Weblink provided by Anthem Blue Cross to help you locate your provider.

Transcription

1 Weblink provided by Anthem Blue Cross to help you locate your provider. Use search as a Guest - Click Continue

2 When you log onto the website it will ask you several questions: The correct responses would be as follows: Through my employer California Medical Select HMO

3 Press Continue This is the screen you will use to select the type of physician.

4 Please Note: When doing a provider search by name even a slight variation can create an error in the search mode. It is sometimes easier to search with a radius and look for the individual name. A list will be provided and you can also refine the search criteria from this screen.

5 For additional assistance please feel free to contact our office. -

6 Manhattan Beach Unified School District Line Item HMO Benefit Comparison Line Items as presented on the current benefits. Anthem Blue Cross Anthem Blue Cross ASCIP Current Level of Benefits Custom Premier HMO 15/100% Custom Premier HMO 10/100% United Health Care - HMO Select HMO Vivity HMO General Features Calendar Year Deductible None None None Maximum Benefits Unlimited - Federal Law Unlimited - Federal Law Unlimited - Federal Law Annual Copayment Maximum (3 individual maximum per family) $1,000 Individual / $3,000 per family $1,000 Individual / $3,000 per family $1,000 Individual / $3,000 per family Physician Office Visits $15 Copayment $15 Copayment $10 Copayment Specialist Office Visits $15 Copayment $15 Copayment $10 Copayment Hospital Benefits Paid In Full Paid In Full Paid In Full Emergency Room $50 Copayment (Waived if admitted) $50 Copayment (Waived if admitted) $50 Copayment (Waived if admitted) Urgently Needed Services $50 Copayment (Waived if admitted) $50 Copayment (Waived if admitted) $50 Copayment (Waived if admitted) Pre-Existing Conditions All conditions covered, provided they are covered benefits. All conditions covered, provided they are covered benefits. All conditions covered, provided they are covered benefits. Benefits Available While Hospitalized as an Inpatient Bone Marrow Transplants Paid In Full Paid In Full Paid In Full Clincial Trials Paid at negotiated rate. Balance (if any) is the responsibility of the Member Paid In Full Paid In Full Hospice Services Paid In Full Paid In Full Paid In Full Hospital Benefits Paid In Full Paid In Full Paid In Full Mastectomy/Breast Reconstruction Paid In Full Paid In Full - Covered by Federal Law Paid In Full - Covered by Federal Law Maternity Care Paid In Full Paid In Full Paid In Full Mental Health Services Paid In Full Paid In Full Paid In Full Newborn Care Paid In Full Paid In Full Paid In Full Physician Care Paid In Full Paid In Full Paid In Full Reconstructive Surgery Paid In Full Paid In Full Paid In Full Rehabilitation Care (Including physical, occupational and speech therapy.) Paid In Full Paid In Full Paid In Full Skilled Nursing Facility Care (Up to 100 days per benefit period.) Paid In Full Paid In Full Paid In Full Termination of Pregnancy (medical/medication and surgical) $75 Copayment Paid In Full Paid In Full Benefits Available on an Outpatient Basis Allergey Testing/Treatment $15 Copayment $15 Copayment $10 Copayment Ambulance Paid In Full Paid In Full Paid In Full Clincial Trials Paid at negotiated rate. Balance (if any) is the responsibility of the Member Paid In Full Paid In Full Cochlear Implant Devices Paid In Full Paid In Full Paid In Full Dental Treatment Anesthesia $15 Copayment $0 to $50 Copayment $0 to $50 Copayment Dialysis $15 Copayment $15 Copayment $10 Copayment Durable Medical Equipment Paid In Full Paid In Full Paid In Full Created: May 3,

7 Manhattan Beach Unified School District Line Item HMO Benefit Comparison Line Items as presented on the current benefits. Anthem Blue Cross Anthem Blue Cross ASCIP Current Level of Benefits Custom Premier HMO 15/100% Custom Premier HMO 10/100% United Health Care - HMO Select HMO Vivity HMO Family Planning (Non-Preventive Care) Vasectomy $50 Copayment $50 Copayment $50 Copayment Depo-Provera Injection $50 Copayment $50 Copayment $50 Copayment Termination of Pregnancy $75 Copayment Paid In Full Paid In Full Hearing Aid - Standard Paid In Full Paid In Full Paid In Full Hearing Exam $15 Copayment $15 Copayment $10 Copayment Home Health Care Visits (Up to 100 visits per calendar year) Paid In Full Paid In Full Paid In Full Hospice Services Paid In Full Paid In Full Paid In Full Infertility Services Not Covered Not Covered Not Covered Infusion Therapy Paid In Full Paid In Full Paid In Full Injectible Drugs Paid In Full Paid In Full Paid In Full X-Ray and Lab Tests Paid In Full Paid In Full Paid In Full Maternity Care, Tests and Procedures Paid In Full Paid In Full Paid In Full Mental Health Services Paid In Full Paid In Full Paid In Full Outpatient Medical Rehabilitation Therapy $15 Copayment $15 Copayment Paid In Full Oral Surgery Services Paid In Full Paid In Full Paid In Full Outpatient Surgery at a participating Free-Standing Outpatient Facility Paid In Full Paid In Full Paid In Full Physician Care $15 Copayment $15 Copayment $10 Copayment Paid In Full - Covered by Federal Law Paid In Full - Covered by Federal Law Preventive Care Services Paid In Full Prosthetics and Corrective Appliances Paid In Full Paid In Full Paid In Full Raditation Therapy (Standard & Complex) Paid In Full Paid In Full Paid In Full Radiology Services (Standard & Advanced) Paid In Full Paid In Full Paid In Full Vision Refractions $15 Copayment $15 Copayment $15 Copayment Prescription Drug Benefits - Provided through United Health of California Generic $10 $10 $10 Brand Formulary $20 $20 $20 Non-Formulary $35 $35 $35 Specialty Drugs (Tier 4) $35 $35 Brand Name Deductible None None None Prescription Calendar Year Out-Of-Pocket Maximum None Applied to Medical OOP Applied to Medical OOP Created: May 3,

8 Manhattan Beach Unified School District - October 1, 2016 Renewal Presented by Matthew Heath Olney & McClain Insurance Services, Inc. Rates Quoted as Tenthly Format - Census Breakdown** SINGLE EE + 1 EE + 2 Anthem S-Premier HMO 15/100% Anthem Vivity Premier HMO 15/100% Anthem Custom Premier PPO 0/10/ Anthem Custom Classic PPO 250/20/ *Kaiser HMO SUBTOTAL Total Employees: 523 Anthem Select & Vivity HMO & Custome PPO - Kaiser HMO* SINGLE EE + 1 EE + 2 Anthem S-Premier HMO 15/100% $ $1, $1, $320, Anthem Vivity Premier HMO 10/100% $ $1, $1, $81, Anthem Custom Premier PPO 0/10/0 $1, $2, $3, $19, Anthem Custom Classic PPO 250/20/20 $ $2, $2, $12, *Kaiser HMO $ $1, $2, $204, Monthly Total $637,773 Anthem S-Premier HMO Annual Subtotal $3,201,891 Anthem Vivity Premier HMO Annual Subtotal $817,538 Anthem Custom Premier PPO 0/10/0 Annual Subtotal $190,046 Anthem Custom Classic PPO 250/20/20 Annual Subtotal $128,180 Kaiser HMO Annual Subtotal $2,040,071 Annual Total $6,377, * Kaiser is unable to release a quote until after the renewal is prepared in May Please Note: There is a break in clause where the rates will remain the same as the trust for 12 months, unless benefit modifications are made. ** Eligibility is based upon the provided census for Active covered employees. ** UHC HMO numbers are broken down by percentage based upon disruption report. Revised: May 2, 2016