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Table of Contents
About Your Benefits
Benefits Eligibility ………………………………………………………………………………………….2
When Can You Make Changes To Your Benefits? ..............................................2
Health Care Benefits
HMO Advantage Platinum Rate Table……………………………………………………………3-4
HMO Advantage Gold Rate Table………………………………………………………………….5-6
Dental & Vision Cost Sharing………………………………………………………………………….7
Medical Plan Choices……………………………………………………………………………………..8
Medical Plans At-A-Glance …………………………………………………………………………….9-10
Dental Plan At-A-Glance ……………………………………………………………………………….11
Vision Plan At-A-Glance ………………………………………………………………………………..12
Health Plan Notices ……………………………………………………………………………………… 13-16
Chun Ha Insurance Dedicate Contact Person…………………………………………………17
Medical, Dental & Vision Member Service Contacts………………………………………18
Appendix
How to Find a Primary Doctor (Medical-UHC)
How to Find a Dentist (Dental-Delta Dental)
How to Find a Vision Provider (Vision-Humana)
Medical, Dental & Vision Online Login Info
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