Page 10 - SC Fuels EE Guide 2020 Imperial & SD

MEDICAL PLAN CHOICES

SIMNSA | HMO Plan
The SIMNSA HMO option is available to San Diego or Mexico PPO - Access to Care
residents who would like to access health care services in The PPO and the HDHP PPO plan options
Mexico. This plan allows you to visit a select network of qualified are Preferred Provider Organization
Spanish-speaking physicians, pharmacies, and hospitals in (PPO) plans and use the Anthem Blue
Tijuana, Mexicali, Rosarito or Tecate. Please note that health Cross “Prudent Buyer” network.
care services in the United States are not covered.
PPO plans allow you to direct your own
Anthem Blue Cross | Traditional PPO Plan care. You have the freedom to choose
The PPO plan gives you access and flexibility to direct your your doctor without the requirement of
own care. For certain services, such as office visits, urgent care, selecting a PCP and you may self-refer
and prescriptions you are covered with flat dollar copays. For to specialists. You may use a network
hospital, lab and x-ray, and emergency services you will first provider whose negotiated rates
meet a calendar year deductible, then share in the cost with provide richer levels of benefits with
Anthem through coinsurance. claim forms filed by the providers. You
may also obtain services using a non-
Anthem Blue Cross | HDHP PPO Plan network provider; however, you will be
responsible for the difference between
With the HDHP PPO plan, you can pay for qualified healthcare the covered amount and the actual
expenses now and grow your savings for future healthcare charges, and you may be responsible for
needs. This plan combines a High Deductible Health Plan filing claims.
(HDHP) with a special, tax-qualified Health Savings Account
(HSA). You and the company can contribute tax-free money
to your HSA up to the HSA IRS maximums shown below. The
money in your account is yours to pay for current healthcare
expenses - or you can save toward future healthcare expenses.

More details about the HSA medical plan are located on page
14 of this guide.

FINDING A MEDICAL PROVIDER
HMO: www.simnsa.com

PPO & HDHP PPO: www.anthem.com/ca
• Scroll down to Find a Doctor
• You may log in or scroll down to “Search
as a Guest by Selecting a Plan” and click
continue
• Enter the type of coverage and the state
• Under type of plan enter “Medical – Educational Video
Employer Sponsored” and refer to Plan/ Health Insurance Terms
Network “Blue Cross PPO (Prudent Buyer) http://video.burnhambenefits.com/terms
– Large Group” - then click continue
• Next you will enter your zip code, a specific
provider name or specialty, and the
distance from your home - click search

10 | TEAM MEMBER BENEFITS