Page 15 - Skechers 2022 Benefits Guide

ANTHEM MEDICAL PLAN OVERVIEW
U.S. DOMESTIC & PUERTO RICO (EXCLUDING HAWAII & EXPATRIATES)
With a choice of four options we encourage you to take time to evaluate the options and consider your costs.
ANTHEM BLUE CROSS
Member Services: 866-641-8472 24/7 Nurseline: 800-700-9184 Website: anthem.com/CA
NETWORK NAME
National PPO Network (BlueCard PPO)
Anthem HSA PPO
In a HSA PPO Plan, you may access care with any Anthem PPO Provider or any licensed physician of your choice. Some services do require prior authorization. Be sure to check Anthem Plan documents or call member services to confirm. You will have greater coverage and lower out-of-pocket expenses when using an Anthem PPO Network provider. The HSA PPO plan has an in-network annual deductible of $1,400 for employees and $2,800 for families. It also has an in-network Out-of- Pocket maximum of $2,000 for employees and $4,000 for families.
PLAN CHOICE
Anthem EPO
In an EPO Plan, which is similar to an HMO plan, all of your care must be received from providers within Anthem’s EPO Network (except in an emergency) or the plan will not pay any benefits. Selecting a primary care physician is not required in an EPO plan. The EPO plan does not have an annual deductible. In addition, the out-of-pocket maximum for employees only is $1,500 for employees and $3,000 for families.
Anthem PPO Silver
In a PPO Plan, you may access care with any Anthem PPO Provider or any licensed physician of your choice. Some services do require prior authorization. Be sure to check Anthem Plan documents or call member services to confirm. You will have greater coverage and lower out- of-pocket expenses when using an Anthem PPO Network provider. The PPO Silver plan has an in-network annual deductible of $1,000 for employees and $2,000 for families. It also has an in-network Out-of-Pocket maximum of $3,000 for employees and $6,000 for families.
Anthem PPO Gold
In a PPO Plan, you may access care with any Anthem PPO Provider or any licensed physician of your choice. Some services do require prior authorization. Be sure to check Anthem Plan documents or call member services to confirm. You will have greater coverage and lower out-of-pocket expenses when using an Anthem PPO Network provider. The PPO Gold plan has an in- network annual deductible of $300 for employees and $900 for families. It also has an in-network Out-of- Pocket maximum of $3,000 for employees and $6,000 for families.
2022 BENEFITS 15