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With
respect to eligibility for plan benefits, the terms of
each plan designate certain individuals as eligible
for benefits under the plan.
Medical
Plans
The
Institute offers the choice of several medical plans. Each
plan offers you and your family array of coverage. With some plans, services are provided at a designated health
facility. Other plans provide services through a
physician’s individual practice or as part of a
group of affiliated physicians.
The Institute offers the following medical plans:
PPO
 Blue
Cross PPO Plan
The Blue Cross Plan is a preferred provider organization (PPO)
plan, which allows you to use a Blue Cross participating provider, or any other non-participating
provider, each time you need care.
By
using a participating provider, you will not be
required to pay for covered services at the time of
service, and the claim will be submitted to Blue Cross
directly by the provider.
When using non-participating providers, the
services will cost you more because you pay a higher
percentage of covered charges than you would if you
use participating providers, and their fees may be
greater than those negotiated with participating
providers.
HMO
Blue
Cross HMO Plan
Kaiser
Permanente
In
a health maintenance organization (HMO), you generally
pay no deductibles and only small co-payments for most
covered expenses. In most cases, you receive no
coverage for treatment from providers who are not in
the HMO.
Please keep in mind that these HMOs, for the
most part, only offer facilities in the Southern
California area.
When making your HMO plan
selection, you should check your zip code with
the specific HMOs to find out what is available in
your area, and consider the proximity to your home
when selecting an HMO.
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Dental Plans
The Institute offers the following choice of dental plans:
Delta Dental
Safeguard Dental
Delta Dental
is a fee for service plan.
With this plan you may choose any dentist and receive
coverage, but your benefits will be greater if you
choose a Delta Dental.
Most dentists in California are members of the
Delta Dental network.
Safeguard Dental is a managed-care dental
program. There
are no deductibles and many of your routine dental
expenses are fully paid by the plan. Other treatments
require set copayments.
When you enroll, you select a Safeguard network
dentist.
Quality Survey Information
You
may also want to use the following resources:
National
Committee for Quality Assurance
California
Department of Managed Health Care
Your
Guide to Choosing Quality Health Care
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