Prudent Buyer Classic PPO / Prudent Buyer Advantage PPO / CaliforniaCare HMO / Kaiser

• Visit www.bluecrossca.com for the latest Blue Cross Prudent Buyer Classic PPO and CaliforniaCare HMO provider listings.
• To find Blue Cross providers outside California contact the BlueCard Provider Access Web site or call 800.810.BLUE (2583).
• Prudent Buyer Classic PPO and CaliforniaCare HMO claim & eligibility inquiries - call 800.284.2466.
• Kaiser eligibility inquiries - call 800.464.4000.
• Kaiser Permanente provider location information may be accessed on-line at www.kaiserpermanente.org.
• For information and copy of your summary of benefits contact ACWA Benefits Department at 800.736.2292.

ACWA proudly offers health benefit opportunities for Public Agency Members. Currently there are 220 employers with over 6,200 employees enrolled in ACWA-sponsored health plans. ACWA benefit plans are offered individually, and with many contribution options, giving the employer the opportunity to create a benefit package to best suit the needs and financial requirements of the employer and the employee. Participants may include active employees, active directors, retirees, all eligible dependents and surviving spouses.

Blue Cross of California has provided health benefits to ACWA members since 1984.

• Prudent Buyer Classic PPO reimburses covered expenses for inpatient hospital room and board and ancillary charges at 100% for participating hospitals. After a $15 copay or a $200 deductible covered outpatient and professional services are paid at 80% for participating providers. Expenses of non-participating providers are reimbursed at lower levels. After the member pays $1,000 out-of-pocket to participting providers or $2,000 to non-participating providers, Blue Cross will pay 100% of services rendered for the remaining portion of that calendar year.
• Prudent Buyer Advantage PPO reimburses covered expenses for inpatient hospital room and board and ancillary charges at 100% for participating hospitals. After a $20 copay or a $500 deductible covered outpatient and professional services are paid at 80% for participating providers. Expenses of non-participating providers are reimbursed at lower levels. After the member pays $3,000 out-of-pocket to participating providers or $10,000 to non-participating providers, Blue Cross will pay 100% of services rendered for the remaining portion of that calendar year.
• CaliforniaCare HMO is a Health Maintenance Organization offered to ACWA members. This plan offers benefits from participating providers, which include 100% coverage for inpatient hospital care and a $10 office visit copayment on outpatient physicians services. A prescription drug card with a $5 generic ($15 brand name) copayment is part of the HMO plan. Services obtained by non-participating providers are not covered except in emergency situations (as determined by Blue Cross of California).

Kaiser Permanente has provided health benefits to ACWA members since 1997.

• Health Maintenance Organization and Medicare Risk offers plans with no deductible, no charge for inpatient stays, low physician office visit copayment and prescription drugs for $5 generic drug copay, $15 brand name for the HMO and $10 generic drug, $20 brand name drug copay for the Medicare Risk plan. Services are provided through Kaiser Permanente facilities in participating regions.