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BENEFITS

Medical Insurance and Prescription Drugs

Delta Health Systems | PPO Medical Plan | Anthem Blue Cross Network
The Preferred Provider Organization (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. CSI contracts with Delta Health Systems to administer the review and payment of provider invoices.

Delta Health Systems | HSA PPO Medical Plan | Anthem Blue Cross Network
With the HSA PPO plan, 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. In addition, CSI will make contributions totaling $840 toward your employee
health savings or $1,680 for your family, annually. 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. CSI contracts with Delta Health Systems to administer the review and payment of provider invoices.
More information on how the HSA works is located on page 7.

Kaiser Permanente | HMO Medical Plan
With the Kaiser Permanente Health Maintenance Organization (HMO) 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 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. In addition, Kaiser Permanente offers online tools so you
can email your doctor’s office, make appointments, refill prescriptions, and more.

Plan Differences PPO HSA PPO Kaiser HMO

Employee Premiums $$ $ $$
Health Savings Account ✓
Cost Sharing Contribution, Copay, HSA Contribution, Copay, Contribution, Copay
Deductible, Coinsurance Deductible, Coinsurance
Network
- Network Size   
- In-Network Benefits ✓ ✓ ✓
- Non-Network Benefits ✓ ✓

Access to Providers Managed by You Managed by You Managed by Your PCP
- Primary Care Physician Not Required Not Required Required
- Referral for Specialist Not Required Not Required Required

Finding a Medical Provider
• PPO or HSA: Go to www.deltahealthsystems.com or call Delta Health Systems at (800) 807-0820. You
may also go to www.anthem.com/ca Refer to the “Anthem Blue Cross Prudent Buyer - Large Group”
network when prompted.
• Kaiser HMO: Go to www.kaiserpermanente.org or call (800) 464-4000.

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