a guide to choosing your anthem blue cross health plan...a guide to choosing your anthem blue cross...

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This guide is information only. You must enroll to be covered. 03429CAMENABC 02/15 37083MUMENMUB REV 01/14 A guide to choosing your Anthem Blue Cross health plan REEP 2016/2017 Benef t Enrollment Kit i Anthem Elements Choice PPO

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This guide is information only. You must enroll to be covered. 03429CAMENABC 02/15 37083MUMENMUB REV 01/14

A guide to choosing your Anthem Blue Cross health plan REEP 2016/2017 Benef t Enrollment Kit iAnthem Elements Choice PPO

An Anthem Blue Cross ID card means something It means you have access to quality care from quality doctors. It means you can always

get your questions answered. It means you have our support before you ever need

health care. And that’s what this guide is for. We want you to have everything you need

to make a good decision.

3 What you pay

What we pay

How most health plans work

1 2 3

Deductible Out-of-pocket limit

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Getting started with health insurance Let's start with how health insurance works in general

1. You pay your deductible. This is a set amount that you pay before your plan starts paying for covered services. If your plan has copays (f at fees like $30 for each visit)l along with a deductible, you only need to pay the copay for most doctor visits.

2. After you meet your deductible, you and your plan share the cost of covered services. You pay a copay or coinsurance (a percentage of the cost) each time you get care. Your insurance covers the rest.

3. You’re protected by your plan’s out-of pocket limit. That’s the most you pay for covered health services each year. With some plans, you still have copays even after you reach your out-of-pocket limit.

What about the money for health insurance that gets deducted from your paycheck? That’s your premium. Think of it like a membership fee. It’s separate from what you pay when you get care.

Remember, this chart is only an example. Your actual costs will depend on the type of plan you choose, the service you get and the doctor. To see your actual costs, please refer to your plan information.

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A health plan that works for you Invest in your health with the right health plan.

The doctors, hospitals and other health care providers in our network have agreed to charge lower rates for our members.

Our Anthem ID card means I can choose my child's doctor.

PPO

This plan covers services from almost any doctor or hospital, but you get a discount if you use a provider from the Preferred Provider Organization (PPO) network. You pay more if you go to a doctor who’s not in the PPO network. You don’t usually need a referral from your main doctor, also called a primary care doctor, to see a specialist.

Some PPO plans may have different rules. So be sure to check your plan details.

Can I keep my current doctor?

Yes, you can. But keep in mind that you get the most out of your benef ts if you choose a doctor in your plan. Some plans coveri only services from doctors in your plan, which means you pay for the full cost if you see a doctor outside of the plan. Other plans cover services from doctors outside the plan — but your plan pays more of the cost when you see a doctor in your plan. Be sure to check the details of your plan.

To f nd out if your doctor is in the plan, or to f nd a new doctor inii the plan, go to our Find a Doctor tool on anthem.com/ca. You can search by specialty and check a doctor’s training, certif cations and member reviews. Be ready to enter your plani name to view the doctors that serve your plan. You can also use Find a Doctor on your smartphone.

How do I use my health plan when I need care?

After you enroll, your member ID card will come in the mail. Be sure to bring it with you to the doctor. You can also show a copy of your ID card from the Anthem mobile app.

Is preventive care covered?

Yes, preventive care from a doctor in the plan is covered at 100%. It’s very important to take care of your health with regular checkups even when you feel f ne. So talk to your doctor abouti screenings and immunizations that you may need to protect your health.

Can I manage my health care on the Web?

Yes. As soon as you become a member, you’ll be able to register at anthem.com/ca. It’s designed to help you manage your health care and your coverage simply and conveniently. Many of our members f nd these self-service tools helpful: i

Check on your claims.

Find a doctor.

Track your health care spending.

Compare quality and costs at hospitals and other facilities.

Download the free anthem.com/ca mobile app so you can manage your health care on the go!

Visit anthem.com/ca/guidedtour to watch a video explaining how our website can help you.

Do I have health and wellness benef ts with my plan? i

Yes. In fact, we have a set of tools and resources that can help you reach your health goals. They can also save you money on products and services for your health. Just go to anthem.com/ca and click the Health & Wellness tab. Once you’re a member, you can log in and see more.

Check out these health and wellness programs your employer is providing in addition to your health insurance benef ts: i

24/7 NurseLine — Our registered nurses can answer your health questions wherever you are — any time, day or night.

Future Moms — Moms-to-be get personalized support and guidance from registered nurses to help them have a healthy pregnancy, a safe delivery and a healthy baby.

ConditionCare — Get the added support you may need if you have asthma, diabetes, heart disease, chronic obstructive pulmonary disease or heart failure. A nurse coach can answer questions about your health and help you reach your health goals based on your doctor’s care plan. You can work with dietitians, health educators, pharmacists and social workers to reach those goals and feel your best.

MyHealth Coach — Get one-on-one professional advice from an experienced health coach for yourself or your family. Topics range from general wellness information to more serious issues like a chronic illness or help with medications.

How can my plan help me save money?

You'll save money every time you go to a doctor in your plan -- they've agreed to charge lower rates for Anthem members. But we'll also help save you money before you go to the doctor.

At anthem.com/ca, you can compare how much a medical procedure will cost at different locations. Plus, all members get discounts on health-related products. You can even print your own coupons for healthier groceries.

Frequently asked questions (FAQs)

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Frequently asked questions (FAQs)

You can register at anthem.com/ca — your simple and convenient solution to managing your health

Your plan details In this next section, you’ll f nd more information about your plan. i

Modified Anthem Elements Choice PPO 5900 Effective 07.01.16 This Summary of Benefits is a brief overview of your plan's benefits only. For more detailed information about the benefits in your plan, please refer to your Certificate of Insurance or Evidence of Coverage (EOC), which explains the full range of covered services, as well as any exclusions and limitations for your plan. In addition to dollar and percentage copays, members are responsible for deductibles, as described below. Please review the deductible information to know if a deductible applies to a specific covered service. Certain Covered Services have maximum visit and/or day limits per year. The number of visits and/or days allowed for these services will begin accumulating on the first visit and/or day, regardless of whether your Deductible has been met. Members are also responsible for all costs over the plan maximums. Plan maximums and other important information appear in italics. Benefits are subject to all terms, conditions, limitations, and exclusions of the Policy. Subject to Utilization Review Certain services are subject to the utilization review program. Before scheduling services, the member must make sure utilization review is obtained. If utilization review is not obtained, benefits may be reduced or not paid, according to the plan. Explanation of Maximum Allowed Amount Maximum Allowed Amount is the total reimbursement payable under the plan for covered services received from Participating and Non-Participating Providers. It is the payment towards the services billed by a provider combined with any applicable deductible, copayment or coinsurance. PPO Providers—The rate the provider has agreed to accept as reimbursement for covered services. Members are not responsible for the difference between the provider's usual charges & the maximum allowed amount. Non-PPO Providers—For non-emergency care, reimbursement amount is based on: an Anthem Blue Cross rate or fee schedule, a rate negotiated with the provider, information from a third party vendor, or billed charges. Members are responsible for the difference between the provider's usual charges & the maximum allowed amount. For Medical Emergency care rendered by a Non-Participating Provider or Non-Contracting Hospital, reimbursement is based on the reasonable and customary value. Members may be responsible for any amount in excess of the reasonable and customary value. When using Non-PPO and Other Health Care Providers, members are responsible for any difference between the covered expense & actual charges, as well as any deductible & percentage copay. Calendar Year Deductible (no cross application)

PPO Providers & Other Health Care Providers $5,900/member; $11,800/family Non-PPO Providers

$11,800/member; $23,600/family

Additional copay for non-Anthem Blue Cross PPO hospital or residential treatment center if utilization review not obtained

$500/admission (waived for emergency admission)

Office Visit* Services with an asterisk have a $35 copay/visit with deductible waived for the first 3 visits for all services combined. After 3 visits, then deductible applies.

Annual Out-of-Pocket Maximums (no cross application) PPO Providers & Other Health Care Providers $6,100/member; $12,200/family Non-PPO Providers $12,700/member; $25,400/family The following do not apply to out-of-pocket maximums: non-covered expense. After a member reaches the out-of-pocket maximum, the member remains responsible; costs in excess of the covered expense. Lifetime Maximum Unlimited

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Covered Services PPO: Per Member Copay Non-PPO: Per Member Copay †

Preventive Care Services Preventive Care Services including*, physical exams, preventive screenings (including screenings for cancer, HPV, diabetes, cholesterol, blood pressure, hearing and vision, immunizations, health education, intervention services, HIV testing), and additional preventive care for women provided for in the guidelines supported by the Health Resources and Services Administration. *This list is not exhaustive. This benefit includes all Preventive Care Services required by federal and state law.

No copay (deductible waived)

50%

Physician Medical Services Office & home visits (includes retail health clinic

& online visit) ‡ No copay * 50%

Specialist office visits ‡ No copay * 50% Hospital & skilled nursing facility visits No copay 50% Surgeon & surgical assistant; anesthesiologist or

anesthetist No copay 50%

Drugs administered by a medical provider (certain drugs are subject to utilization review)

No copay 50%

Diabetes Education Programs Physician office visits ‡ No copay *

50%

Specialist office visits ‡ No copay * 50% Physical Therapy, Physical Medicine & Occupational Therapy, including Chiropractic Services (limited to 24 visits/calendar year; additional visits may be authorized)

No copay * 50%

Speech Therapy No copay 50% Acupuncture Services for the treatment of disease, illness or

injury (limited 12 visits/calendar year) No copay * 50%

Diagnostic X-ray & Lab Other diagnostic x-ray & lab No copay 50% Advanced Imaging (subject to utilization review) No copay 50% (benefit limited to

$800/procedure) Urgent Care (Physician services) ‡ No copay 50% Emergency Care Emergency room services & supplies No copay No copay Physician services No copay No copay

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Covered Services PPO: Per Member Copay Non-PPO: Per Member Copay †

Hospital Medical Services (subject to utilization review for inpatient and certain outpatient services; waived for emergency admissions)

Semi-private or private room, medically necessary services & supplies

No copay

50%

Outpatient medical care, surgical services & supplies (hospital care other than emergency room care)

No copay

50%

Skilled Nursing Facility (subject to utilization review)

Semi-private room, services & supplies (limited to 100 days/calendar year; limit does not apply to mental health and substance abuse)

No copay 50%

Related Outpatient Medical Services & Supplies Ground or air ambulance transportation, services &

disposable supplies (air ambulance in a non-medical emergency is subject to pre-service review and benefit limited to $50,000 for non-PPO)

No copay In an emergency or with an authorized referral: No copay; Non-emergency: 50%

Blood transfusions, blood processing & the cost of

unreplaced blood & blood products §

20% 20%

Autologous blood (self-donated blood collection, testing, processing & storage for planned surgery)§

20% 20%

Ambulatory Surgical Centers (certain surgeries are subject to utilization review)

Outpatient surgery, services & supplies No copay 50% (benefit limited to $350/admit)

Pregnancy & Maternity Care Physician office visits No copay * 50% Specialist office visits No copay * Prescription drug for abortion (mifepristone) No copay 50% Normal delivery, cesarean section, complications of pregnancy & abortion. Refer to the Physician & Hospital Medical Services benefits for both inpatient and outpatient hospital coverage.

Mental or Nervous Disorders and Substance Abuse Inpatient facility care (subject to utilization review;

waived for emergency admissions) No copay

50%

Inpatient physician visits No copay 50% Outpatient facility care; No copay

50%

Physician office visits (Behavioral Health treatment for Autism or Pervasive Development disorders require pre-service review)

No copay * 50%

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Covered Services PPO: Per Member Copay Non-PPO: Per Member Copay †

Durable Medical Equipment (may be subject to utilization review)

Rental or purchase of DME (hearing aids benefit is available for one hearing aid per ear every three years; breast pump and supplies are covered under preventive care at no charge for in-network)

50% 50%

Home Health Care (subject to utilization review) Services & supplies from a home health agency

(limited to 100 visits/calendar year, one visit by a home health aide equals four hours or less)

No copay 50%

Home Infusion Therapy (subject to utilization review)

Includes medication, ancillary services & supplies; caregiver training & visits by provider to monitor therapy; durable medical equipment; lab services

No copay 50% (benefit limited to $600/day)

Hemodialysis Outpatient hemodialysis services & supplies No copay 50% (benefit limited to

$350/visit)

Hospice Care Inpatient or outpatient services; family bereavement

services No copay 20%

Bariatric Surgery (subject to utilization review; covered only when performed at a Blue Distinction Center for Specialty Care [BDCSC])

Inpatient services provided in connection with medically necessary surgery for weight loss, only for morbid obesity

No copay

Not coveredƒ

Travel expenses for an authorized, specified surgery (recipient & companion transportation limited to $3,000 per surgery)

No copay (deductible waived)

Not coveredƒ

Organ & Tissue Transplants (subject to utilization review; specified transplants covered only when performed at Centers of Medical Excellence [CME] and Blue Distinction Centers for Specialty Care [BDCSC] for California; Blue Distinction Centers for Specialty Care [BDCSC] for out of California)

Inpatient services provided in connection with non-investigative organ or tissue transplants

No copay

Not coveredƒ

Transplant travel expense for an authorized, specified transplant (recipient & companion transportation limited to $10,000 per transplant)

No copay (deductible waived)

Not coveredƒ

Unrelated donor search, limited to $30,000 per transplant

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Covered Services PPO: Per Member Copay Non-PPO: Per Member Copay †

Prosthetic Devices Coverage for breast prostheses; prosthetic devices

to restore a method of speaking; surgical implants; artificial limbs or eyes; the first pair of contact lenses or eyeglasses when required as a result of eye surgery; & therapeutic shoes & inserts for members with diabetes

No copay 50%

Outpatient Prescription Drug Benefits Coverage provided by Express Scripts

This Summary of Benefits has been updated to comply with federal and state requirements, including applicable provisions of the recently enacted federal health care reform laws. As we receive additional guidance and clarification on the new health care reform laws from the U.S. Department of Health and Human Services, Department of Labor and Internal Revenue Service, we may be required to make additional changes to this Summary of Benefits. This Summary of Benefits, as updated, is subject to the approval of the California Department of Insurance and the California Department of Managed Health Care (as applicable).

† The percentage copay for non-emergency services from Non-Anthem Blue Cross PPO providers is based on the scheduled amount.

‡ The dollar copay applies only to the visit itself. An additional copay applies for any services performed in office (i.e., X-ray, lab, surgery), after any applicable deductible.

§ These providers are not represented in the PPO network.

ƒ Exception: If service is performed at a Centers of Medical Excellence [CME], the services will be covered same as the PPO (in-network) benefit.

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Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company is an independent licensee of the Blue Cross Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association. anthem.com/ca Anthem Blue Cross/Anthem Blue Cross Life and Health Insurance Company;(EC) Effective 2016-01 Printed 04/2016 REEP Anthem Elements Choice 5900

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Ready to improve your health? Let us help.ConditionCare: health support

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

MCASH1304CSI VPOD Rev. 08/15

Healthier today, better tomorrow

If you have a condition that puts you at risk for future health problems, let us give you the help you need. When you join the ConditionCare program, your physical and mental health may improve. It’s easy to sign up. Just call us toll free at 800-621-2232. The program is additional to your health plan for you and your covered family members.

Our health support programs help with:

Low-back pain.

High cholesterol, high blood pressure and metabolic syndrome.

Arthritis, hip and knee replacement, and osteoporosis.

When you join ConditionCare, you’ll get tools and information to help you manage your condition. And based on your needs, the program also gives you:

Round-the-clock phone access to nurse care managers who can answer your questions and help you cope with your condition.

A health screening and follow-up calls with health professionals, as needed, to help you reach your health goals.

We may call to f nd out if ConditionCare can help you and aski you to sign up. For your protection, we’ll verify your address or date of birth before talking about your health.

Get help managing your condition To learn more or to join ConditionCare, call us toll free at 800-621-2232.

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The numbers speak for themselves!A recent study showed that Future Moms participants are getting the help they need, resulting in:

}} 30% less emergency room visits than those not in the program.2

}} Babies born to Future Moms participants spending 25% less time in the NICU, leading to a 50% reduction in NICU costs.2

Each pregnancy is unique. That’s why Future Moms offers personalized support for pregnant members, starting at the beginning of pregnancy and continuing after birth. Participants get education and coaching to help them make healthier decisions during pregnancy. This keeps them out of the hospital, reduces neonatal intensive care unit (NICU) admissions and helps keeps medical costs down.

Future Moms nurse coaches provide customized support so members understand what’s best for them and their babies. Nurse coaches:

}} Check for risks and manage members based on risk level.

}} Provide case management for high-risk participants.

}} Give moms-to-be information on healthy eating and exercise during pregnancy.

}} Provide prenatal education and information on labor options.

}} Refer members to specialists, such as pharmacists, nutritionists or others, as needed.

}} Help smokers quit, if needed.

}} Screen for depression during and after pregnancy.

}} Answer questions during pregnancy and after the baby’s birth.

Integrate with other plans for a total health solution

Future Moms offers personalized support through birth and beyond

Healthy babies start with healthy moms

90% of participants said the program information and tools helped them manage a healthy pregnancy1

1 Internal Health and Wellness Solutions Member Satisfaction Study, 2014. 2 2013 internal data utilizing 450,000 members.

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

ECASH1289C VPOD Rev. 03/15

Include Future Moms with Anthem Blue Cross behavioral health, disability, dental and vision plans. It’s a smart way to increase member engagement and address the total health care needs of moms-to-be.

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Looking for a doctor?

Here’s all you need to do:

If you’re a member

Or use your ID number or the first three letters to search without logging in.

Under Useful Tools on the right, select Find a Doctor.

If you’re not a member yet

Next, select a type of provider, place or name.

Select Search.

Select a provider to see more information, such as:

}} Training}} Specialties}} Languages spoken}} Address (including a map)}} Phone number

Going mobile

1

2

3

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

00734CAMENABC VPOD 08/15

Finding one online is fast and easy Use our online Find a Doctor tool to look for doctors, hospitals, labs and other health care providers in your Anthem network. Check if your favorite doctor is in the network, or look for one near you. Avoid getting out-of-network care if you can — it will cost you more or your plan may not cover it all.

Go to anthem.com/ca and log in.

Use your mobile device to search for doctors, hospitals and more with our free app from the App StoreSM or Google PlayTM. Just search for Anthem Blue Cross and download the app. You can even get turn-by-turn directions to f nd a doctor’s off ce. ii

*If you don’t know the name of the plan or network, check with your human resources department or benef ts administrator. i

Go to anthem.com/ca.

Under Useful Tools on the right, select Find a Doctor.

First answer a few questions, so we can help f nd iyou the right plan and in-network doctor. Then enter or select the plan/network*.

Next, select a type of provider, place or name. Select Search.

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24/7 NurseLine

Always here for you

Health concerns can happen when you least expect them. You might be on vacation or even on a business trip. Or your child may have a fever in the middle of the night. But there’s somewhere you can turn for help any time of the day or night.

Call the 24/7 NurseLine to talk with a registered nurse about your health concern. Whether it’s a question about allergies, fever, types of preventive care or any other topic, nurses are always there to provide support and peace of mind. And, if you want, a nurse will call you later to see how you’re doing.

Our nurses can help you choose the right place for care if your doctor isn’t available and you aren’t sure what to do. Do you need to head straight to the emergency room? Is urgent care best? Or do you need to see your doctor? Making the right call can save you time and money – and give you access to the best possible care.

Do you speak Spanish or another language other than English? We have Spanish-speaking nurses and translators on call. TTY/TDD services are available, too.

If you’d prefer not to talk about your health concern over the phone, the AudioHealth Library might be for you. These helpful prerecorded messages cover more than 300 health topics in English and Spanish. Just call the 24/7 NurseLine number and choose the AudioHealth Library option.

Health questions? 24/7 NurseLine is always here for you. Call toll free at 800-977-0027. 85% of members like you would recommend 24/7 NurseLine to others.

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association. MCASH1301CP VPOD Rev. 8/11

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Vision and hearing

Glasses.comTM — Get the latest, brand-name frames for just a fraction of the cost at typical retailers — every day. Plus, you get an additional $20 off orders of $100 or more, free shipping and free returns.

Premier LASIK — Save 15% on LASIK with all in-network providers. Prices are as low as $695 per eye with select providers.

Amplifon — Get a low-price guarantee with the seven top companies that work with Amplifon. Save $50 on one hearing aid or $125 on two. Plus, get a three-year repair/loss/damage warranty and a free two-year supply of batteries.

Beltone™ — Get hearing screenings and in-home service at no additional cost, and up to 50% off all Beltone hearing aids.

Fitness and health

Jenny Craig® — Join Jenny Craig and obtain 50% off All Access Enrollment plus 5% off all Jenny Craig Food.

Lindora® — Save 20% on weight-loss programs.

SelfHelpWorks — Choose one of the online Living programs and get a 40% discount to help you lose weight, stop smoking, manage stress or face an alcohol problem.

GlobalFit™ — Save on gym memberships, home fitness equipment and GlobalFit’s Virtual Gym.

ChooseHealthy™ — Get preferred pricing on fitness club memberships and a one-week free trial. Enjoy discounts on acupuncture, chiropractors and massage — plus 40% off certain wellness products.

Performance Bicycle — Get $20 off a purchase of $80 or more in store or online.

Garmin — Save 20% on the vívofit 2, vívosmart, vívoactive, or Forerunner 15 wearable activity trackers.

Live life to the fullest – without paying full price

Save money with discounts at anthem.com/ca Saving money is good. Saving money on things that are good for you — that’s even better. With SpecialOffers, you can get discounts on products and services that help promote better health and well-being.* It’s just one of the perks of being a member. Check out how much you can save:

1-800 CONTACTS® — Get contact lenses quick and easy — plus discounts only available to Anthem members, like $20 off when you spend $100 or more and free shipping.

MCASH1231C VPOD Rev. 09/15 Check out more SpecialOffers on the other side. 17

Family and home

Safe Beginnings® — Babyproof your home while saving 15% on everything from safety gates to outlet covers.

VPI Pet Insurance — Get 5% off pet insurance. Get peace of mind knowing that you have help paying the medical costs for your pet’s accidents, illnesses and routine medical care.

ASPCA Pet Health Insurance — Get 5% off pet insurance. You can choose from three levels of care, including flexible deductibles and custom reimbursements.

LinkWell — Get coupons for healthier products.

WINFertility® — Save up to 40% on infertility treatment. WINFertility helps make quality treatment affordable.

LifeMart® — Get great deals on beauty and skin care, diet plans, fitness club memberships and plans, personal care, spa services and yoga classes, sports gear and vision care.

HelpCare Plus — Get discounts on Senior Care Services by paying $11.25 per month. You even get a pharmacy discount card.

Medicine and treatment

Puritan’s Pride — Save 10% and get free shipping on a large selection of vitamins, minerals, herbs, supplements and much more.

Allergy Control products — Save 25% on Allergy Control encasings for your bed. Plus, save 20% on a variety of doctor-recommended products for a healthier home and enjoy free shipping on orders of $150 or more.

National Allergy® supply — Save 15% on mattress encasings, air filtration products, compressors and other products that can help relieve your allergy, asthma and sinus symptoms.

SpecialOffers on anthem.com/ca

To f nd the discounts that are available ito you, log in to anthem.com/ca and select Discounts.

* All discounts are subject to change without notice.

Si necesita ayuda en español para entender este documento, puede solicitarla sin costo adicional, llamando al número de servicio al cliente que aparece al dorso de su tarjeta de identif cación o en el folleto de inscripción. i

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

anthem.com/ca

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As a member, you have the right to expect the privacy of your personal health information to be protected, consistent with state and federal laws and our policies. And you also have certain rights and responsibilities when receiving your health care.

To learn more about how we protect your privacy, your rights and responsibilities when receiving health care and your rights under the Women’s Health and Cancer Rights Act, go to www.anthem.com/ca/memberrights. To request a printed copy, please contact your Benef ts Administrator or Humani Resources representative.

How we help manage your care

To decide if we'll cover a treatment, procedure or hospital stay, we use a process called Utilization Management (UM). UM is a program that lets us make sure you’re getting the right care at the right time. Licensed health care professionals review information your doctor has sent us to see if the requested care is medically needed. These reviews can be done before, during or after a member’s treatment. UM also helps us decide if the services will be covered by your health plan.

We also use case managers. They're licensed health care professionals who work with you and your doctor to help you

learn about and manage your health conditions. They also help you better understand your health benef ts. i

To learn more about how we help manage your care, visit www.anthem.com/ca/memberrights. To request a printed copy, please contact your Benef ts Administrator or Humani Resources representative.

How we protect our members

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Life products underwritten by Anthem Blue Cross Life and Health Insurance Company. Disability products underwritten by Anthem Life Insurance Company.

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross, Anthem Life Insurance Company and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

Express Scripts, Inc. is a separate company that provides pharmacy services and pharmacy benef t management services on behalf of health plan members. i

The Healthy Lifestyles programs are administered by Healthways, Inc., an independent company.

Carry an ID card that means something. Enroll now.