Page 10 - Remita Guide 2020 - NonCA FINAL

Blue Shield | PPO Medical Plan

The Blue Shield Preferred Provider Organization (PPO) plan allows you to direct your own care. You are not limited to the
physicians within the network and you may self-refer to specialists. If you receive care from a physician who is a member
of the PPO network, a greater percentage of the entire cost will be paid by the insurance plan. You may 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 may be responsible for filing claims.

Blue Shield | HSA PPO Medical Plans

The Health Savings Account (HSA) plan through Blue Shield combines a high deductible health plan (HDHP) with a
special, tax-qualified savings account. You may use your HSA funds to pay for current medical expenses or save toward
future expenses. You have the freedom to choose your doctor without the requirement of selecting a PCP and you may
self-refer to specialists. If you receive care from a physician who is a member of the PPO network, a greater percentage
of the entire cost will be paid by the insurance plan. You may 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 may be
responsible for filing claims. Remita Health will contribute $250 toward employee health savings and $500 for family
annually. In addition to the company contributions, you may elect to make contributions into the account up to the IRS
maximums.

Finding a Medical Provider
Access to National Blue Cross Blue Shield Network
• Blue Shield PPO: Go to www.blueshieldca.com/networkppo or
providers.bcbs.com (Network Plan: BlueCard PPO/EPO)

Blue Shield Prescription Drug Formulary:
www.blueshieldca.com/wellness/drugs/formulary#heading2

Educational Video
Health Insurance Terms
http://video.burnhambenefits.com/terms