrix) Gold Access+ HMO $30 OffEx Benefit Summary (For groups 1 to 50) (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Effective January 1, 2015 THIS MATRIX IS INTENDED TO BE USED

More information

Platinum Local Access+ HMO $25 OffEx

Platinum Local Access+ HMO $25 OffEx Platinum Local Access+ HMO $25 OffEx Benefit Summary (For groups 1 to 50) (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Effective January 1, 2015 THIS MATRIX IS INTENDED

More information

Online Tools and Resources

Online Tools and Resources Online Tools and Resources Log on to Blue Access for Members SM Go to bcbstx.com via web or mobile Or click Register Now for New Users To register you will need your ID number (1) on the back your ID card,

More information

Direct Care Deductible 2000 Hybrid Benefit Summary Benefits effective January 1, 2018 and beyond

Direct Care Deductible 2000 Hybrid Benefit Summary Benefits effective January 1, 2018 and beyond Direct Care Deductible 2000 Hybrid Benefit Summary Benefits effective January 1, 2018 and beyond The Fallon difference Direct Care is a Limited Provider Network. With Direct Care Deductible 2000 Hybrid,

More information

SUMMARY OF P-5-5 BENEFITS AND SCHEDULE OF COPAYMENTS

SUMMARY OF P-5-5 BENEFITS AND SCHEDULE OF COPAYMENTS SUMMARY OF P-5-5 BENEFITS AND SCHEDULE OF COPAYMENTS THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND IS A SUMMARY ONLY. THE EVIDENCE OF COVERAGE AND PLAN CONTRACT SHOULD BE

More information

Summary of Benefits [Silver Access+ HMO 1750/55 OffEx] [Silver Local Access+ HMO 1750/55 OffEx]

Summary of Benefits [Silver Access+ HMO 1750/55 OffEx] [Silver Local Access+ HMO 1750/55 OffEx] Blue Shield of California is an independent member of the Blue Shield Association Summary of Benefits [Silver Access+ HMO 1750/55 OffEx] [Silver Local Access+ HMO 1750/55 OffEx] Group Plan HMO Benefit

More information

Blue Options. Health Plan Information Guide. What should I know about my benefits? What happens next? Where do I go to get assistance?

Blue Options. Health Plan Information Guide. What should I know about my benefits? What happens next? Where do I go to get assistance? Blue Options Health Plan Information Guide What happens next? What should I know about my benefits? Where do I go to get assistance? Welcome At Florida Blue, we provide you with guidance and support because

More information

Steward Community Care Choice 2000 (HSA)

Steward Community Care Choice 2000 (HSA) Steward Community Care Choice 2000 (HSA) Benefit Summary Benefits effective April 1, 2013 and beyond The FCHP difference FCHP Steward Community Care is a limited network HMO plan designed in partnership

More information

2016 OPEN ENROLLMENT MEDICAL PLANS

2016 OPEN ENROLLMENT MEDICAL PLANS 2016 OPEN ENROLLMENT MEDICAL PLANS Table of Contents Section I. Enrollment Guidelines Page 3 Health Plan Comparison Chart Page 4 Health Plan Premiums and Employee Cost-Sharing Page 5 Section II. Blue Shield

More information

Change can be good. And when change is easy, it s even better.

Change can be good. And when change is easy, it s even better. It s a smooth, easy transition to your new health plan. Change can be good. And when change is easy, it s even better. If you are currently a Health Net employer, we believe that you will find Oxford 1

More information

Select Care Deductible 1200 Hybrid Benefit Summary Benefits effective January 1, 2018 and beyond

Select Care Deductible 1200 Hybrid Benefit Summary Benefits effective January 1, 2018 and beyond Select Care Deductible 1200 Hybrid Benefit Summary Benefits effective January 1, 2018 and beyond The Fallon difference With Select Care Deductible 1200 Hybrid, you get everything you need to live a healthy

More information

Summary of Benefits Platinum Trio HMO 0/25 OffEx

Summary of Benefits Platinum Trio HMO 0/25 OffEx Blue Shield of California is an independent member of the Blue Shield Association Summary of Benefits Platinum Trio HMO 0/25 OffEx Group Plan HMO Benefit Plan This Summary of Benefits shows the amount

More information

Welcome to Regence! Meet your employer health plan

Welcome to Regence! Meet your employer health plan is an Independent Licensee of the Blue Cross and Blue Shield Association Regence BlueCross BlueShield of Utah Welcome to Regence! Meet your employer health plan 1 Health insurance is a big, wonderful benefit.

More information

Benefits & Coverage Discover the benefits of your health insurance and what is covered by your plan under the Benefits & Coverage tab.

Benefits & Coverage Discover the benefits of your health insurance and what is covered by your plan under the Benefits & Coverage tab. Membership Benefits Your My Health Plan homepage dashboard gives you an overview of your benefits, including the total billed amount, the discount applied, what Medical Mutual paid and your financial responsibility.

More information

The HMO provider network is available by clicking on this website address: Plan Provider Directory Search<b/>

The HMO provider network is available by clicking on this website address: Plan Provider Directory Search<b/> GENERAL PROVISIONS Web Site Address Find a Plan Doctor or Facility Health Plan Telephone Number NCQA Accreditation Status http://www.bcbsil.com The HMO provider network is available by clicking on this

More information

Blue Shield of California

Blue Shield of California An independent member of the Blue Shield Association City of San Jose Custom ASO PPO 100 90/70 Active Employees Benefit Summary (For groups of 300 and above) (Uniform Health Plan Benefits and Coverage

More information

Enrollment Guide WASHINGTON COUNTY PUBLIC SCHOOLS. Washington County Public Schools Enrollment Guide C1

Enrollment Guide WASHINGTON COUNTY PUBLIC SCHOOLS. Washington County Public Schools Enrollment Guide C1 Enrollment Guide WASHINGTON COUNTY PUBLIC SCHOOLS 2014 Washington County Public Schools Enrollment Guide C1 Table of Contents Welcome... 1 Exclusive Provider Organization (EPO)... 2 Preferred Provider

More information

HMO-POS. BCN Advantage SM. Group. Resource Guide. Put your coverage to work.

HMO-POS. BCN Advantage SM. Group. Resource Guide. Put your coverage to work. BCN Advantage SM Group HMO-POS Resource Guide Put your coverage to work www.bcbsm.com/medicare You have a new plan. Now what? We want you to know we re happy you chose our plan. Whether you joined for

More information

Medical Plans Benefit Guide

Medical Plans Benefit Guide Medical Plans Benefit Guide Employers with 1-50 employees 1.1.01 Provider network built for value and quality... Wellness rewards...3 Medical Travel Support and Air or Surface Transportation... Support

More information

Access+ HMO Welcome brochure. Important HMO resources. Phone numbers: Websites: Other useful phone numbers:

Access+ HMO Welcome brochure. Important HMO resources. Phone numbers: Websites: Other useful phone numbers: Important HMO resources Access+ HMO 2017 Welcome brochure How to make the most of your benefits Phone numbers: Shield Concierge... (800) 334-5847 NurseHelp 24/7... (877) 304-0504 LifeReferrals 24/7...

More information

Benefits are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Benefits are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY PLAN FEATURES Annual Deductible The maximum out-of-pocket limit applies to all covered Medicare Part A and B benefits including deductible. Hearing aid reimbursement does not apply to the out-of-pocket

More information

Decision Power. Healthy Discounts

Decision Power. Healthy Discounts Decision Power Healthy Discounts Decision Power How It Works Your health, your time, your choice. Decision Power helps you become an active partner in decisionmaking about your health and the health of

More information

The Power of Blue. PPO Program

The Power of Blue. PPO Program 2018 The Power of Blue PPO Program Get to know your health insurance plan Feeling your best means taking care of your health needs and your well-being. Our comprehensive benefits, tools, and support help

More information

Blue Care Network Geared perfectly for your needs. Enroll by calling Retiree Health Care Connect (contact information inside)

Blue Care Network Geared perfectly for your needs. Enroll by calling Retiree Health Care Connect (contact information inside) Blue Care Network Geared perfectly for your needs Enroll by calling Retiree Health Care Connect (contact information inside) November 2011 Dear UAW Trust Member: The UAW Retiree Medical Benefits Trust

More information

Anthem Blue Cross Your Plan: Custom Premier HMO 10/100% Your Network: California Care HMO

Anthem Blue Cross Your Plan: Custom Premier HMO 10/100% Your Network: California Care HMO Anthem Blue Cross Your Plan: Custom Premier HMO 10/100% Your : California Care HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary

More information

2019 Select HMO. Benefit guide. One of the most affordable CalPERS HMO plans CAMENABC Rev. 07/18

2019 Select HMO. Benefit guide. One of the most affordable CalPERS HMO plans CAMENABC Rev. 07/18 2019 Select HMO Benefit guide One of the most affordable CalPERS HMO plans 40184CAMENABC Rev. 07/18 Why choose the Select HMO plan? We re glad you re taking time to check out all that Anthem has to offer

More information

A guide to choosing your Anthem Blue Cross health plan MANPOWER TEMPORARY SERVICES (NON-CORE HMO) Effective January 1, 2016

A guide to choosing your Anthem Blue Cross health plan MANPOWER TEMPORARY SERVICES (NON-CORE HMO) Effective January 1, 2016 What's Inside Getting started with health insurance...3 A health plan that works for you...4 More coverage for you...5 Frequently asked questions (FAQs)...6 A guide to choosing your Anthem Blue Cross health

More information

Confidence comes with every card. BCN Advantage SM HMO-POS and HMO. Resource Guide. Put your coverage to work.

Confidence comes with every card. BCN Advantage SM HMO-POS and HMO. Resource Guide. Put your coverage to work. Confidence comes with every card. 2017 BCN Advantage SM HMO-POS and HMO Resource Guide Put your coverage to work www.bcbsm.com/medicare You have a new plan. Now what? We want you to know we re happy you

More information

HMO Plan Option. Your Commercial. Health Net of California, Inc. (Health Net) Edison

HMO Plan Option. Your Commercial. Health Net of California, Inc. (Health Net) Edison Commercial Edison Your 2018 HMO Plan Option of California, Inc. () Carol Kim, We focus on getting you the health information you need, when you need it. Welcome to We created this guide to help members

More information

Horizon PPO. HorizonBlue.com

Horizon PPO. HorizonBlue.com Horizon PPO HorizonBlue.com Get to Know Horizon Blue Cross Blue Shield of New Jersey Horizon Blue Cross Blue Shield of New Jersey is transforming health care. We re New Jersey s largest and most experienced

More information

2016 Open Enrollment Presentation for: University of California Senior Advantage

2016 Open Enrollment Presentation for: University of California Senior Advantage 2016 Open Enrollment Presentation for: University of California Senior Advantage 2 Three ways we make good health easier Quality care. We do what it takes to help you get healthy, and partner with you

More information

This plan is pending regulatory approval.

This plan is pending regulatory approval. Bronze Full PPO 3000 OffEx Benefit Summary (For groups 1 to 50) (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Effective October 1, 2015 THIS MATRIX IS INTENDED TO BE USED

More information

Anthem Blue Cross Your Plan: Modified Classic HMO 15/30/250 Admit/125 OP Your Network: California Care HMO

Anthem Blue Cross Your Plan: Modified Classic HMO 15/30/250 Admit/125 OP Your Network: California Care HMO Anthem Blue Cross Your Plan: Modified Classic HMO 15/30/250 Admit/125 OP Your : California Care HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process.

More information

We re Tufts Health Plan, and our goal is better health and wellness for you.

We re Tufts Health Plan, and our goal is better health and wellness for you. We re Tufts Health Plan, and our goal is better health and wellness for you. Thank you for taking the time to read this short overview of Tufts Health Plan. Being willing to learn about your healthcare

More information

YOUR TRUSTED HEALTH COMPANION. A plan for life.

YOUR TRUSTED HEALTH COMPANION. A plan for life. YOUR TRUSTED HEALTH COMPANION A plan for life. Being healthy is about more than preventing illness. It s achieving the best possible quality of life, physically and emotionally. That s what CDPHP is all

More information

Vivity offered by Anthem Blue Cross Your Plan: Custom Classic HMO 25/45/500 Admit /250 OP Your Network: Vivity

Vivity offered by Anthem Blue Cross Your Plan: Custom Classic HMO 25/45/500 Admit /250 OP Your Network: Vivity Vivity offered by Anthem Blue Cross Your Plan: Custom Classic HMO 25/45/500 Admit /250 OP Your : Vivity This summary of benefits is a brief outline of coverage, designed to help you with the selection

More information

Benefits and Premiums are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Benefits and Premiums are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY The maximum out-of-pocket limit applies to all covered Medicare Part A and B benefits including deductible. Primary Care Physician Selection Optional There is no requirement for member pre-certification.

More information

Anthem Blue Cross Your Plan: Modified Classic HMO 20/40/250 Admit /125 OP Your Network: California Care HMO

Anthem Blue Cross Your Plan: Modified Classic HMO 20/40/250 Admit /125 OP Your Network: California Care HMO Anthem Blue Cross Your Plan: Modified Classic HMO 20/40/250 Admit /125 OP Your Network: California Care HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection

More information

Vivity offered by Anthem Blue Cross Your Plan: Custom Premier HMO 10/100% Your Network: Vivity

Vivity offered by Anthem Blue Cross Your Plan: Custom Premier HMO 10/100% Your Network: Vivity Vivity offered by Anthem Blue Cross Your Plan: Custom Premier HMO 10/100% Your : Vivity This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary

More information

Health plans for Maine small businesses Available through the Health Insurance Marketplace

Health plans for Maine small businesses Available through the Health Insurance Marketplace Health plans for Maine small businesses Available through the Health Insurance Marketplace Effective January 1, 2016 We can help you navigate the health care road We re here to help. In fact, for more

More information

Health plans for New Hampshire small businesses Available through the Health Insurance Marketplace

Health plans for New Hampshire small businesses Available through the Health Insurance Marketplace Health plans for New Hampshire small businesses Available through the Health Insurance Marketplace 1 38476NHEENABS Rev. 09/14 We can help you navigate the health care road We re here to help. In fact,

More information

arizona health net a better decision sm Putting you at the center of everything we do.

arizona health net a better decision sm Putting you at the center of everything we do. arizona health net a better decision sm Putting you at the center of everything we do. Nothing s more important than your health. When you re healthy, you want to stay healthy. When you re sick or have

More information

BCBSM provides administrative claims services only. Your employer or plan sponsor is financially responsible for claims.

BCBSM provides administrative claims services only. Your employer or plan sponsor is financially responsible for claims. Michigan Catholic Conference Group Number: 71755 Package Code(s): 010 Section Code(s): 1000, 2000 PPO - PPO1, Hearing, Vision ( Exam only) Effective Date: 01/01/2018 Benefits-at-a-glance This is intended

More information

Your Out-of-Pocket Type of Service

Your Out-of-Pocket Type of Service Calendar Year Deductible (CYD) 1 $3,000 single/ 3x family Out-of-Pocket Maximum - Deductibles and copays all accrue towards the out-of-pocket $6,200 single/ 2x family maximum. With respect to family plans,

More information

Medicare Coverage. You Can Count On. A simple guide to your University of California benefit choices. Medicare

Medicare Coverage. You Can Count On. A simple guide to your University of California benefit choices. Medicare Medicare Group Plans Medicare Coverage You Can Count On A simple guide to your University of California benefit choices Health Net Seniority Plus (Employer HMO) H0562_18_2989EGBROC_08232017 Health Net

More information

Thank you for choosing Ambetter from Sunshine Health Plan!

Thank you for choosing Ambetter from Sunshine Health Plan! FROM Thank you for choosing Ambetter from Sunshine Health Plan! There s nothing more important than your health. And now, it s time for you to take charge of it. As a member of Ambetter from Sunshine Health

More information

Benefits are effective January 01, 2017 through December 31, 2017

Benefits are effective January 01, 2017 through December 31, 2017 Benefits are effective January 01, 2017 through December 31, 2017 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY PLAN FEATURES Network & Out-of- Annual Deductible $0 This is the amount

More information

Irvine Unified School District ASO PPO /50

Irvine Unified School District ASO PPO /50 An Independent member of the Blue Shield Association Irvine Unified School District ASO PPO 500 90/50 Benefit Summary (For groups of 300 and above) (Uniform Health Plan Benefits and Coverage Matrix) THIS

More information

A Guide on How to Use Your Cigna-HealthSpring Benefits. Handbook. South Carolina 14_HB_20_SC_20. Y0036_14_8563_FINAL_21 Approved

A Guide on How to Use Your Cigna-HealthSpring Benefits. Handbook. South Carolina 14_HB_20_SC_20. Y0036_14_8563_FINAL_21 Approved A Guide on How to Use Your Cigna-HealthSpring Benefits 2014 Member Handbook South Carolina 14_HB_20_SC_20 Y0036_14_8563_FINAL_21 Approved 08132013 3 Welcome Cigna-HealthSpring Plans Offer You 9 24-Hour

More information

Summary of Benefits Platinum Full PPO 0/10 OffEx

Summary of Benefits Platinum Full PPO 0/10 OffEx Blue Shield of California is an independent member of the Blue Shield Association Summary of Benefits Platinum Full PPO 0/10 OffEx Group Plan PPO Benefit Plan This Summary of Benefits shows the amount

More information

Guide to Accessing Quality Health Care Spring 2017

Guide to Accessing Quality Health Care Spring 2017 Guide to Accessing Quality Health Care Spring 2017 MolinaHealthcare.com 5771749DM0217 MyMolina MyMolina is a secure web portal that lets you manage your own health from your computer. MyMolina.com is easy

More information

Benefits and Premiums are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Benefits and Premiums are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY Benefits and Premiums are effective January 01, 2018 through December 31, 2018 PLAN FEATURES Network & Out-of- Annual Deductible This is the amount you have to pay out of pocket before the plan will pay

More information

Your Choice. 3-Tier Network Option Plan

Your Choice. 3-Tier Network Option Plan Your Choice 3-Tier Network Option Plan What is Your Choice? Click Here to Watch Video Your Top Questions What is Your Choice? Are my doctors in the plan? Are my medications covered by the plan? If I get

More information

Medicare Plus Blue SM Group PPO. Resource Guide. Put your coverage to work. Michigan Public School Employees Retirement System

Medicare Plus Blue SM Group PPO. Resource Guide. Put your coverage to work. Michigan Public School Employees Retirement System 2018 Medicare Plus Blue SM Group PPO Resource Guide Put your coverage to work Michigan Public School Employees Retirement System www.bcbsm.com/mpsers Make your coverage work for you We want you to know

More information

HERE ARE THE TOP 3 MOST COMMON BENEFIT ISSUES:

HERE ARE THE TOP 3 MOST COMMON BENEFIT ISSUES: Medical Benefits What You Should Know MEDICALBENEFITS HEALTH INSURANCE TERMS YOU SHOULD KNOW Balance Billing This is practice where a provider charges full fees in excess covered amounts, bills you for

More information

INFORMATION ABOUT YOUR OXFORD COVERAGE REIMBURSEMENT PART I OXFORD HEALTH PLANS OXFORD HEALTH PLANS (NJ), INC.

INFORMATION ABOUT YOUR OXFORD COVERAGE REIMBURSEMENT PART I OXFORD HEALTH PLANS OXFORD HEALTH PLANS (NJ), INC. OXFORD HEALTH PLANS (NJ), INC. INFORMATION ABOUT YOUR OXFORD COVERAGE PART I REIMBURSEMENT Overview of Provider Reimbursement Methodologies Generally, Oxford pays Network Providers on a fee-for-service

More information

Be Well. Outstanding Benefits are among the many rewards of working for UCSB Make the most of them!

Be Well. Outstanding Benefits are among the many rewards of working for UCSB Make the most of them! Be Well Outstanding Benefits are among the many rewards of working for UCSB Make the most of them! This presentation is intended for communication purposes only. Please see the UCnet website (http://ucnet.universityofcalifornia.edu)

More information

Plan Overview. Health Net Platinum 90 HSP. Benefit description Member(s) responsibility 1,2

Plan Overview. Health Net Platinum 90 HSP. Benefit description Member(s) responsibility 1,2 PureCare HSP is available through Covered CA in Kings, Madera, Sacramento, and Yolo counties, and parts of El Dorado, Fresno, Nevada, Placer, and Santa Clara counties. Plan Overview Health Net Platinum

More information

High Deductible Health Plan (HDHP)

High Deductible Health Plan (HDHP) High Deductible Health Plan (HDHP) BeneFIts Summary Effective July 1, 2012 or October 1, 2012 Benefit Highlights How The Plan Works...1 Summary Of Benefits...4 Special Programs...7 Approval Of Care At

More information

2018 MEDICAL BENEFITS GUIDE. September 1, August 31, (800)

2018 MEDICAL BENEFITS GUIDE. September 1, August 31, (800) 2018 MEDICAL BENEFITS GUIDE September 1, 2017 - August 31, 2018 www.ers.texas.gov (800) 252-8039 WELCOME! CONTENTS What You Need to Know...3 We Are Here to Help...4 Don t Forget Your ID Card!...6 Additional

More information

Wentworth Institute of Technology. Effective Date January 1, 2014

Wentworth Institute of Technology. Effective Date January 1, 2014 Wentworth Institute of Technology Effectie Date January 1, 2014 Agenda Agenda Welcome to Tufts Health Plan Proider Network Plan Design Prescription Coerage Transition of Care Value Added Benefits Customer

More information

Anthem Blue Cross Wellness PPO Plan Rewarded for Wellness. Quick Start Step 1 Step 2 Step 3

Anthem Blue Cross Wellness PPO Plan Rewarded for Wellness. Quick Start Step 1 Step 2 Step 3 Anthem Blue Cross Wellness PPO Plan 2017-18 Rewarded for Wellness Congratulations on taking the next step in improving your health! With the Anthem Blue Cross Wellness PPO plan, you ll gain access to valuable

More information

Anthem Blue Cross Your Plan: Custom Premier HMO 25/100 admit 3 day max/100 OP Your Network: California Care HMO

Anthem Blue Cross Your Plan: Custom Premier HMO 25/100 admit 3 day max/100 OP Your Network: California Care HMO Anthem Blue Cross Your Plan: Custom Premier HMO 25/100 admit 3 day max/100 OP Your : California Care HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection

More information

SUMMARY OF BENEFITS. Hamilton County Department of Education Network Copay Plan. Connecticut General Life Insurance Co.

SUMMARY OF BENEFITS. Hamilton County Department of Education Network Copay Plan. Connecticut General Life Insurance Co. SUMMARY OF BENEFITS Connecticut General Life Insurance Co. Hamilton County Department of Education Annual deductibles and maximums Lifetime maximum Pre-Existing Condition Limitation (PCL) Coinsurance All

More information

Introducing. UPMC Community Care. UPMC Community Care. Your choice for wellness and recovery. at a glance

Introducing. UPMC Community Care. UPMC Community Care. Your choice for wellness and recovery. at a glance Introducing UPMC Community Care Your choice for wellness and recovery There are two parts to good health behavioral and physical. You ve already taken a step toward good health by accessing behavioral

More information

Renee J. Rhem Director Customer Service ( ) 4/03 WELCOMELETTERV003

Renee J. Rhem Director Customer Service ( ) 4/03 WELCOMELETTERV003 We would like to thank you for joining Keystone Health Plan East. Carrying a Keystone Identification Card (ID Card) entitles you to access a large network of providers, our friendly service, our value-added

More information

Skilled nursing facility visits

Skilled nursing facility visits Modified Premier HMO 20 Non Union This Summary of Benefits is a brief overview of your plan's benefits only. For more detailed information about the benefits in your plan, please refer to your Certificate

More information

A Guide to Accessing Quality Health Care

A Guide to Accessing Quality Health Care A Guide to Accessing Quality Health Care Spring 2015 MolinaHealthcare.com 37894DM0115 Molina Healthcare s Quality Improvement Plan and Program Your health care is important to us. We want to hear how we

More information

For Large Groups Health Benefit Single Plan (HSA-Compatible)

For Large Groups Health Benefit Single Plan (HSA-Compatible) Financial Features (DED 1 ) (PBP 2 ) (DED is the amount the member is responsible for before Florida Blue pays) Out-of-Network Inpatient Hospital Facility Services Per Admission (PAD) Coinsurance (Coinsurance

More information

Anthem Blue Cross Effective: January 1, 2018 Your Plan: University of California CORE Plan Your Network: Anthem Prudent Buyer PPO

Anthem Blue Cross Effective: January 1, 2018 Your Plan: University of California CORE Plan Your Network: Anthem Prudent Buyer PPO Anthem Blue Cross Effective: January 1, 2018 Your Plan: University of California CORE Plan Your Network: This summary of benefits is a brief outline of coverage, designed to help you with the selection

More information

Providence Medicare Advantage Plans

Providence Medicare Advantage Plans This is an advertisement Providence Medicare Advantage Plans 2018 Plan Comparison King and Snohomish County Service area map Snohomish King 2018 Providence Medicare Service Area Summit + RX (HMO-POS) Harbor

More information

Trio HMO Plan. Combined Evidence of Coverage and Disclosure Form

Trio HMO Plan. Combined Evidence of Coverage and Disclosure Form An independent member of the Blue Shield Association Trio HMO Plan Combined Evidence of Coverage and Disclosure Form San Francisco Health Service System Fund Effective Date: January 1, 2018 Group Number:

More information

The following benefit is being added: Behavioral health treatment applied behavior analysis (ABA)

The following benefit is being added: Behavioral health treatment applied behavior analysis (ABA) Customer No.: Dear , Thank you for your business. We re writing to let you know of changes to

More information