Our Plans

Ameritas

A division of Ameritas Life Insurance Corp., Ameritas 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.

Dentist

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

Need to find a dentist lets you quickly verify patient benefits, view dental and/or orthodontic claims, confirm payment amounts and check dates for processed claims.

• 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.

Anthem Blue Cross

Our plans offer choices and meet Affordable Care Act requirements.

Anthem, Inc. is one of the largest health benefits companies in the United States. Through its affiliated health plans, Anthem companies deliver a number of leading health benefit solutions through a broad portfolio of integrated health care plans and related services, along with a wide range of specialty products such as life and disability insurance benefits, dental, vision, behavioral health benefit services, as well as long term care insurance and flexible spending accounts. With local service and the value of the Blue Cross brand, we have been committed to ensuring our members have access to affordable health benefits for over 80 years.

Our Anthem portfolio of plans, including HMO, PPO, EPO and CDHP/PPO, are designed to be the best health care value in our industry. All plans meet federal and state compliance laws, manage total cost of care through network, clinical and product design solutions, and provide choice in flexibility. This means CaliforniaChoice® customers receive essential health benefits (EHBs) including:

• medical
• pharmacy
• pediatric vision coverage
• pediatric dental coverage
• emergency care
• hospital stays
• maternity and newborn care
• prescription drugs
• preventive care

as well as other features needed to comply with the Affordable Care Act (ACA).

• All Anthem plans provide you with access to one of California's best provider networks: Select PPO, Prudent Buyer PPO, Full HMO and Select HMO.
• Access to an extensive retail pharmacy network of more than 66,000 pharmacies across the country, including most major chains as well as many independent neighborhood pharmacies.

Get the most out of your health plan! All Anthem Blue Cross members are encouraged to register for our website, www.anthem.com/ca or download our new digital platform, Syndey Health, on your device. You'll be able to:

• View your benefits and deductibles
• Use our Find a Doctor search tool
• Find out the estimated cost for procedures (must be logged in)
• Check the price of a medicine
• Request a new ID Card or print a temporary one
• Download your plan document - COI (PPO) or an EOC (HMO) (must be logged in)
• Check out our health and wellness support selection
• Access our glossary to help you understand terminology
• And so much more!

Don't forget to download our mobile app - available for Androids and Apple phones.

• Blue View Vision - Adult routine eye exams are covered in all plans to maintain eye health.
• 24/7 NurseLine^SM - speak to a registered nurse for general health questions.
• Condition Care - personal support and 24/7 access to health professionals for members with chronic conditions.
• MyHealth Advantage - Get reminders about screenings, tests and programs to help you stay healthy; find cost saving tips and more.
• Behavioral Health support - offers immediate mental health care and information.
• LiveHealth Online - see a doctor 24/7, 365 days a year from their home or office. Register at www.livehealthonline.com and download the mobile app.
• Employee Assistance Program with myStrength - Help with everyday life issues, plus extra emotional support through myStrength and three no-cost LiveHealth Online counseling visits.
• Future Moms - Receive free breastfeeding support at LiveHealth Online.

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.

Dentegra Smile Club

With Dentegra Smile Club, you can access sweet discounts whenever you visit the dentist.

EyeMed (provided by Ameritas)

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.

Cigna + Oscar

Cigna + Oscar is designed to work for small businesses like yours. We’re bringing together the power of Cigna's nationwide and local provider networks, and Oscar’s member-focused experience, to deliver small group health insurance that understands the unique needs of small businesses and their employees. We’re here to provide affordable care that works for your team, and insurance that cares for your business.

Our small group portfolio of EPO plans range across metal tiers, and feature varying balances of copay-based and coinsurance-based benefits to meet all employee needs.

All carriers have networks, benefits and rates (see ours below) but the Cigna + Oscar difference is centered around the member experience with plan features like:

• $0 Copay, Unlimited Virtual Urgent Care, available 24/7: With the Oscar app, employees can talk to a doctor from the comfort of their home or on the go.
• Easy prescriptions: Your clients will save on prescriptions with Express Scripts and can refill them right from their phones.
• Help with finding affordable care: Employees get a personalized team of care guides dedicated to helping employees find the right doctors and care in their neighborhood.

• We save you money on premiums: our pricing is on par with comparable HMO plans, and on average 5-10% less expensive than comparable PPO plans.
• You can see any in-network specialist directly—no referrals required! All of our plans are EPOs, which means you do not need to choose a primary care physician (PCP) as a gatekeeper to your network.

All Cigna + Oscar members get full access to Cigna’s LocalPlus® network, a locally designed network of doctors, specialists, and hospitals that offer cost-effective medical care without sacrificing the quality employees expect.

• Access popular health systems like UCSF, Stanford, John Muir, Dignity Health, Scripps, and more!
• It's easy to find doctors and drugs in-network by using our Doctors and Drugs tool.

Health Net

When it comes to health, experience matters. For over 40 years, we’ve been part of the local California community, helping individuals and families get the health care they need through every stage of their lives. We’re here for you, helping you stay healthy and get well with health plan choices that are comprehensive, affordable and easy to use.

Kaiser Permanente

What began 70 years ago as an innovative health care program for shipyard and steel mill workers has become the model for health care in the 21st century. Serving 11.8 million members in 8 states and the District of Columbia, Kaiser Permanente is the convenient, affordable health plan you can rely on to keep your employees and their families healthy and engaged. From preventive care that catches health problems early to specialty care for illnesses and injuries, we’ve got your employees covered.

Here for you in California

Founded in California in 1945, and now headquartered in Oakland, Kaiser Permanente currently serves 8.5 million members in the state — with nearly 16,000 doctors at over 450 medical offices and 36 hospitals.

Affordable options to meet your needs

Our plans are priced with your business in mind. In fact, Kaiser Permanente was rated the most cost-efficient plan in California.¹ And you have 14 group plans to choose from, including:

• Copayment HMO plans
• Deductible HMO plans
• HRA and HSA-qualified plans

Dedicated to excellence

As new members, your employees can browse our online doctor profiles to choose a personal doctor based on factors that are important to them — and they can change doctors anytime. And when members register on kp.org, they can enjoy easy-to-use, customized features like being able to:

• Email their doctor’s office with questions
• Order most prescription refills for delivery at no cost
• Schedule and cancel appointments
• View their medical history and lab results
• Get cost estimates and pay bills online

Members also have 24/7 access to care by phone, including help determining what level of care they may need.

Shaping the future of health care

We’re continually advancing patient services through innovation and technology. For example, more than half of member visits now take place through email, phone, and video — which removes barriers like distance, traffic, and busy schedules that may keep your employees from getting the care they need.

Kaiser Permanente was also an early adopter of electronic health records, and now operates one of the nation’s largest private electronic health record systems. This allows us to gather patient data that identifies trends and gaps in care, which can translate into better health outcomes for your employees.

Choose Kaiser Permanente and experience the difference. Learn more at kp.org/choosebetter.

¹ Aon Hewitt Health Value Initiative™ benchmarking study — Kaiser Foundation Health Plan, Inc., Aon Hewitt, October 12, 2016.

² Kaiser Permanente 2016 HEDIS® scores. Benchmarks provided by the National Committee for Quality Assurance (NCQA) Quality Compass® and represent all lines of business.

³ America’s Hospitals: Improving Quality and Safety, The Joint Commission’s Annual Report 2015, The Joint Commission.

⁴ Kaiser Permanente 2016 Annual Report.

MetLife/SmileSaver

Dental HMO Plans:

• MET100
• MET185
• SmileSaver1000
• SmileSaver3000

The MetLife DHMO plans provide access to a large network of dental providers throughout California. Preventive dental care is an important part of overall health and MetLife is committed to ensuring that its members receive a high level of dental care. 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.

Oscar

Hi, we're Oscar.

Oscar Health is the country’s first technology-driven health insurer focused on improving the member experience through easy, personalized service. Oscar for Business was launched to bring the same Oscar experience that individuals already love to the employer market.

We offer health coverage to small businesses located in Los Angeles and Orange County.

Our small group portfolio of 13 EPO plans range across metal tiers, and feature varying balances of copay-based and coinsurance-based benefits to meet all employee needs.

Our EPO plans combine the flexibility of a PPO with the affordability of an HMO.

• We save you money on premiums: our pricing is on par with comparable HMO plans, and on average 20% less expensive than comparable PPO plans.
• We give you control over your health care: all of our plans are EPOs, which means you do not need to choose a primary care physician (PCP) as a gatekeeper to your network. You can see any in-network specialist directly—no referrals required!

All Oscar members get full access to our network of top-tier providers.

• Our network includes top health systems like UCLA, USC Keck, Hoag, Huntington, and others—in fact, we have 4 of LA’s top 5 hospitals (as ranked by US News & Reports 2018) in-network!
• It’s easy to find doctors and drugs in-network by using our Doctors and Drugs tool.

Our customer satisfaction score is 2x the industry average.

We deliver high-value health care, along with an unmatched experience for our members. Here are just a few of our cool features:

• Our unique Care Team service model reinvents customer service with a personalized team of care guides and a nurse. Each member is assigned to one Care team (that means you talk to the same folks every time!). See a video demo here.
• Virtual Urgent Care: Our telemedicine offering is unlimited across all plans. You can speak to a board-certified physician within 15 minutes—24/7. All plans offer telemedicine at a $0 Copay. See a video demo here.
• The Oscar app: Members can manage virtually every part of their health care in our industry-leading Oscar app. You can find doctors, get Virtual Urgent Care, access your digital Member ID card, message your Care team, see prescriptions and lab results, track your deductible, and more. See it for yourself here.

Want to learn more about what sets Oscar apart? Visit us at hioscar.com

Sharp Health Plan

Sharp Health Plan is a not-for-profit, locally based health plan that offers San Diegans of all ages access to high quality and affordable health insurance through their individual and family plans, commercial group plans, and Medicare plans. Sharp Health Plan continues to be recognized in California and nationally for their high-quality care and service. They are the highest member-rated health plan in California, and they also hold the highest member ratings for health care, personal doctor and specialist among reporting California health plans.¹ As part of Sharp HealthCare’s integrated delivery system, Sharp Health Plan directly connects members to an expansive network of nationally recognized doctors, elite-rated medical groups and hospitals.

Sharp Health Plan delivers The Sharp Experience from health insurance to health care, making it easy for members to access the care they need, when they need it. Members enjoy the added benefit of their after-hours nurse advice line, Sharp Nurse Connection®, their Emergency Travel Services for assistance with emergency services nationally or abroad, and access to MinuteClinic®, the walk-in clinics inside select CVS Pharmacy® stores. Members also enjoy free access to Sharp Health Plan’s nationally accredited Best Health® wellness program, which allows members to become and stay their healthiest through personal health assessments, one-on-one health coaching, educational classes and more. For additional information please visit sharphealthplan.com or call Customer Care toll-free at 1-800-359-2002.

¹ The source for this data is Quality Compass® 2019 and is used with the permission of the National Committee for Quality Assurance (NCQA). Quality Compass® 2019 includes certain CAHPS® data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass® is a registered trademark of NCQA. CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). Sharp Health Plan achieved the following summary ratings (9+10): 57.30 for Rating of the Health Plan compared to the California all LOBs average (excluding PPOs & EPOs) of 47.23; 65.25 for Rating of Health Care compared to the California all LOBs average (excluding PPOs & EPOs) of 51.87; 74.47 for Rating of Personal Doctor compared to the California all LOBs average (excluding PPOs & EPOs) of 65.60 and 75.68 for Rating of Specialist compared to the California all LOBs average (excluding PPOs & EPOs) of 63.50.

Sutter Health Plus

Sutter Health Plus, a local not-for-profit HMO, offers health plans that give you access to a network of high-quality health care providers, including many of Sutter Health's affiliated hospitals, doctors and health care services. Here, providers work together to deliver safe, personal and accessible care.

We offer traditional and deductible plan designs, including high-deductible health plans that are compatible with HSAs.

Our affordably priced health plans give you and your family access to:

• An integrated network of high-quality local providers and hospitals
• Comprehensive medical benefits
• Same-day care with Sutter Walk-In Care and video visits with your primary care physician or another Sutter provider
• A 24/7 nurse advice line
• Health coaching and disease management programs
• Preventive care services at no additional out-of-pocket cost
• Coverage for urgent and emergency care anywhere in the world
• A secure member portal to access eligibility, benefits, copays, claims, member identification cards, and more
• Health and Wellness site, including a personal health assessment
• My Health Online (offered by select providers) to schedule appointments, email doctors, view test results and access your records

UnitedHealthcare

UnitedHealthcare of California is committed to providing quality coverage and affordable benefits to help keep you and your family healthy. Our plans offer more than just doctor visits; preventive care services are also provided for every member of the family.

Plans designed to be cost-effective

• UnitedHealthcare Signature¹ - The Signature plan includes our full network of contracted providers. With this HMO plan, members simply choose a primary care physician (PCP) from our full network of contracted providers to coordinate all their medical care. They can then visit their PCP for routine checkups, and when they need to see a specialist, their PCP provides a referral. Members are charged only a copayment for each doctor’s visit. Preventive care, including checkups, is covered.
• UnitedHealthcare Advantage¹ - The Advantage plan offers the same level of benefit coverage as a traditional HMO plan at a lower premium. The difference is in the network. The Advantage plan offers a narrower network of contracted providers. Members must choose a PCP from the Advantage network to coordinate all their medical care.
• UnitedHealthcare Alliance¹ - Designed with affordability and quality in mind, the Alliance plan puts members at the center of a “patient-centered care” experience to promote better outcomes and lower costs. Upon enrollment, members select a PCP to coordinate their care throughout a network of well-recognized physicians and facilities selected based on a track record of practicing evidence-based medicine and keeping costs in check. Alliance physicians are committed to using and sharing de-identified health data to advance best practices and help deliver better care, every step of the way.
• UnitedHealthcare Harmony¹ - offers a performance network with a more integrated physician-driven care experience, supported by shared data, and streamlined processes. Member can choose from a selection of physicians and hospitals within the following Southern California counties: Los Angeles, Orange, Riverside, San Bernardino, and parts of San Diego.

Choose from a large California HMO network.

Our Signature plan offers access to a full network of contracted providers with more than 62,590 physicians and health care professionals, and 273 hospitals. The Advantage, Alliance and Harmony plans offer the same level of benefit coverage as our Signature plan but has a narrower network of contracted providers. You can find listings for physicians and hospitals in our provider directories.

Extra programs and services at no additional cost.

You'll get access to programs and services that help you get and stay healthy - at no extra cost.

• Rally - This online health and wellness tool on myuhc.com® uses a fun, interactive experience to help engage and energize members about getting and staying healthier. Every time members visit Rally, they’ll earn Rally Coins, which can be used for a chance to win great things. They can also use the tool to track their personal health record and connect with others online that have similar goals.
• Advocate4Me® - Delivering a proactive, highly personalized experience. UnitedHealthcare makes it easier for individuals to make informed health care choices and get the most out of their benefits. And, for employers, we help you better manage costs. Our advocacy is built on a foundation of robust data and insights that:
  • Offers proactive, personal guidance.
  • Simplifies the benefits experience.
  • Provides access to quality care.
• Virtual Visits - Let's employees and their covered family members see and speak to a doctor 24 hours a day, 7 days a week using a mobile device** or computer, wherever they are. If needed, a prescription*** can be sent to their local pharmacy. No appointment is necessary—and usually takes less than 20 minutes. Costs are similar to a typical copay and much less than the usual cost of urgent care.
  
  Virtual Visits are fully integrated with the benefit plan administered by UnitedHealthcare and provided at no additional administrative cost to the employer.
• myuhc.com^® Member Website - Gives Select Plus, Core, Consumer-driven Health and Non-Differential PPO members a single site that has just about all they need to get the most out of their plan benefits. myuhc.com provides free, 24/7 access to online tools members use to:
  • Check current and past claim status.
  • Review benefits and coverage.
  • Find network doctors and hospitals.
  
  myuhc.com® also provides customized information and articles on hundreds of health-related topics.

With a mix of benefits that deliver patient-centered care, health and wellness programs and award-winning customer service, UnitedHealthcare is a smart choice for your family's health care coverage needs.

¹ Formal HMO product names:

Signature = UnitedHealthcare SignatureValue^TM

Advantage = UnitedHealthcare SignatureValue Advantage

Alliance = UnitedHealthcare SignatureValue Alliance

Harmony = UnitedHealthcare SignatureValue Harmony

Health plan coverage provided by or through UnitedHealthcare Insurance Company and UnitedHealthcare of California. Administrative services provided by United Healthcare Services, Inc., OptumRx or OptumHealth Care Solutions, Inc. Behavioral health products are provided by U.S. Behavioral Health Plan, California (USBHPC) or United Behavioral Health (UBH).

VSP (provided by Ameritas)

VSP (provided by Ameritas) is dedicated to offering affordable, high-quality eye care plans that promote visual wellness and improve their member's quality of life. As the nation's largest provider of eye care coverage, thousands of companies rely on VSP to provide a range of vision plans.

VSP provides coverage to more than 70 million members nationwide. Their provider network includes more than 25,000 doctors in 19,000 offices around the country. Whether their members live in cities, suburbs or rural areas, their doctors are nearby - an average of only four miles from where our members live and work.

Western Health Advantage

Western Health Advantage Benefits Overview

• Affordable coverage with many choices
• A network of thousands of local, trusted doctors and specialists
• Responsive customer service staffed by local, real people
• MyWHA Wellness program with online health and wellness tools
• Discounts on gym memberships
• Nurse24 advice line with registered nurses 24/7
• Worldwide urgent and emergency coverage with Assist America

We care about you

We have a passion for health care. WHA is all about helping people obtain quality health care. We also support medical innovation and promote whole-person health to suit the various needs of the communities we serve. WHA offers affordable coverage to employer groups, individuals and families, for every stage of life. We are here to help you stay healthy and facilitate the care you need when you need it.

We're proud of our reputation

For 23 years and counting, we’ve been a reliable partner in your community. We are known for acting with integrity and for interacting honestly with our partners, while building a relationship of trust. We support the doctor-patient relationship and offer access to quality doctors and hospitals.

We love being local

WHA prides itself in being the choice of thousands. Your community is our community. We strengthen our neighborhoods and enrich the lives of community members by supporting local organizations. We affect positive change in our community through charitable outreach and volunteer efforts. Supporting the communities where we live and work is one of WHA’s core values.

We're always here for you

We build long-term, personal relationships because we’re easy to work with, reliable and innovative. The mission of our local service team is to provide exceptional service to our members, providers and partners. You can easily reach us in person or on the phone. We’re responsive and make decisions without delay.

As a 501(c)(4) community benefit, non-profit health plan created by local doctors and hospitals, Western Health Advantage’s HMO network includes major hospitals and medical centers and thousands of local, trusted doctors and specialists from Mercy/Dignity Health, NorthBay Healthcare, Hill Physicians, Meritage Medical Network, St. Joseph Health Medical Network and Woodland Clinic Medical Group. WHA offers affordable, quality health care to its neighbors in Sacramento, El Dorado, Placer, Yolo, Colusa, Solano, Napa, Sonoma and Marin counties.

FACILITIES BY COUNTY

Marin County

• Marin Health Medical Center

Napa County

• Queen of the Valley Medical Center

Sacramento County

• Mercy Hospital of Folsom
• Mercy General Hospital
• Methodist Hospital
• Mercy San Juan Medical Center
• Woodland Memorial Hospital

Solano County

• NorthBay Medical Center
• NorthBay VacaValley Hospital

Sonoma County

• Healdsburg District Hospital
• Petaluma Valley Hospital
• Santa Rosa Memorial Hospital
• Sonoma Valley Hospital

Yolo County

• Woodland Memorial Hospital

MEDICAL GROUPS

• Hill Physicians
• Mercy Medical Group
• Meritage Medical Network
• NorthBay Healthcare
• St. Joseph Health Medical Network
• Woodland Clinic

OUR SERVICE AREA

Serves employers and individuals in Napa, Placer, Sacramento, Solano, Sonoma, Marin and Yolo counties and parts of Colusa and El Dorado counties.