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MEDICAL PLAN BENEFITS

 
Riverside Unified School District offers 5 medical plan choices for benefit eligible employees who work at least 20 hours (Classified) 16 hours (Certificated) per week.  Coverage for all newly hired employees, eligible dependents and for any employees who experience a qualifying life event begins on the first day of the month following the start date or qualifying event date.
 
Please visit Benefits Costs Sheets for cost information 

 

RUSD EPO MEDICAL PLAN (In-Network ONLY) - Available in CALIFORNIA ONLY 

*Anthem Select PPO Network*
 
The RUSD EPO (Exclusive Provider Organization) Plan, administered by Delta Health Systems offers members access to medical care through a number of medical groups "in-network" throughout CALIFORNIA including but not limited to:
 
  • Riverside Medical Clinic
  • Prime Care of Riverside
  • Beaver Medical Group
  • Redlands-Yucaipa Medical Group
  • Loma Linda University Medical Center 
  • St. Jude/St. Joseph Heritage Healthcare
  • CHOC Childrens Specialists
  • and MORE 
  • *This listing is subject to change without notice due to contracts between the provider's office and Delta Health Systems.  Always verify if your provider's office is "in-network"
This health plan gives you the flexibility to choose your doctor and other healthcare professionals, specialists and facilities that are from the list of providers in the ANTHEM SELECT PPO NETWORK (only).  
 
This is a "No referral specialists care" plan that allows you to see any provider or specialist without a referral as long as the provider participates in the EPO (Anthem Select PPO) Network!  Pre-certification may be necessary for hospitalizations and certain types of outpatient care.   You are your own personal health advocate and are not assigned to a PCP.  You have the freedom to choose your own in-network personal doctor or doctors to help coordinate your care.  However, if you choose to see a provider that is not in the network, your care will not be covered except in emergencies and you will be responsible for 100% of the cost.  
 
Please, be sure to verify and confirm that the doctor or specialist that you wish to see, is in fact in-network by calling Delta Health Systems directly at (866) 268-2480 or visiting www.anthem.com/ca to research participating providers.  Refer to "How to Find an EPO Provider"
 
This plan has a calendar year deductible of $100 for individual and $300 for family.  Please review the RUSD EPO Plan Summary of Benefits for more information.
 
 

 

RUSD HDHP EPO MEDICAL PLAN - Available in CALIFORNIA ONLY 

*Anthem Select PPO Network* 

The RUSD HDHP EPO (High Deductible Health Plan Exclusive Provider Organization) Plan, administered by Delta Health Systems offers members access to medical care through a number of medical groups "in-network" throughout CALIFORNIA (please refer to list above). 

This health plan gives you the flexibility to choose your doctor and other healthcare professionals, specialists and facilities that are from the list of providers in the ANTHEM SELECT PPO NETWORK (only).  
 
Please, be sure to verify and confirm that the doctor or specialist that you wish to see, is in fact in-network by calling Delta Health Systems directly at (866) 268-2480 or visiting www.anthem.com/ca to research participating providers.  Refer to "How to Find an EPO Provider"
 
While this plan offers the EXACT same benefits and coverage as the RUSD EPO plan, the MAIN difference and most notable is that this plan has a calendar year deductible of $2,500 for individual and $2,500 for family. This plan is meant to provide employees at 70% employment, an opportunity to enroll in an affordable health plan.  Please be sure to recognize the high deductible on this plan and make the best decision for you and your family.  
 
Please review the RUSD HDHP EPO Plan Summary of Benefits for more information and contact your Benefits Department if you have any questions.
 


RUSD PPO MEDICAL PLAN - Nationwide Coverage (If obtaining services outside of California, Out-of-network Coverage Available ONLY )

 *Anthem Blue Cross PPO (Prudent Buyer) Network*
 
The RUSD PPO (Preferred Provider Organization) Plan, administered by Delta Health Systems offers members access to medical care through any recognized provider or hospital.  Each time you need care under one of the RUSD PPO Plans you can choose the doctors, specialists and other health professionals and facilities from the providers in the Anthem Blue Cross PPO (Prudent Buyer) Network to ensure the least out-of pocket expenses. Unlike, the EPO Plans, the PPO plans allow you the freedom to visit doctors or use facilities that are not part of the PPO network and still receive a benefit.  However, your costs will be higher and you may need to file a claim.
 
This is a "No referral specialists care" plan that allows you to see any provider or specialist without a referral! Pre-certification may be necessary for hospitalizations and certain types of outpatient care.   You are your own personal health advocate and are not assigned to a Primary Care Provider/Physician (PCP).  You have the freedom to choose your own in-network and out-of-network personal doctor or doctors to help coordinate your care.  Again, if you choose to see a provider that is not in the network, your out-of-pocket costs will be higher and you may need to file a claim.
 
For more information on coverage or plan information, please contact Delta Health Systems at (866) 268-2480 or visit www.anthem.com/ca to research participating providers. Instructions on "How to Find a PPO Provider
 
This plan has a calendar year deductible for "In-Network" of $300 for individual and $600 for family and "Out-of-Network" of $500 for individual and $1,000 for family.  
 
Please review the RUSD PPO Plan Summary of Benefits for more information.

 

RUSD HDHP PPO MEDICAL PLANNationwide Coverage (If obtaining services outside of California, Out-of-network Coverage Available ONLY )

*Anthem Blue Cross PPO (Prudent Buyer) Network* 

The RUSD HDHP PPO (High Deductible Preferred Provider Organization) Plan, administered by Delta Health Systems offers members access to medical care through any recognized provider or hospital.  Each time you need care under one of the RUSD PPO Plans you can choose the doctors, specialists and other health professionals and facilities from the providers in the Anthem Blue Cross PPO (Prudent Buyer) Network to ensure the least out-of pocket expenses. Unlike, the EPO Plans, the PPO plans allow you the freedom to visit doctors or use facilities that are not part of the PPO network and still receive a benefit.  However, your costs will be higher and you may need to file a claim.

How is the HDHP PPO Plan Different?  By introducing a high deductible for hospital and outpatient services, this plan maintains a very comprehensive coverage and same access to providers as the PPO plan but at a more affordable cost.  This plan offers the EXACT same benefits and coverage as the RUSD PPO Plan, the MAIN difference and most notable is that this plan has a calendar year deductible for "In-Network" of $2,500 for individual and $4,000 for family and "Out-of-Network" of $4,000 for individual and $6,000 for family.
 
For more information on coverage or plan information, please contact  Delta Health Systems at (866) 268-2480 or visit www.anthem.com/ca to research participating providers. Instructions on "How to Find a PPO Provider
 
Please review the RUSD HDHP PPO Plan Summary of Benefits for more information and contact your Benefits Department if you have any questions.
 

KAISER HMO MEDICAL PLAN - Available in Southern California Region ONLY 

The Kaiser HMO (Health Maintenance Organization) Plan offers members access to medical care through Kaiser Permanente physicians and hospitals.  The Services described herein are covered only if the Services are medically necessary and are provided, prescribed, authorized or directed by a Kaiser Plan Physician.  You must receive the Services from Plan Providers inside our Southern California Region Service Area (your home region), except where specifically noted to the contrary in the Evidence of Coverage (EOC) for authorized referrals, hospice care, Emergency Services, Post-Stabilization Care, Out-of-Area Urgent Care and emergency ambulance Services.
 
This plan does not have a calendar year deductible for individual or family.
 
Please review the Kaiser HMO Plan Summary of Benefits for more information or Explanation of Benefits.
 
 
KAISER TELEPHONE APPOINTMENTS NOW AVAILABLE:  Click HERE for more information
 
 

VISION PLAN BENEFITS

Vision plan benefits are offered to employees who enroll in the RUSD Health Plans or Kaiser HMO medical plan.  You may not enroll in a vision plan separately or independently from the health plan.  The plans outlined below are included in the medical plans offered by the District. 
 

VSP VISION SERVICES - Available for RUSD Health Plan Members ONLY

VSP Vision coverage is included and available to members who enroll in one of the four RUSD Medical Plan options listed above.  This PPO vision plan is a "Non-Referral" based benefit that allows members the most flexibility when choosing their provider. WellVision Exams are included for a $10 co-pay every 12 months and up to $150 allowance on select frames and lenses.  
 
For more information please see VSP Benefit Coverage .  This vision plan is not available to "purchase" separately.  You MUST enroll in one of the four RUSD Medical Plans (EPO, PPO, and HDHPs) to access this benefit coverage.

VISION ESSENTIALS by Kaiser Permanente (Available to Kaiser Members ONLY)

Vision coverage through Vision Essentials by Kaiser Permanente is included and available to members who enroll in the Kaiser HMO medical plan.  Routine vision exams are covered at no cost to the member.  If you receive a prescription for eyewear and you are a Certificated or Management employee you are eligible  for a $100 eyewear (glasses OR contacts) allowance every 24 months at your Kaiser facility.  
 
NOTE:  Classified employees do not receive the eyewear allowance on this plan.  Classified employees receive the vision exam and are 100% responsible for out of cost expenses for frames or lenses. 
 
For coverage information, contact Member Services Contact Center at (800) 464-4000, option 4 or register at www.kp.org

 2017 EMPLOYEE BENEFITS GUIDE

For more detailed information regarding health and wellness plans available, please view our online Employee Benefits Guide.
 
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