Page 5 - Oremor EE Guide 01-18_FINAL1
P. 5

Benefits





         Medical Insurance


         Option 1
         Network PPO | EBA&M (Anthem Blue Cross)
         Our most affordable option, the Network Preferred Provider Organization (PPO) plan allows you to direct your own care. This plan
         requires you utilize 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 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 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.

         Option 3
         HMO | Kaiser Permanente
         With the Kaiser Permanente Health Maintenance Organization (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  time,  for  any  reason.  Kaiser  Permanente  integrates  all  elements  of  healthcare  such  as  physicians,  medical  centers,
         pharmacy, and administration 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 after your benefits effective 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
         stipulations

                         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 Participants” 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 Locations” and under Select an
                             area, enter “California”. Enter the city or zip code for your search
                         •   Telephone: Call (800) 464-4000




                                                                                                                   5
   1   2   3   4   5   6   7   8   9   10