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Health Savings
Account (HSA). You can contribute tax-free money to your HSA up to IRS maximums.
expenses now and grow your savings for future healthcare needs. This plan combines a
please note that you will be responsible for the difference between the covered amount
With the HSA plan through Anthem Blue Cross, you can pay for qualified healthcare
The money in your account is yours to pay for current healthcare expenses - or you can
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
specialists. You may use a network provider whose negotiated rates provide richer levels
save for future healthcare 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
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
The PPO plan allows you to direct your own care. If you receive care from a physician
and you may self-refer to specialists. If you obtain services using a non-network provider,
covered amount and the actual charges and you may be responsible for filing claims.
Educational Video Deductibles, Copays, Coinsurance, and Out-of-Pocket Maximums http://video.burnhambenefits.com/terms/
Plan (HDHP) with a special, tax-qualified

MEDICAL PLAN CHOICES

Options 3 and 4 Anthem Blue Cross | PPO Plans and the actual charges, and you may be responsible for filing claims. Option 5 Anthem Blue Cross | HSA PPO Plan High Deductible Health

Anthem Blue Cross | HMO Plan—California Employees
or medical group within the network. All of your care must be directed
through your PCP or medical group. Any specialty care you need will
With the Kaiser Permanente Health Maintenance Organization (HMO)
administration in one convenient facility. In addition, Kaiser Permanente
selected doctor, but you can choose and change your doctor at any
be coordinated through your PCP and will generally require a referral or
plan, you must obtain services at a Kaiser Permanente facility, except in
the case of emergency. All of your care must be directed through your
if you use the doctors, Option 2: Go to www.anthem.com/ca or call (800) 888-8288. Refer to the “California Care HMO” network. Non-California Residents: Refer to the “National PPO (Blue Card) PPO” network.
healthcare such as physicians, medical centers, pharmacy, and
make
any reason. Kaiser Permanente integrates all elements of
With the HMO plan, you must choose a primary care physician (PCP)
Kaiser Permanente | HMO Plan– California Employees
online tools so you can email your doctor’s office,
receive benefits only clinics, and hospitals that belong to the medical group in which you are enrolled, except in the case of an emergency. Option 1: Go to www.kp.org or call (800) 464-4000. Options 3, 4 & 5: Go to www.anthem.com/ca or call (800) 888-8288. California Residents: Refer to the “Prudent Buyer PPO” network.
appointments, refill prescriptions, and more.

Option 1 time, for offers Option 2 authorization. You will Finding a Medical Provider   EMPLOYEE BENEFITS

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