Page 9 - Veritone EE OOS Benefit Guide_2020

MEDICAL PLAN CHOICES

Option 1 &2
Anthem Blue Cross | PPO Plans
The 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.

Option 3
Anthem Blue Cross | HSA PPO Plan

With the HSA 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. The money in your account is yours to pay for current healthcare expenses - or you can 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 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.

Finding a Medical Provider
• Options 1, 2 & 3: Go to www.anthem.com/ca or call (800) 888-8288.
• Non-California Residents: Refer to the “National PPO (Blue Card) PPO” network.
Educational Video
Deductibles, Copays, Coinsurance, and
Out-of-Pocket Maximums
http://video.burnhambenefits.com/terms/

9 EMPLOYEE BENEFITS