Page 5 - KNCH Benefits Guide 2019
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MEDICAL INSURANCE




         ANTHEM BLUE CROSS | HMO CACARE (FULL NETWORK) MEDICAL PLAN
         Available in CA Only
         With the Anthem Blue Cross CaliforniaCare HMO plan, you must choose a Primary Care Physician (PCP) or Medical Group within
         the  Anthem  CACARE  Network  for  all  of  your  covered  family  members.  This  plan  offers  the  full  Anthem  HMO  network  of
         physicians to provide you the greatest access within Anthem’s HMO 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. Please note that it is your responsibility to ensure that all family
         members choose providers from the Anthem Blue Cross (CACARE) HMO Network—Large Group.


         ANTHEM BLUE CROSS  | EPO (EXCLUSIVE PPO) MEDICAL PLAN
         Only Available in AZ, FL, NV & TX (Non-CA)
         The Anthem Blue Cross EPO Plan allows you to direct your own care within the Anthem Blue Cross National Blue Card PPO
         network of physicians, and you may self-refer to specialists. Note with this plan, if you receive care from a physician who is not
         within the Anthem Blue Cross National Blue Card PPO network, you will be responsible for most if not all charges, except in the
         case of an emergency.  With this plan, there is very limited to no coverage for services rendered through non-network physicians
         and facilities.


         ANTHEM BLUE CROSS  | PPO MEDICAL PLAN
         Available in all states
         The Anthem Blue Cross 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
         Anthem Blue Cross Prudent Buyer 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.


         ANTHEM BLUE CROSS  | HSA PPO MEDICAL PLAN
         Available in all states
         The  Health  Savings  Account  (HSA)  plan  through  Anthem  Blue  Cross  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
         medical expenses. Similar to the PPO plan, you have the freedom to choose your doctor without the requirement of selecting a
         PCP  and  you  may  self-refer  to  specialists.  You  may  use  a  network  provider  whose  negotiated  rates  provide  richer  levels  of
         benefits with claim forms filed by the providers. 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.

         You may contribute into your HSA account up to IRS maximums:

                                                            2019 Annual IRS                  2020 Annual IRS
                                                     Employee Contribution Maximum    Employee Contribution Maximum


          Employee                                              $3,500                           $3,550
          Employee + Family                                     $7,000                           $7,100
          Catch-up for Employees Over the Age of 55             $1,000                           $1,000


         Additional information about how the HSA Medical plan works is located on page 10 of this guide.



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