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Insurance/Risk Management

CAPISTRANO UNIFIED SCHOOL DISTRICT

An unwavering commitment to student success

Medical Plans

Summary of Benefits

Summary of Benefits

United HealthCare

2027 UHC Summary of Benefits - COMING SOON!
  • UHC Harmony $10 HMO
  • UHC Alliance $10 HMO
  • UHC Harmony HMO w/ HRA
  • UHC Alliance HMO w/ HRA
  • UMR (UHC) Select Plus PPO
 
2026 UHC Summary of Benefits

Kaiser Permanente

2027 Kaiser Summary of Benefits - COMING SOON!
  • Kaiser $15 HMO
  • Kaiser $25 HMO
 
2026 Kaiser Summary of Benefits

Cigna

2027 Cigna Summary of Benefits  - Coming Soon!
  • Cigna Select $10 HMO
 
2026 Cigna Summary of Benefits

Family

 

CUSD OFFERS 9 MEDICAL PLANS:

 

Access your virtual ID cards online!

 

United Healthcare and UMR Logos

UHC/ UMR Plan Names:
  • UHC Harmony $10 HMO
  • UHC Alliance $10 HMO
  • UHC Harmony HMO w/ HRA 
  • UHC Alliance HMO w/ HRA 
  • UMR Select Plus PPO
 
Express Scripts (All UHC Plans):
 
HealthInvest HRA (for UHC Harmony w/ HRA and Alliance w/ HRA Plans)
Chiropractic Services - Optum Health
 
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:
 
Fitness
  • UHC One Pass
  • Calm App
    • Please include '33' prior to your complete member ID number when registering. 
      • ex. 33XXXXXXXXX
 
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 v.s. out-of-network costs are different
  • Find an in-network UMR provider
  • UMR Mobile App
 
Carrum Health (Surgery Benefit)
  • Customer Service: (888) 855-7806
    • For questions please contact VEBA Advocacy or Carrum Health directly.

 
 
Kaiser Plan Names:
  • Kaiser $15 HMO
  • Kaiser $25 HMO
 
Chiropractic Services - Optum Health
 
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
 


Plan Name: Cigna Select HMO - Southern California
 
Fitness
 
Chiropractic Services
 
Mental Health Services for Cigna Select HMO

 

 
Out of Area Dependents 
 
Disabled Adult Dependents
  • The following application processes are processed by the insurance carriers on a first come, first serve basis. This means it can take anywhere between a few weeks to months for them to approve or deny. Please be mindful of when you submit your applications to the insurance carriers due to these delays. 
  • 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). 
  • 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.