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Ameritas Group
A division of Ameritas Life Insurance Corp., Ameritas Group is proud to offer flexible dental plans backed by efficient, informed and accessible customer service.

eServices
We offer enhanced online services for employees and dentists, with quick access to dental benefits and coverage information.

Plan Members
With a secure member account , you have benefit summary information for you and your dependents at your fingertips. You can view a benefit summary, certificate of coverage, pending and paid claims, pretreatment estimates and the status of plan maximums and deductibles.

Dentists
Your secure account lets you quickly verify patient benefits, view dental and/or orthodontic claims, confirm payment amounts and check dates for processed claims.

Find a Dental Provider
Need to find a dentist in your area? Choose one from our Participating Provider Organization (PPO) and you'll be sure to get impeccable service at a great price.

Ameritas Group:
  • Processes more than 2.6 million dental claims each year. The accuracy of processed claims exceeds 99% and we have a claims processing turnaround time of 5-10 working days.
  • Has a high-tech electronic claims system designed specifically for processing dental claims.
  • Consistently earns high ratings from the industry's leading independent insurance analysts for its outstanding financial strength and operating performance.

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Assurity

Innovative group product marketing, customer service at the highest level and top-notch administrative expertise at reasonable costs are the familiar characteristics of Assurity's Group Insurance Division. As the first carrier to offer an accelerated death benefit on a group life plan and a group critical illness product, we continue to be among the industry leaders in inventive product design.

Assurity's Group Division works with brokers, third-party administrators (TPAs) and managing general underwriters (MGUs) to develop lasting marketing, customer service and administrative relationships. We also provide a level of plan customization not usually possible with the large national carriers.



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Blue Shield of California HMO Plans
Our Access+ HMO® plans are a good choice when you want predictable out-of-pocket costs throughout the year and a simple way to manage healthcare expenses. And only BlueShield's HMO plans let you self-refer to a specialist in your Personal Physicians' medical group/IPA for a slightly higher office visit copayment.

Key features of Blue Shield of California HMO plans:
  • Choice of six HMO plans: CalChoice® 15, CalChoice 25, CalChoice 25 Value , CalChoice 30, CalChoice 40 and CalChoice 40 Value
  • No charge for preventive care
  • Physician office visits for a fixed copayment of $15, $25, $30, or $40 depending on the HMO plan you choose
  • No annual benefit maximums for prescription drugs
  • No lifetime maximum on plan benefits
  • An easy and efficient way to manage your health care and your costs with virtually no claim forms

Access to care:
  • Wide choice of practitioners with one of the largest HMO networks in California: Our HMO network has more than 28,800 doctors and 274 hospitals throughout the state

Quality ratings and financial strength:
  • Weiss Ratings named Blue Shield of California one of the strongest HMOs in the nation as of February 15, 2005
  • "Excellent" accreditation for our commercial HMO plans by the National Committee for Quality Assurance (NCQA)

Please contact your CaliforniaChoice® representative to learn more about how a Blue Shield of California HMO health plan can fit your specific needs.

Access+ HMO is a registered mark of Blue Shield of California.
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Blue Shield Lifepath Resources
Lifepath Resources is our collection of programs that provide health and wellness support to our members. These services are available at no extra charge with all BlueShield health plans. Some noteworthy Lifepath Resources include:
  • Lifepath AdvisersSM : Blue Shield members get expert advice on health and life issues by phone or via the Internet. Lifepath Advisers resources are available 24 hours a day through a single toll-free number and online at MyLifePath.com .
  • Lifepath Decision GuideSM : designed for member facing an important medical decision, the guide includes tools to create reports on treatment alternatives, hospital comparison tool and pharmacy consultation services
  • MyLifePath.com : the award-winning Blue Shield member Web site for health and personalized plan information allows members to check their claim status, order ID cards and change doctors
  • Health management programs aiming to keep member well: self-care guidance for members living with chronic conditions such as diabetes, congestive heart failure and asthma
  • Discount programs: get at least 25 percent off alternative care services – acupuncture, chiropractic and massage therapy – and a 20 percent discount off vision care and supplies from participating practitioners

Please contact your CaliforniaChoice representative to learn more about BlueShield's Lifepath Resources.

Lifepath Advisers and Lifepath Decision Guide are service marks of Blue Shield of California.
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Blue Shield PPO Plans
The Blue Shield PPO plans available through CaliforniaChoice offer you choice and flexibility in how you access care. You can see any doctor or specialist you prefer with a PPO plan. When you receive care from providers in the Blue Shield PPO network, you benefit from the contracts we've established for medical services - as a result, your out-of-pocket costs will be less than when you go outside of the network. However, the choice of which providers to see is always your decision.

Key features of Blue Shield PPO Plans:
  • Blue Shield is the only health plan carrier that offers PPO-type plans through CaliforniaChoice.
  • Choice of three PPO plans with different annual deductibles: CalChoice PPO 750, CalChoice PPO 1000 and CalChoice PPO 2400*
  • Choice of two HSA-eligible high-deductible health plans: CalChoice PPO Savings Plan 1500 and CalChoice PPO Savings Plan 2400
  • CalChoice  Active ChoiceSM Plan 500* features first dollar benefits for professional services, immediate coverage for inpatient services and emergency services, and flexible drug coverage.
  • Maximum choice and personal control over your care: you decide which physician or hospital to use every time you need medical care
  • Preventive care services such as routine physical exams, immunizations, well-baby care and annual gynecological exams are available for a fixed copayment before meeting the annual deductible or are covered under the first dollar benefits for the Active Choice plan
  • For inpatient and outpatient medical services, you pay only a low percentage of the cost for these services after you meet the plan's annual deductible - from 10% to 30% depending on which PPO plan and which network you choose
  • Generic prescription drugs are covered with a fixed copayment and no annual deductible
  • Calendar-year copayment maximums help contain your out-of-pocket costs
  • Out-of-state coverage with the BlueCard®  Program: when you travel for work or pleasure, your health coverage goes with you

Access to care:
  • Among California's largest PPO provider networks: Blue Shield of California has more than 52,000 doctors and 360 hospitals throughout the state and Blue Shield of California Life & Health Insurance Company (Blue Shield Life) has more than 46,000 doctors and 350 hospitals

Quality ratings and financial strength:
  • Accreditation from the Utilization Review Accreditation Commission (URAC) for PPO care management program
  • Blue Shield of California received a financial strength rating upgrade to "A" from "A-" from Standard & Poor's in May 2005 and an affirmed financial strength rating of "A" from A.M. Best in June 2005

Please contact your CaliforniaChoice representative to learn more about how a Blue Shield PPO health plan can fit your specific needs.

* Plan underwritten by Blue Shield of California Life & Health Insurance Company (Blue Shield Life), an Independent Licensee of the Blue Shield Association.

Active Choice is a service mark of Blue Shield of California.

BlueCard and Blue Shield are registered marks of the BlueCross BlueShield Association, an Association of Independent Blue Cross and Blue Shield Plans.

While both the Shield Select and Preferred Savings Plans give you the freedom to see any licensed provider, your costs will be highest when you choose a provider who is not a member of a Blue Shield network.

Prescription Drug Program
For Shield Select Plan members, outpatient drug coverage is based on the drugs listed in the Blue Shield of California Prescription Drug Formulary. Medically necessary outpatient prescription drugs on the formulary are covered at the highest level when you use a Blue Shield participating pharmacy. Non-formulary drugs require a higher copayment. Coverage is lower when you use a non-participating pharmacy.

The Prescription Drug Program is not available to Preferred Savings Plan members, who pay full price then submit prescription drug claims to Blue Shield.
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EyeMed
Eye exams are an important part of any health and wellness program. Comprehensive eye exams allow your eye care professional to view the interior of the eye and can lead to the early detection of serious illnesses like diabetes, heart disease and high blood pressure.

EyeMed Vision Care is a leading vision benefits company providing vision wellness programs to more than 140 million members. Ensuring vision wellness is easy with EyeMed. Members have the choice of thousands of private practitioners and leading optical retailers including LensCrafters® , Sears Optical® , JCPenney Optical® and most Pearle Vision® locations. EyeMed's unique approach to vision care offers substantial savings on eye care and eyewear purchases.

Our program makes it easy to protect your vision and your health by providing:
  • No claim forms for in-network services
  • Customer service representatives available seven days a week
  • Freedom to choose from a wide selection of providers in California and across the country
  • Additional discounts on non-covered items, laser vision correction surgery and replacement contact lenses by mail
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First Dental Health
First Dental Health (FDH) has been one of the leading independent dental networks in California since 1995, and recently expanded into Arizona and Nevada. Based in San Diego, FDH has always been committed to a strong statewide presence. Today, our PPO network includes more than 12,000 credentialed dentist locations, making FDH the largest independent network in the state of California.
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Health Net
  • Committed to empowering member choice through delivering informational tools that allow members to be active players in receiving quality health care, including:
    • Evidence-Based Medicine Online: up-to-date information on medical terms, treatment and options, searchable by condition.
    • Hospital Comparison Report: interactive hospital comparisons to evaluate and determine which hospital scores highest, in key categories, for a particular condition or surgery.
    • Medical Group Comparison Report: this online tool allows Health Net members to compare HMO medical groups based on the quality of care and service the groups provide members.
  • Committed to bringing simplicity to the delivery of health care.
  • Award-winning website, www.HealthNet.com , provides a portal for members and other stakeholders to perform administrative functions, gather information and learn about Health Net wellness initiatives.
  • Delivers simple, affordable and comprehensive products that provide our members with access to high quality health care services.
  • Provides employers with options that provide comprehensive benefits - at appropriate costs - while giving consumers a greater voice in their health care decisions.
  • Our customer service is designed to offer members, physicians and providers the highest quality of support and information. On an average day, our Customer Service representatives answer more than 35,000 calls from members and providers throughout the country.
  • In 2002, our Claims representatives processed approximately 20 million physician and hospital claims - 97 percent in less than 30 days.
  • Within Health Net's National Health Plan Operations team, initiatives to improve our ability to resolve customer issues on the first call are beginning to take hold. Our goal is resolving 85 percent of our customers' inquiries on the first call.
  • We devote significant resources every year to programs that help members with specific chronic conditions such as diabetes, heart disease, asthma and depression. Through intense member education, telephone counseling and medication compliance monitoring, we've also seen significant improvements in the treatment and health of our members who suffer from rare diseases such as multiple sclerosis and cystic fibrosis. In addition to elevating their health status, we have seen 25 percent fewer hospital admissions for members enrolled in these programs.
  • Health Net has been a wellness pioneer for many years. By offering reminders and information on the importance of getting preventive health screenings, our prevention programs help members maintain better health.
  • Nearly quarter-century history of health coverage.
  • Network of nearly 49,000 contracted physicians, 570 physician group locations and 4,400 pharmacies.
  • Solid base of 2.5 million members
  • A.M. Best Rating of A- (Excellent).
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Health Net Elect Open Access 

HMO Benefits PPO Doctors
An HMO benefit that has a self-referral feature to PPO doctors. Members pay $25 to see their HMO PCP, or for a $40 copay, can self-refer to a Health Net PPO doctor.
  • Elect Open Access is a good in between plan that is priced like an HMO but gives you access to PPO doctors.
  • You first select a PCP (your doctor).
  • Self referrals to the Health Net PPO network are for doctor and specialist office visits only
  • You have unlimited self-referral to any physician in the Health Net PPO network (over 44,000 doctors) for a $40 per visit copay
  • All major services (such as hospitalization and surgery) are managed by your PCP
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Kaiser Permanente
Kaiser Permanente was founded more than a half-century ago by Sidney Garfield, MD, and Henry J. Kaiser to provide medical and hospital services to Kaiser shipyard and steel mill workers. It was one of the first health programs to offer such comprehensive healthcare services on a prepaid basis. The same innovative spirit also drives the nation's largest nonprofit health care organization today - a nonprofit health plan that is guided by physicians and focused on providing high quality care to our members.

We're where our members need us to be
  • We provide health care in  nine states and the District of Columbia.
  • We serve 8.7 million members nationwide, including 6.5 million members in California.
  • In California, more than 9,000 physicians provide care at over 300 medical offices and 50 medical centers.

You and your medical team manage your care
  • Physicians have the final say on your prescriptions for medically necessary drugs.
  • You can choose or change your personal physician for any reason.
  • Your Kaiser Permanente physician can easily refer you to a Plan specialist.

Our Health care professionals are dedicated to excellence
  • We're selective about the physicians we hire. In California, only one of every ten applicants is chosen to become a Kaiser Permanente physician.
  • A number of our physicians have national reputations, and some teach at leading universities.
  • Kaiser Permanente's of California Regions earned "Excellent" ratings from the National Committee for Quality Assurance (NCQA), the nation's leading reviewer of health plan quality for consumers and employers. "Excellent" is the top rating granted by NCQA, which reviews satisfaction surveys, preventive measures, physician credentialing, member services, and improvement initiatives.*
*Commercial HMO and Medicare-contracted product lines. Northern California: April 2003; Southern California: May 2003

What began as an innovation in health care nearly 60 years ago has become the model for health care for the twenty-first century. The innovative health plan that's convenient, affordable, and totally dedicated to your health and well-being-that's Kaiser Permanente.
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Sharp Health Plan
Sharp Health Plan is San Diego's largest locally based health plan. Our provider network includes over 3,000 high quality primary care and specialty care physicians. We are not-for-profit, so more of our resources are devoted to ensuring high quality care for our members. And as a provider-owned health plan, we are uniquely attuned to physicians' perspective. We keep decision-making in the hands of doctors and strive to make it as easy as possible for them to treat their patients.

Our goal is to keep our members healthy. We encourage regular doctor visits for routine and preventive care. We also offer a variety of health education classes and health promotion programs, and 24-hour telephone nurse advice. If you do get sick, we work with your doctor to help you get access to medically needed care. When it comes to your health, you need a health plan you can count on. In San Diego, there is really only one choice: Sharp Health Plan. You can count on us!
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Salud HMO y mas
Residents in select zip codes of Los Angeles County, Orange County and the Inland Empire have access to the Health Net Salud HMO y mas plan through CaliforniaChoice .

Because the doctors on Salud speak Spanish and understand the Hispanic culture it's perfect for companies with Spanish speaking employees. Or anyone looking for a lower cost benefit option.

Key features of Salud include:
  • A special Los Angeles County doctor and hospital network through Health Net
  • A $25 co-pay HMO plan with lower premiums
  • Rates starting at $144
  • Dependents living in Baja can enroll in the SIMNSA network which features a $5 copay in Mexico

While designed for Hispanic employees, any LA employee can enroll and enjoy the savings! Salud rates cannot be used to calculate a minimum employer contribution due to the specialized nature of the benefit and network.

To enroll in Salud, employees will need special applications. Employees can simply go to "Download Forms" on our website or call our Customer Service Center at (800) 558-8003 to request the Salud application and enrollment materials.
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SmileSaver
SmileSaver Dental & Vision was licensed as a Knox-Keene prepaid health plan in 1981. Today the company provides services to approximately 310,000 members throughout California. SmileSaver is committed to ensuring that its members receive a high level of healthcare. As part of this commitment, all Quality Management activities are designed to meet or exceed NCQA standards. These standards are applied to plan design through the credentialing of network providers, member services standards and on-going peer review and facility audits.
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Western Health Advantage
A Unique Model of Health Care…
Western Health Advantage (WHA) was founded in 1997 by a coalition of doctors, providers and medical facilities committed to providing personalized managed care in Northern California. WHA is a not-for-profit HMO, owned and operated by providers that offer a new model of managed care, emphasizing quality, and service with the need to provide quality health care in a compassionate manner.

Why choose Western Health Advantage?
What may attract members to WHA is the plan's flexibility. As the region's only locally based health plan, WHA is owned and operated cooperatively by Mercy Healthcare Sacramento, UC Davis Health System and NorthBay Healthcare System. This common ownership provides WHA members the option to move between any physician, clinic or hospital within its five-county network, not just within their particular medical group. This benefit is known as the "Advantage Referral" program and gives people the opportunity to take advantage of "centers of excellence" within the WHA network. The Advantage Referral program gives our members more choice, since they are not locked into one medical group for specialty care. Our members have access to all specialists listed in our provider directory, giving them some of the best medical care available in the area.

The key to WHA's innovative model is keeping administrators and administration to a minimum. Emphasis is on quality, service and patient care, rather than corporate profits. That means more money can be returned to health care providers in the counties WHA serves instead of investors. This health plan focuses on patients and not profits .

Our Member Services Representatives are available if you have any questions.
Western Health Advantage
1-888-563-2250
Monday-Friday 8:00 a.m.-5:00 p.m.
English/Spanish/Hmong
www.WesternHealth.com
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  ©2003-2009 CaliforniaChoice® —
Click here to visit the Choice Administrators website