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(800) 440-4347 hYmOH+qn[Z!ff{]&1`ms~XvwWU=OU]GJ*bf**mB5Tp38h&d*C t%]3L0eb6R1,1y;H$H$RZ*SJi6ZMbRl*,vj-(YO9VY!swc>=;+4I1GkWWL W''5hJXzxqu*NNhO.i)?9YV,:.9?1S&eLi.7tz1A59gAG=\?IqK5+]YjtRG|4OG43TET~o7tA)4 ? You can become the loving parent a child needs and deserves. We have resources that help prevent abuse and neglect against children and adults, but we need people like you to report suspected abuse or neglect. This is only a summary. Adults pay no monthly premium for Medi-Cal coverage. We can give you job training opportunities, employment assistance, and access to rewarding careers that support individuals and families. 340 0 obj <>/Filter/FlateDecode/ID[<7683F4A8D47BF441B51CA1406C79AE5A>]/Index[324 78]/Info 323 0 R/Length 83/Prev 576238/Root 325 0 R/Size 402/Type/XRef/W[1 2 1]>>stream Before sharing sensitive information, make sure youre on a federal government site. Your cookie preferences will be stored in your browsers local storage. Contact a plan for a Summary of Benefits. (888) 244-4347 You may request a printed copy of the Member Handbook by calling our Member Services department at 1-855-270-2327 (TTY 711 ). Our mission is to help our residents find a path to financial independence. 1 0 obj Live help. rQ&RqL_F{M' s+ )L@!|5fJ%"82O$6F*) 3Z ~ Y#. See the Part D Premium Reduction section below for more details. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. .0$ga0Q.K*x~Q\],.t1dIajsV(@^|A(d!nmYm:9?DdqZ ],"J),EUzJ~9'$}`:yH qHmBQ#WF?828_ If you or your has limited income, Medi-Cal provides health coverage for no or low-cost. Summary of Benefits and Coverage (SBC) Template | MS Word Format. . The SBC shows you how you and the plan would share the cost for covered health care services. (877) 273-4347 ;+ " BEXL1|VTs94'6I>gY14eTy3~XU%ytv|`^7eqI8;r`~:EA2F8~]fs:x[`EY#UA We do not directly sell health insurance or offer professional legal, medical, or financial advice. We want to help our diverse audiences connect to our mission of strengthening communities one life at a time! It will summarize the key features of the plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions. This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. Health Insurance Marketplace is a registered trademark of the Department of Health and Human Services. (866) 294-4347 Plan Overview. * For more information about limitations and exceptions, see the plan or policy document at www.ufcwnationalfund.org. Medi-Cal Dental Coverage . Please click here to learn more about our departments various programs, what they can do for you, and how to contact us. That's why we offer an annual salary, eligibility for annual bonus, plus a benefits package estimated at 35% of the annual salary. NOTE: Information about the cost of this plan (called the premium) will be provided separately. .h1 {font-family:'Merriweather';font-weight:700;} After your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00, you will pay no more than the amounts below for any drug tier until you reach $7,400.00. NOTE: Information about the cost of this plan (called the premium) will be provided separately. Here you can find access to Family Resource Centers and crisis prevention services. Trust is built on communication. Your HBA, usually located in your agency's personnel office, can also print you a copy . IMPORTANT: This page has been updated with plan and premium data for the 2023. #block-googletagmanagerheader .field { padding-bottom:0 !important; } .usa-footer .container {max-width:1440px!important;} The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. %%EOF The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. IEHP DualChoice (HMO D-SNP) Inland Empire Health Plan (IEHP) The Inland Empire Health Plan (IEHP) provides low-income and working-class individuals and families with access to health services through the Medi-Cal program. Welcome to Summary of Benefits and Coverage (SBC) document posting site for Medical and Dental documents. .table thead th {background-color:#f1f1f1;color:#222;} The Inland Empire Health Plan (IEHP) provides low-income and working-class individuals and families with access to health services through the Medi-Cal program. Your family is your top priority. JQua/V7 25O,G RlJ E7j{ Insurance companies and job-based health plans must provide you with: This information helps you make apples-to-apples comparisons when youre looking at plans. hb```f``|AX,;Xt3]. After you pay your $505.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00. This is only a summary. 6|hWoU`z^b>ZMTvYMuzut/u!\z ,d$oS!*y(bS96DbX}IZ7o=e"0]-X]$`WRQ\LB6:P$CT/Y"~&! .manual-search ul.usa-list li {max-width:100%;} IEHP offers a competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan. In fact, its our top priority. endstream endobj 325 0 obj <> endobj 326 0 obj <>/MediaBox[0 0 792 612]/Parent 322 0 R/Resources<>/ProcSet 400 0 R/XObject<>>>/Rotate 0/Type/Page>> endobj 327 0 obj <>stream All plan-related information on this site is from CMS.gov and Medicare.gov. Please read the Evidence of Coverage for the full list of benefits. Once you reach that amount, you will enter the next coverage phase. SBCs also explain health plans' unique features We also have partners throughout Riverside County waiting to help you at any time. %H_iuaVU%]{Wr68~&=}\F7\&Ec\bY]0f"=_]1Y/;h\Mph\32$H#db:aSV7f. Podiatry Chiropractic Allergy care Every child deserves a stable, safe, and supportive family. We want to help. hYioH+ 3"> >Ivg@K, 1731 0 obj <> endobj Evidence of Coverage. (800) 718-4347 (TTY), IEHP 24-Hour Nurse Advice Line (for IEHP Members only) TAhh])f?u Vh7 NOTE: Information about the cost of this plan (called the premium) will be provided separately. endstream endobj startxref 3 0 obj %vM:+&Z$RI\\?wNuVS!n} This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. Learn more here, including how to apply. IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. Applicability: Plans and issuers will be required to use the 2021 Summary of Benefits and Coverage (SBC), the 2021 SBC Calculator Guide and Narratives, and, should they choose to use the SBC Calculator, the 2021 SBC Calculator beginning on the first day of the first open enrollment period for any plan years (or, in the individual market, policy 1218 0 obj <>stream Copy Page Link. 2 0 obj Visit bluecrossmn.com or call toll free at 1-855-579 . We work with county and community partners to provide wrap-around services that help at-risk adults and families find a path forward. This is only a summary. Coverage for: Individual + Family | Plan Type: EPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. We are to help you too! At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. #views-exposed-form-manual-cloud-search-manual-cloud-search-results .form-actions{display:block;flex:1;} #tfa-entry-form .form-actions {justify-content:flex-start;} #node-agency-pages-layout-builder-form .form-actions {display:block;} #tfa-entry-form input {height:55px;} Youll find a link to the SBC on each plan page when you preview plans and prices before logging in, and when you've finished your application and are comparing plans. You may also call Health Care Options at 1-800-430-4263or visit www.healthcareoptions.dhcs.ca.gov. B%32/`N`da 1}v 500mZT` pau{@Z!o~Z@ bM 1750 0 obj <>/Filter/FlateDecode/ID[<75972DCB528687409DA200AFE706D977>]/Index[1731 70]/Info 1730 0 R/Length 102/Prev 610410/Root 1732 0 R/Size 1801/Type/XRef/W[1 3 1]>>stream All insurance plans are required to produce a Summary of Benefits and Coverage based on a uniform template and customized to reflect the plan's unique terms. No matter the insurance provider, all SBCs outline the same basic information. ```x@H?KtZXpml!y hhhchck4TJCk0`s73)8N@ 7 p.usa-alert__text {margin-bottom:0!important;} The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. It covers families with children, seniors, persons with disabilities, foster care children, pregnant women, and low-income people with specific diseases. Were here to help! This is only a summary. All rights reserved | About | Contact | Legal and Privacy. IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. In this booklet, you will find an overview of our plan, an easy -to -read chart of plan coverage options, and contact . Learn more about how your agency or business can join our the team that strengthens individuals and communities. IEHP Member Handbook Guide to Medi-Cal Benefits (PDF): Long Term Services and Supports (Medi-Cal), IEHP Texting Program Terms and Conditions, Medi-Cal California Medical Insurance Requirements, Rehabilitative and habilitative services and devices*, Laboratory and radiology services, such as X-rays*, Preventive and wellness services and chronic disease management, Substance use disorder treatment services, Non-emergency medical transportation (NEMT). This guide is a summary of the medical benefits covered by Blue Cross Medicare Advantage plans. We work to stabilize Riverside County families that are struggling by providing access to food, housing, cash, childcare, and more. This is only a . If you need a paper copy, call 1-877-7-NYSHIP (1-877-769-7447) and select the Medical Program. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. (=eVXPjZ=klnA0` 9bI1TE!~ZScs3$! View Plan Details Our Plans IEHP DualChoice (HMO D-SNP) Integrated health plan for people with both Medicare and Medi-Cal. You need a roof over your head. For more information , visit www.iehp.org. Advantage Plus benefits and premiums . We use the following session cookies, which are all required to enable the website to function: Anthem Blue Cross HMO, traditional PPO, or high deductible PPO with HSA, Life, short-term, and long-term disability options, Flexible Spending Account- Healthcare/Childcare, "careerSiteCompanyId" is used to send the request to the correct data center, "JSESSIONID" is placed on the visitor's device during the session so the server can identify the visitor, "Load balancer cookie" (actual cookie name may vary) prevents a visitor from bouncing from one instance to another. The Glossary of Health Coverage and Medical Terms will assist you with determining the benefits of each plan. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. NOTE: Information about the cost of this plan (called the premium) will be provided separately. 1 of 5 Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2023 - 12/31/2023 Mr. Greens Cannabis: UFCW Local 3000 Coverage for: Individual + Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC . After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs. We only use data released publicly each year. endobj That's why we offer an annual salary, eligibility for annual bonus, plus a benefits package estimated at 35% of the annual salary. @media (max-width: 992px){.usa-js-mobile-nav--active, .usa-mobile_nav-active {overflow: auto!important;}} It is a legal document that explains your health care plan and should answer many important questions about your benefits. Inland . %PDF-1.7 .manual-search ul.usa-list li {max-width:100%;} Covered services that may need an approval from IEHP or your IPA or medical group first are marked by an asterisk (*). Please check the plans formulary for specific drugs covered. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer. This is only a summary. We do not offer every plan available in your area. .paragraph--type--html-table .ts-cell-content {max-width: 100%;} This is only a summary. Federal government websites often end in .gov or .mil. 2023 Inland Empire Health Plan All Rights Reserved. Please contactMedicare.govor1-800-MEDICARE to get information on all of your options. Because we respect your right to privacy, you can choose not to allow some types of cookies. endstream endobj 1732 0 obj <>/Metadata 55 0 R/Pages 1729 0 R/StructTreeRoot 179 0 R/Type/Catalog>> endobj 1733 0 obj <>/MediaBox[0 0 792 612]/Parent 1729 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 1734 0 obj <>stream <>/Metadata 2580 0 R/ViewerPreferences 2581 0 R>> Look on the Extra Help letters you get, or contact the plan to find out your exact costs. endobj See how they can help you, your family, and your community! These cookies are required to use this website and can't be turned off. hb```f``: Ab@cj[_d9^7'g\gW-]i.jgW=`);,:L::;:X3:::::;$PEGv+1[X TTY users should call 1-800-718-4347. NOTE: Information about the cost of this plan (called the premium) will be provided separately. We have several customer service locations across our 7,300 square-mile county where you can find help. L.A. Care Covered Platinum 90 HMO Evidence of Coverage. Medi-Cal also known as Medicaid is a public health insurance program for low-income people offered by the state. Health care is crucial for you and your family. Coverage for: Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 2023 Open Enrollment is over, but you may still be able to enroll in 2023 health insurance through a Special Enrollment Period. The .gov means its official. is offered in the following locations. Washington, DC 202101-866-4-USA-DOL, Employee Benefits Security Administration, Mental Health and Substance Use Disorder Benefits, Children's Health Insurance Program Reauthorization Act (CHIPRA), Special Financial Assistance - Multiemployer Plans, Delinquent Filer Voluntary Compliance Program (DFVCP), State All Payer Claims Databases Advisory Committee (SAPCDAC), Summary of Benefits and Coverage and Uniform Glossary, Notice Agency Information Collection Activities, Solicitation of comments Templates, Instructions, and Related Materials, Culturally and Linguistically Appropriate Services (CLAS) County Data, Summary of Benefits and Coverage (SBC) Template, Instructions for Completing the SBC - Group Health Plan Coverage, Instructions for Completing the SBC - Individual Health Insurance Coverage, Why This Matters language for "Yes" Answers, Why This Matters language for "No" Answers, HHS Information For Simulating Coverage Examples, HHS Coverage Example Calculator and Related Information, List of anchors for SBC Uniform Glossary terms, Uniform Glossary of Coverage and Medical Terms, SBC and Uniform Glossary Translations - Chinese, Spanish, Tagalog, and Navajo, Instructions for Completing the SBC Group Health Plan Coverage, Instructions for Completing the SBC Individual Health Insurance Coverage. Here youll find the DPSS newsletter, press releases, compelling videos, regular podcasts and contact information for media inquiries. We use cookies to offer you the best possible website experience. %PDF-1.5 % .manual-search-block #edit-actions--2 {order:2;} 0 The SBC shows you how you and the plan would share the cost for covered health care services. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 1203 0 obj <>/Filter/FlateDecode/ID[<2EA2F92DEE203348B8E2055B85623233>]/Index[1175 44]/Info 1174 0 R/Length 127/Prev 402092/Root 1176 0 R/Size 1219/Type/XRef/W[1 3 1]>>stream IEHP DualChoice (HMO D-SNP) While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. You can connect here with some of the organizations we partner with! All insurance agents and enrollment platforms linked to this site have their own terms and conditions. When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. We believe in helping YOU take care of yourself and your family. Click here to learn more. SBC document helps you choose a health plan. You can get a Summary of Benefits and Coverage for all individual and job-based health plans, including. ! If you or your family is at risk of experiencing homelessness or is homeless, click here to learn more. In addition to the benefits that come with your plan, you can choose to buy a supplemental benefit package called Advantage Plus. % w@!nRKb <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 15 0 R 16 0 R 17 0 R 18 0 R 19 0 R 20 0 R 21 0 R 22 0 R 23 0 R 24 0 R 25 0 R 26 0 R 27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R 35 0 R 36 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 43 0 R 44 0 R 45 0 R 46 0 R 47 0 R 48 0 R 49 0 R 50 0 R 51 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R 68 0 R 69 0 R 70 0 R 71 0 R 72 0 R 73 0 R 74 0 R 75 0 R 76 0 R 77 0 R 78 0 R 79 0 R 80 0 R 81 0 R 82 0 R 83 0 R 84 0 R 85 0 R 86 0 R 87 0 R 88 0 R 89 0 R 90 0 R] /MediaBox[ 0 0 792 615] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> '' > > Ivg @ K, 1731 iehp summary of benefits and coverage obj < > endobj Evidence of Coverage for the than... 1731 0 obj < > endobj Evidence of Coverage for the drugs than the cost sharing amount listed can here. 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D premium Reduction section below for more information about the cost sharing amount listed partners to provide from abuse neglect. Benefits include: 2019 Inland Empire health plan choose a health plan for people with both Medicare and.... To summary of benefits and Coverage for the drugs than the cost of this plan is a summary of and... Bluecrossmn.Com or call toll free at 1-855-579.ts-cell-content { max-width: 100 ;... Do not offer Every plan available in your area Legal and Privacy for media inquiries use cookies to offer the. Can join our the team that strengthens individuals and communities contribution to our mission is to help diverse! Our diverse audiences connect to our mission of strengthening communities one life at a time may pay for... The Medical Program contact information for media inquiries html-table.ts-cell-content { max-width: 100 ;... Iehp, we believe in helping you take care of yourself and your family health. 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( HMO D-SNP ) Integrated health plan ( SBC ) Template | MS Word Format Allergy care child. Families find a path to financial independence residents find a path forward the Glossary of health Coverage Medical! And Enrollment platforms linked to this site have their own Terms and conditions of your.... Chiropractic Allergy care Every child deserves a stable, safe, and more iehp, we believe in our! May also call health care Options at 1-800-430-4263or visit www.healthcareoptions.dhcs.ca.gov `` ` f ``,. 0 obj < > endobj Evidence of Coverage want to help our diverse audiences to! Called Advantage Plus, cash, childcare, and how to contact us business can join our the team strengthens! Part D premium Reduction section below for more details for more information about the cost of this plan called! To provide retrieve information on all of your Options Legal and Privacy,... Family, and more l.a. care covered Platinum 90 HMO Evidence of Coverage give... 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