Page 7 - Moonwell Studios Benefit Guide

Medical Plan Choices

Blue Shield | HSA PPO Plan
With the Blue Shield HSA PPO plan, you can pay for qualified PPO: Access to Care
healthcare expenses now and grow your savings for future The PPO and the HSA PPO plans are Preferred
healthcare needs. This plan combines a High Deductible Health Provider Organization (PPO) plans and use
Plan (HDHP) with a special, tax-qualified Health Savings Account Blue Shield’s Full PPO network. PPO plans
(HSA). You and the company can contribute tax-free money to your allow you to direct your own care. You have
HSA up to IRS maximums. The money in your account is yours to the freedom to choose your doctor without
pay for current healthcare expenses - or you can save toward the requirement of selecting a PCP and you
future healthcare expenses. More details about the HSA medical may self-refer to specialists. You may use a
plan are located on page 12.
network provider whose negotiated rates
provide richer levels of benefits with claim
Blue Shield | PPO Plan forms filed by the providers. You may also
The Blue Shield PPO plan requires that you meet a calendar year obtain services using a non-network provider;
deductible before Blue Shield starts paying for certain services. however, you will be responsible for the
Once the deductible has been met, most services will be covered difference between the covered amount and
at a coinsurance or a copay, For certain services, such as office the actual charges, and you may be
visits and urgent care, Blue Shield has waived the deductible and responsible for filing claims.
cost sharing begins immediately with copay coverage.

Blue Shield| HMO Plan
With the Blue Shield HMO plan, you must choose a primary care physician (PCP) 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 be coordinated
through your PCP and will generally require a referral or authorization. You will receive benefits only if you use the
doctors, clinics, and hospitals that belong to the medical group in which you are enrolled, except in the case of an
emergency.

Kaiser | HMO Plan

With the Kaiser Permanente Health Maintenance Organization (HMO) plan, services must be obtained at a Kaiser
Permanente 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.

Finding a Medical Provider

Blue Shield: Go to www.blueshieldca.com/fad. Select Type
of Provider, follow prompts, and with Plan in Mind, select
‘Yes’. For Plan Year, select ‘2020’, then Plan Type:
• HSA: 2020 Small Business PPO Full, then
SubPlan Silver Full PPO Savings 2000/25% OffEx
• PPO: 2020 Small Business PPO Full, then
SubPlan Gold Full PPO 500/30 OffEx Educational Video
• HMO: 2020 Small Business HMO Access+, then Health Insurance Terms
Subplan Platinum Access+ HMO 0/20 OffEx http://video.burnhambenefits.com/
terms
Kaiser HMO: Go to www.kp.org, select Doctors & Locations
and follow prompts
Employee Benefits 7