CLASSIFIED & SUPERVISORY

INSURANCE BOOKLET - CLASSIFIED ACTIVE
20-21 PLAN RATES

Medical Plan Descriptions

KAISER $20



KAISER DHMO

ANTHEM PREMIER HMO
Premier HMO Prescription Coverage

ANTHEM CLASSIC HMO
Classic HMO Prescription Coverage

ANTHEM CLASSIC PPO $20
Premier PPO Prescription Coverage

ANTHEM CLASSIC PPO $40
Classic PPO Prescription Coverage

 

Medical Plan Explanation of Benefits (EOC)

Kaiser $20 FULL Explanation of Coverage (EOC)

Kaiser DHMO FULL Explanation of Coverage (EOC)

Anthem Premier HMO FULL Explanation of Coverage (EOC)

Anthem Classic HMO FULL Explanation of Coverage (EOC)

Anthem PPO 20 FULL Explanation of Coverage (EOC)

Anthem PPO 40 FULL Explanation of Coverage (EOC)


MEDICAL FORMS
(Please print form and complete)

MEDICAL PLAN ELECTION FORM

ANTHEM BLUE CROSS ENROLLMENT FORM

CHANGE FORM

KAISER ENROLLMENT/CHANGE FORM

WAIVER FORM

 

Anthem Blue Cross Anthem Blue Cross

HMO Provider Finder   PPO Provider Finder

American Specialty Health (ASH) Chiropractic

All Medical Plan Members: 800-678-9133

Prescription Drug Program for non-Kaiser Members

NAVITUS CUSTOMER CARE

HOURS: 24 Hours a Day | 7 Days a Week

866-333-2757 (toll-free) TTY (toll-free) 711

MAILING ADDRESS: Navitus Health Solutions P.O. Box 999 | Appleton, WI 54912-0999

Anthem Blue Cross members have access to a MDLIve appointment for a $5 co-pay.

Please check the link here for more information: MDLive Appointment Information

Additional Medical Plan Forms and Information

IMPORTANT: If enrolling dependents, you must provide proof of dependent relationship. Please see dependent verification requirements: Dependent Verification Documents

Anthem Temp Medical ID Card

COSTCO Prescription Drug Flyer - Not valid for Kaiser members

ADVANCE MEDICAL - Expert Medical Opinion

It's free, it's easy, it's 100% confidential. 855.201.9925 | advance-medical.net/sisc

Advance Medical is fully sponsored by Self-Insured Schools of California.

All of Advance Medical's services including Expert Medical Opinion are available at no cost to all members covered by a SISC health plan. Advance Medical Information Flyer

For all SISC Anthem Members:

SOLERA - It's a 16-week, cutting-edge program that can help you lose weight, adopt healthy habits and significantly reduce your risk of developing diabetes. And it's available at no cost to members that qualify.

877.486.0141 | solera4me.com

For all SISC PPO Members:

Need surgery for Hip Replacement, Knee Replacement or Spinal Fusion? Contact Carrum Health at 888-855-7806

Get Access to top quality surgeons at Scripps Medical, No medical bills (co-insurance and deductibles are waives), and travel expenses are covered.