Page 6 - Asian Box Guide FINAL 9.11

Medical Plan

Anthem Blue Cross | Limited Network BASE HMO Plan, Select Network
The company contributes 70% of the premium for employee only coverage for the Base HMO - Silver 55 plan.

With the Select Health Maintenance Organization (HMO) plan through Anthem Blue Cross, you have access to a limited
network of providers through the Select HMO Network. You must choose a Primary Care Physician (PCP) or medical group
within the Select HMO network for all of your covered family members. 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.

Please note that it is your responsibility to ensure that all family members choose providers from the Select HMO network.
Please find a medical provider by visiting www.anthem.com/find-doctor or call (800) 888-8222 and list their PCP ID in the
Ease Central system. You will be prompted to list a 6 digit code (i.e. PCP ID: 69U185)

Anthem Blue Cross | HMO Plan, Full CA Network

This plan works just like the Select HMO plan, but is a larger network of
providers in the Full California Care HMO network. Since this plan
offers a richer benefit plan, you will experience higher per paycheck PPO: Access to Care
premiums than the Select HMO plan. The PPO plan is a Preferred Provider Organization
(PPO) plan and uses Anthem Blue Cross’s Prudent
Please note that it is your responsibility to ensure that all family Buyer network. PPO plans allow you to direct your
members choose providers from the California Care HMO network.
own care. You have the freedom to choose your
Please find a medical provider by visiting www.anthem.com/find-
doctor or call (800) 888-8222 and list their PCP ID in the Ease Central doctor without the requirement of selecting a PCP
and you may self-refer to specialists. You may use
system. You will be prompted to list a 6 digit code (i.e. PCP ID: 69U185)
a network provider whose negotiated rates
Anthem Blue Cross | PPO Plans
provide richer levels of benefits with claim forms
The Anthem Blue Cross Preferred Provider Organization (PPO) plans filed by the providers. You may also obtain services
allow you to direct your own care. If you receive care from a physician
using a non-network provider; however, you will
who is a member of the PPO network, a greater percentage of the
entire cost will be paid by the insurance plan. However, you are not be responsible for the difference between the
limited to the physicians within the network and you may self-refer to covered amount and the actual charges, and you
specialists. If you obtain services using a non‐network provider, please may be responsible for filing claims.
note that you will be responsible for the difference between the
covered amount and the actual charges, and you may be responsible
for filing claims.

Finding a Medical Provider
Go to www.anthem.com/find-doctor or
Educational Video
call (800) 888-8222
Health Insurance Terms
• HMO: Select your state of residence, then refer to http://
the plan/network when prompted video.burnhambenefits.com/
• “Select HMO” terms
• “California Care HMO/Small Group”
• “Blue Cross PPO (Prudent Buyer—Small Group)”

6 Employee Benefits