Page 7 - FSSI EE Guide 07-19 - OOS
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Blue Shield | PPO Plan
         The PPO plan requires that you meet a calendar year deductible   PPO: Access to Care
         before Blue Shield starts paying for certain services. Once the   The PPO and the HSA PPO plans are
         deductible has been met, most services will be covered at a     Preferred Provider Organization (PPO) plans
         coinsurance or a copay, For certain services, such as office visits   and use Blue Shield’s Large Group PPO
         and urgent care, Blue Shield has waived the deductible and cost   network. PPO plans allow you to direct your
         sharing begins immediately.                                     own care. You have the freedom to choose

                                                                         your doctor without the requirement of
         Blue Shield | HSA PPO Plan                                      selecting a PCP and you may self-refer to
         With the HSA PPO plan, you can pay for qualified healthcare     specialists. You may use a network provider
         expenses now and grow your savings for future healthcare        whose negotiated rates provide richer levels
         needs. This plan combines a High Deductible Health Plan (HDHP)   of benefits with claim forms filed by the
         with a special, tax-qualified Health Savings Account (HSA). You   providers. You may also obtain services
         and the company can contribute tax-free money to your HSA up    using a non-network provider; however, you
         to IRS maximums. The money in your account is yours to pay for   will be responsible for the difference
         current healthcare expenses - or you can save toward future     between the covered amount and the actual
         healthcare expenses. More details about the HSA medical plan    charges, and you may be responsible for
         are located on page 12.                                         filing claims.






            Finding a Medical Provider
            Go to www.blueshieldca.com. Refer to the “Blue Shield PPO Network - Large
            Group” network






                                                              Blue Shield Mobile App
                                                              Consider downloading Blue Shield’s mobile app for
                                                              instant access to your health plan details. Blue Shield’s
                                                              mobile app provides secure member information,
                                                              anytime, anywhere. Use it to search for a doctor, urgent
                                                              care center, or facility. The app is convenient, easy-to-
                       Educational Video                      use, and free. Download the Blue Shield of California
                     Health Insurance Terms                   mobile app for free from the iTunes App Store or Google
                                                              Play Store. Please note, you must first register as a
              http://video.burnhambenefits.com/terms          member at www.blueshieldca.com.
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