Medical Plan Options
Anthem Plans
Anthem HMO – No employee contribution
Anthem HMO Plan Summary (Enrollment Form)
Anthem Network Comparison Guide
Anthem Sydney Health App – Access to ID card
Find a doctor (follow prompts below)
>Guest
>Type of care = medical
>State = California
>Type of plan = Medical (Employer Sponsored)
>Plan/Network = Blue Cross HMO (CA Care) Large Group
>Click continue
>Search for facilities/providers/Groups
Anthem PPO 80E – No employee contribution
Anthem PPO 80E Plan Summary & Maven Maternity Benefit (Enrollment Form)
Find a doctor (follow prompts below)
>Guest
>Type of care = medical
>State = California
>Type of plan = Medical (Employer Sponsored)
>Plan/Network = Blue Cross PPO (Prudent Buyer) Large Group
>Click continue
>Search for facilities/providers/Groups
Anthem PPO 100A – Requires employee contribution
Single = $207.00/12 mo. & $248.40/10 mo.
2 Party = $404.00/12 mo. & $484.80/10 mo.
Family = $570.00/12 mo. & $684.00/10 mo.
Anthem PPO 100A Plan Summary & Maven Maternity Benefit (Enrollment Form)
Find a doctor (follow prompts below)
>Guest
>Type of care = medical
>State = California
>Type of plan = Medical (Employer Sponsored)
>Plan/Network = Blue Cross PPO (Prudent Buyer) Large Group
>Click continue
>Search for facilities/providers/Groups
Kaiser Plans
Kaiser HMO – No employee contribution
Kaiser HMO Plan Summary (Enrollment Form)
Kaiser HDHP with WEX Benefits HSA – No employee contribution
Kaiser HDHP Plan Summary (Enrollment Form)
Find a doctor
Includes Employer Funded WEX Health Savings Account
WEX Customer Service: (833-225-5939) Set up account online: https://benefitslogin.wexhealth.com/Login.aspx?ReturnUrl=%2f
Single annual employer contribution = $3,400.00
Family annual employer contribution = $6,800.00
Dental Plan Options
DeltaCare USA HMO – No employee contribution
DeltaCare DHMO Plan Summary (Enrollment Form)
Find a HMO Dentist (select the DeltaCare USA option from the drop-down list)
Understanding Your Plan
Delta PPO – Requires employee contribution
$44.30/12 mo. & $51.60/10 mo.
Delta PPO Plan Summary (Enrollment Form)
Find a PPO Dentist (select the PPO option from the drop-down list)
Delta Premier – Requires employee contribution
$71.00/12 mo. & $85.20/10 mo.
Delta Premier Plan Summary (Enrollment Form)
Find a Premier Dentist (select the Premier option from the drop-down list)
EyeMed Vision Plan
Insight Network – No employee contribution
EyeMed Plan Summary (Enrollment Form)
Basic Long Term Care – No employee contribution
LTC Policy Information
Term Life, AD&D, LTD – No employee contribution
VOYA Life and AD&D Enrollment Form (Life Policy Information)
Required Evidence of Insurability
Long Term Disability (LTD) – No employee contribution
VOYA LTD Plan Summary – This policy replaces employee state disability benefits