2024 SUMMARY OF BENEFITS
2024 SUMMARY OF BENEFITS
United HealthCare
2024 UHC SUMMARY OF BENEFITS:
Kaiser Permanente
2024 SUMMARY OF BENEFITS:
Cigna
2024 CIGNA SUMMARY OF BENEFITS:
CUSD OFFERS 9 MEDICAL PLANS:
- 2024 Group Plan Numbers
- 2024 Medical Side-by-Side Comparison Sheet
- 5 - United HealthCare (UHC) HMO Plans
- 1 - UMR/ United HealthCare (UHC) PPO Plan
- 2 - Kaiser HMO Plans
- 1 - Cigna HMO Plan
- Guest MyVEBA Account
- ID: CAPUSD
Need virtual access to your carrier ID cards? Click HERE!
- UHC Customer Service: (888) 586-6365
- UHC Website
- How to Find a UHC HMO PCP
- UHC Mobile App
- UMR Customer Service: (800) 826-9781
- UMR Website
- How to Find a UMR PPO PCP (Choose Select Plus on the Search Page)
UHC/ UMR Plan Names:
- UHC Harmony $10 HMO
- UHCCS VEBA Alliance HMO $10
- UHC Harmony HMO Journey w/ HRA
- UHC CS VEBA Alliance HMO Journey w/ HRA
- UMR Select Plus PPO
Express Scripts (All UHC Plans):
- Customer Service: (800) 918-8011
- 2023 Update Regarding Kroger Pharmacies
- Website
- Express Scripts Flyer
Journey Harmony and Journey Alliance Health Reimbursement Account (HRA)
- BrainShark Videos
Chiropractic Services - Optum Health
- Customer Service: (800) 428-6337
- Optum Website
- Optum Chiropractic and Acupuncture
Mental Health Service for UHC Plans
- Get pre-authorization from Optum Behavioral Health
- Call Optum Customer Service for pre-authorization and for emergencies, 24/7, at (888) 625-4809
- Costs:
- Outpatient services are the same as medical outpatient office co-pays/costs
- Find an in-network Provider
Substance Abuse Services
- No need for pre-authorization for inpatient or outpatient services
- Coverage through Optum
- Contact UMR for cost information: (800) 826-9781
- In-network vs. out-of-network costs are different
- Find an in-network UMR provider
- UMR Mobile App
Carrum Health (Surgery Benefit)
- Customer Service: (888) 855-7806
- 2019 Carrum Health Letter
- ***Important Note: The member will be required to call Carrum Health prior to scheduling their surgery.
- If the member contacts Carrum and uses a Carrum recommended facility for their surgery they will have the procedure coinsurance or deductible waived.
- If the member contacts Carrum but chooses not to use a Carrum recommended facility- they may use a facility of their choice and pay the standard plan coinsurance and deductible.
- If the member does not contact Carrum Health prior to scheduling their surgery they will be required to pay a $1,000 pre-certification penalty in addition to their plan deductible and coinsurance.
- For questions please contact VEBA Advocacy or Carrum Health directly.
Rally Marketplace
- An interactive website and phone app that helps you manage your health.
- Earn Rally Coins!
- Learn more about the marketplace.
- Rally Website
- Kaiser Customer Service: (800) 464-4000
- Kaiser Website
- Kaiser Coverage
Kaiser Plan Names:
- Kaiser HMO $15
- Kaiser HMO $25
Chiropractic Services - Optum Health
- Customer Service: (800) 428-6337
- Optum Website
- Optum Chiropractic and Acupuncture
Fitness
Mental Health Services
- To schedule a mental health appointment, call: Orange County: (714) 644-6480
- Members do not need a referral.
- Behavioral Health Line & Mental Health Crisis Line: (800) 900-3277
- Available 24/7
- Resolution specialists to help members resolve concerns about mental health care appointments: (800) 390-3503
- PowerPoint on Mental Health Escalation Line
- PowerPoint on Digital Wellness Tools
- Calm App Info
- Digital Tools Info
- myStrength App Info
Plan Name: Cigna Select HMO - Southern California
- Customer Service: (800) 244-6224
- Cigna Website
- Cigna and St. Joseph HOAG Health Select
- Find a Cigna PCP
- Cigna Guest Flyer
- Know Before You Go
- So Cal Network
- After Hours Care
Fitness
Chiropractic Services
- Contact your PCP for Referral
- General Knowledge
- Policy of Therapy Services
Mental Health Services for Cigna Select HMO
- Contact your PCP for Referral
- Mental Health Benefits
Out of Area Dependents
- Urgent Care and Emergency Services (Applicable to ALL Medical Plans)
- UHC Surest PPO Summary of Benefits (Applicable to UHC and Cigna Medical Plans ONLY)
- UHC Surest PPO Mobile App Information in English (Applicable to UHC and Cigna Medical Plans ONLY)
- UHC Surest PPO Mobile App Information in Spanish (Applicable to UHC and Cigna Medical Plans ONLY)
- If I am enrolled in a UHC HMO or the Cigna HMO plan, how do I get my out of area dependent onto UHC Surest PPO while they're living out of the area?
- Send an email inquiry to one of our department contacts to start the process!
Disabled Adult Dependents
- UHC Members: Please have the treating physician complete the below form and return it directly to UHC per the instructions on the application. UHC will notify the member of approval or denial.
- UHC Disabled Adult Dependent Application
- Once the member receives approval, they can submit a copy to our insurance department so we can provide the approval to VEBA (the trust that administers our insurance).
- UHC Disabled Adult Dependent Application
- Kaiser Members: Contact Kaiser directly at (800) 731-4661 or (858) 614-3584.
- Once the member receives approval, they can submit a copy to our insurance department so we can provide the approval to VEBA (the trust that administers our insurance).
- Cigna Select HMO: Contact Cigna directly at (800) 244-6224.
- Delta Dental and VSP Members: Delta Dental and VSP rely on the status approval granted by the medical carriers.
GENERAL NOTES REGARDING HEALTH COVERAGE
GENERAL NOTES REGARDING HEALTH COVERAGE
GENERAL NOTES REGARDING HEALTH COVERAGE
*Employees electing one of the United HealthCare HMO Networks will select a physician from a list of Primary Care providers, that physician then directs the medical care. Benefits accessed are covered at 100% except for office visit co-payments and prescription medications.
*Employees electing the Cigna Select HMO will select a physician from a list of Primary Care providers in the St. Joseph Hoag Health Network. Benefits accessed are covered at 100% except for office visit co-payments and prescription medications.
*Employees electing Kaiser Permanente HMO will access care from any Kaiser Permanente facility. Benefits accessed are covered at 100% except for office visit-co-payments and prescription medication.
*Employees electing the UHC/ UMR PPO can access physicians and specialist at any time without referrals. The employee has a co-payment for primary care and specialists. For most other services, an annual deductible does apply, then the plan pays a percentage.