Page 5 - Milani EE Benefits Booklet.pub

EMPLOYEE BENEFITS

MEDICAL INSURANCE

ANTHEM BLUE CROSS | HMO SELECT NETWORK PLAN
With the Select Network Health Maintenance Organization (HMO) plan through Anthem Blue Cross, you must choose a Primary Care
Physician (PCP) or medical group within the Select 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. This plan uses a smaller network of the most cost-effective providers to offer lower per
paycheck premiums. Please note that it is your responsibility to ensure that all family members choose providers from the Select network.

ANTHEM BLUE CROSS | HMO VIVITY NETWORK PLAN

With the Vivity Health Maintenance Organization (HMO) plan through Anthem Blue Cross, you must choose a Primary Care Physician (PCP)
or medical group within the Vivity 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 health system in which you are
enrolled, except in the case of an emergency. This plan includes a smaller network, with seven healthy systems – all with hospitals ranked
in the top 10 in Los Angeles and Orange County: Cedars-Sinai, Good Samaritan Hospital, Huntington Hospital, MemorialCare Health
System, PIH Health, Torrance Memorial Medical Center, and UCLA. Since this plan offers less provider options, you will experience lower
per paycheck premiums.

ANTHEM BLUE CROSS | HSA PPO PLAN

With the HSA PPO 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. In addition, Milani will make contributions totaling $500 toward
your health savings account, annually. The money in your account is yours to pay for current healthcare expenses - or you can save for
future healthcare expenses. 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.

ANTHEM BLUE CROSS | PPO PLAN
The Anthem Blue Cross Preferred Provider Organization (PPO) plan allows you to direct your own care. If you receive care from a physician
who is a member of the network, a greater percentage of the entire cost will be paid by the insurance plan. However, you are not limited
to the physicians within the network and you may self-refer to specialists. If you obtain services using a non‐network provider, please 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/ca or call (800) 888-8288 or the number on your ID card.
 HMO Select Network: Refer to the Select HMO network.
 HMO Vivity Network: Refer to the Vivity HMO network.
 PPO & HSA (CA): Refer to the Blue Cross PPO (Prudent Buyer) - Large Group network.
 PPO & HSA (Non-CA): Refer to the Na onal PPO (Blue Card PPO) network.

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