Page 9 - SunWest EE Guide 09-19 Outside CA
P. 9
Medical Plan Choices
Anthem Blue Cross | HRA PPO Plan
With the HRA PPO plan, you have access to an employer-funded PPOs: Access to Care
account to pay for certain medical expenses you incur under the The HRA, HSA and PPO plans are Preferred
Anthem HRA PPO plan, including the plan deductible, Provider Organization (PPO) plans and use
coinsurance, copays and prescriptions for you and your family. Anthem Blue Cross’s BlueCard PPO network.
Once you’ve met $3,000 (Employee) or $6,000 (Employee + PPO plans allow you to direct your own care.
Dependents) of your deductible, Sun West will cover the You have the freedom to choose your
remaining $1,500 / $3,000, respectively, of your deductible prior doctor without the requirement of selecting
to coinsurance and prescription drug copays applying. More a PCP and you may self-refer to specialists.
details about the HRA medical plan are located on page 13. You may use a network provider whose
negotiated rates provide richer levels of
Anthem Blue Cross | HSA PPO Plan benefits with claim forms filed by the
With the HSA PPO plan, you can pay for qualified healthcare providers. You may also obtain services
expenses now and grow your savings for future healthcare using a non-network provider; however, you
needs. This plan combines a High Deductible Health Plan (HDHP) will be responsible for the difference
with a special, tax-qualified Health Savings Account (HSA). You between the covered amount and the actual
can contribute tax-free money to your HSA up to IRS maximums. charges (which can exceed the plan’s non-
The money in your account is yours to pay for current healthcare network out of pocket maximums), and you
expenses - or you can save toward future healthcare expenses. may be responsible for filing claims.
More details about the HSA medical plan are located on page 12.
Anthem Blue Cross | PPO Plan
The PPO plan requires that you meet a calendar year deductible
before Anthem Blue Cross starts paying for certain services. Once
the deductible has been met, most services will be covered at a
coinsurance or a copay, For certain services, such as office visits
and urgent care, Anthem Blue Cross has waived the deductible
and cost sharing begins immediately.
Finding a Medical Provider
Go to www.anthem.com/ca
PPO and HSA PPO: Refer to the National “BlueCard PPO” network
Educational Video
Health Insurance Terms
http://video2.burnhambenefits.com/terms
Employee Benefits 9
