Page 5 - Oremor EE Benefits Guide 01-19.pub

Benefits

Medical Insurance

Option 1
Network PPO | EBA&M (Anthem Blue Cross)
Our most affordable op on, the Network Preferred Provider Organiza on (PPO) plan allows you to direct your own care. This plan
requires you u lize doctors, clinics, and hospitals in the Blue Cross PPO network, except in the case of an emergency. You also
have the ability to self‐refer to any specialist in the network. Over 92% of physicians outside of Kaiser are typically contracted with
Blue Cross. If you choose a provider who is not part of the network, you will be required to pay the full cost for your care.

Option 2
PPO | EBA&M (Anthem Blue Cross)
The Preferred Provider Organiza on (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 en re 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.

Option 3
HMO | Kaiser Permanente
With the Kaiser Permanente Health Maintenance Organiza on (HMO) plan, services must be obtained at a Kaiser facility, except in
the case of emergency. All of your care must be directed through your selected doctor, but you can choose and change your doctor
at any me, for any reason. Kaiser Permanente integrates all elements of healthcare such as physicians, medical centers,
pharmacy, and administra on in one convenient facility.

Option 4
HRA Supplemental Medical Plan
A Health Reimbursement Arrangement (HRA) is a health benefit plan that reimburses employees for out of pocket medical
expenses and is offered to employees who are waiving Oremor’s PPO plan and enrolling into a Spouse’s employer medical plan.
The plan will reimbursed up to $2,000 of qualified healthcare expenses. The reimbursed medical expenses may be incurred by you,
your spouse, or your eligible dependents a er your benefits effec ve date with Oremor. Medical expenses are reimbursable on a
calendar year basis (January 1 to December 31). A qualified medical expense is subject to the medical plan provisions as well as IRS
s pula ons

Contacting EBA&M—Our PPO & HRA Plan Administrator
 Website: Go to www.ebam.com. You are encouraged to register online. Once you register and log in to
the secure site you can find providers, check status of claims, and issue order replacement ID cards.
 Telephone: Call (800) 249‐8440.

Anthem Blue Cross: Provider Finder Instructions
 Website: Go to www.ebam.com. Select “Plan Par cipants” and “Find a Provider”
 California Employees: Click on the Prudent Buyer Network (EPO and PPO Plans) link.
 Non‐California Employees: Click on the BlueCard Network link.
 Telephone: Call EBA&M at (800) 249‐8440

Kaiser Permanente: Provider Finder Instructions
 Website: Go to www.kaiserpermanente.org. Select “Find Doctors and Loca ons” and under Select an
area, enter “California”. Enter the city or zip code for your search
 Telephone: Call (800) 464‐4000

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