Page 5 - Confie Benefits Guide 01-19_FINAL

Benefits

Medical Insurance

Option 1
Anthem Blue Cross | HMO Medical Plans (California Only)
With the Anthem Blue Cross Health Maintenance Organization (HMO) plans, you must choose a primary care physician (PCP) or
medical group within the network. All of your care must be directed through your PCP or medical group. Any specialty care you
need will be coordinated through your PCP and will generally require a referral or authorization. You will receive benefits only if
you use the doctors, clinics and hospitals that belong to the medical group in which you are enrolled, except in the case of an
emergency.

Option 2
Anthem Blue Cross |Network PPO2 Medical Plan
The Network PPO plan allows you to self-direct your own care within the Blue Cross PPO network of healthcare providers. This
network of doctors and hospitals is the largest in the country and includes most of our nations finest providers. As a network
provider, they will also be responsible for filing your claim with our insurance, saving you time and hassle. As part of the network,
these providers have agreed to provide their services at a discounted fee resulting in a lower expense for you and your family. If
you see a non-network healthcare provider, you will be responsible for the entire cost of the claim.

Option 3
Anthem Blue Cross | Traditional PPO1 Medical Plan
The Traditional PPO plan allows you to direct your own care both in-network and out-of-network giving you coverage to all
healthcare providers in the country. The network of providers is the same as in Option 2 above. By receiving care from these
network providers, you will have the lowest possible out of pocket costs as our plan pays a higher percentage of the claim. You can
also obtain services using a non‐network provider; however, you will be responsible for the difference between the covered
amount and the actual charges and you will be responsible for filing claims for reimbursement.

Option 4
Anthem Blue Cross | HSA Medical Plan
With the HSA plan through Anthem Blue Cross, you can pay for qualified healthcare expenses now and grow your savings for future
healthcare needs. This plan combines a High Deductible Health Plan (HDHP) with a special, tax-qualified Health Savings Account
(HSA). You can contribute tax-free money to your HSA up to IRS maximums. The money in your account is yours to pay for current
healthcare expenses - or you can save toward future healthcare expenses. Similar to the Traditional PPO plan above, you have the
freedom to choose your doctor in and out of network. Using a network provider provides the richest level of benefits. You may
obtain services using a non-network provider; however, you can also be responsible for any amount above the allowed amount.
Finding a Medical Provider

Go to the provider directory: Anthem Blue Cross Provider Search Directory
• Option 1 HMO: Refer to the “Select HMO” network when prompted.
• Option 2-3 PPO: Refer to the “Blue Cross PPO (Prudent Buyer)” large group network when
prompted.
• Options 4 HSA: Refer to the “Lumenos” network when prompted.

Utilize Your Free Preventive Care Benefits

In order to receive the full value of your plan, schedule your preventive care exams! Our medical plans cover these exams 100%
when you use in-network providers. Preventive exams can help identify any potential health problems early on. Not all preventive
care is recommended for everyone, so talk with your doctor to decide which services are right for you and your family.

Educational Video

Benefits terminology can get confusing. Click here to watch a quick video to learn the basics of how our
medical plans work. Deductibles, Copays, Coinsurance, and Out-of-Pocket Maximums
http://video.burnhambenefits.com/terms/

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