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1Important Reminders A California state-issued certificate of domestic partnership must be on file with SISC for alldomestic partnerships by 10/01/2020. Since 10/01/2018, Anthem PPO members were made subject to reference pricing for fivecommon procedures that can be performed safely at an Ambulatory Surgery Center (ASC) atcosts significantly lower than at a hospital. Members with questions should contact thecustomer service number on their ID cards.ArthroscopyCataractSurgery 2,000Colonoscopy 1,500Upper GIEndoscopywith BiopsyUpper GIEndoscopywithoutBiopsy 1,250 1,000Maximum benefit at an in-networkoutpatient hospital facility 4,500There is no limit at an in-networkAmbulatory Surgery Center (ASC)There is no benefit change at an ASC.The limits at an outpatient hospital facility do not apply at an ASC. Since 10/01/2015, Anthem PPO members are required to have hip and knee replacements,and certain inpatient spine surgeries, performed at an Anthem Blue Cross Blue Distinction center in order to be covered their PPO plan. Members with questions should contact thecustomer service number on their ID cards. Anthem members receive 0 generics (excludes certain pain and cough medications) fromCostco once deductibles (if any) are satisfied.
2AnthemOnline and Mobile AppAt Anthem.com/Ca or with the Sydney app, memberscan stay on top of their care 24/7: Find a doctor or urgent care center near youView or print your Anthem member ID cardCheck your deductible, out-of-pocket maximum, andcopayment/coinsuranceView your claimsReview your benefits informationSee your wellness benefitsSync with your fitness trackerCheck My Family Health RecordsAnd more!
3AnthemCare OptionsAnthem PPO members have access to in-personand virtual care: Visit your doctor at your local facilityMeet face-to-face with a video visit via MDLiveSave yourself a trip to the doctor’s office with atelephone appointment via MDLiveEmergency and urgent care coverage worldwideand 24/7 support with the Global Core Programat 1-800-810-BLUE
4Added Value Programs24/7 Phone and Video Physician ConsultationsAnthem PPO members can consult a licensed doctor,pediatrician, therapist, or psychiatrist over the phone, byvideo visit, or by using the mobile app, for a 5 copay* viaMDLive. All visits are confidential.Members can speak with a physicians for a variety ofmedical conditions, including:General Conditions Cold/Flu Respiratory Problems Allergies Children’s health issues And moreBehavioral Health Depression Bipolar disorders Stress Grief and loss And moreMDLive physicians can diagnose and prescribe medicationwhen appropriate.Visit MDLive.com/SISC or call 1-800-657-6169 for moreinformation.*Per IRS guidelines for HSA plans, this benefit is subject to deductible for members enrolled in the following plans: Minimum Value, Anchor Bronze, HSA-A and HSA-B.
5Added Value ProgramsOne-on-One Digital Health Coaching Available at No Cost*Vida AppAnthem PPO members* have access to a virtual careplatform that treats a full range of lifestyle, chronic, andbehavioral health conditions through Vida Health. Usersreceive: 1:1 health coaching and therapy available through avirtual platformDigital interventions and programsProgress tracked through in-app trackers andconnected devicesTools and resources such as videos and lessonsVisit Vida.com/SISC or call 1-855-442-5885 to learn more.*Per IRS guidelines for HSA plans, this benefit is subject to deductible for members enrolled in the following plans: Minimum Value, Anchor Bronze, HSA-A and HSA-B.
6Added Value ProgramsEnhanced Cancer Benefit Available at No Cost*Oncology Center of Excellence ProgramAnthem PPO members* have access to an enhanced cancerbenefit at the City of Hope in Duarte, California, through HealthDesign Plus.Members receive: In-person evaluation at City of Hope with confirmation ofcancer diagnosisDevelopment of a customized treatment planPaid travel for patient and one companionAccess to a personal care nurse to coordinate careClinical trial and genetic risk educationTransition of care and collaboration with homeoncologist for one year post-evaluationVisit SISC.HDPlus.com or call 1-877-220-3556 to learn more.*Per IRS guidelines for HSA plans, this benefit is subject to deductible for members enrolled in the following plans: Minimum Value, Anchor Bronze, HSA-A and HSA-B.
7Added Value ProgramsDigital Programs for Chronic Pain Available at No Cost*Hinge HealthAnthem PPO members have access to a digital physical therapyprogram through Hinge Health. The program provides personalized,interactive physical therapy using the latest technology for thosesuffering with chronic pain.Eligible members receive wearable sensors and a monitoring device toguide them through virtual therapy sessions from home. The programalso includes unlimited access to a personal health coach, links toeducational articles, and information regarding available treatmentoptions.Members can access support for the following conditions: Hip pain Knee pain Neck pain Spine pain Shoulder painVisit HingeHealth.com/SISC or call 1-855-902-2777 to learn more.*Per IRS guidelines for HSA plans, this benefit is subject to deductible for members enrolled in the following plans: Minimum Value, Anchor Bronze, HSA-A and HSA-B.
8Added Value ProgramsDiabetes Prevention Program Available at No CostSolera4MeAnthem PPO and HMO members can access a 16-week, cutting-edgediabetes prevention program through Solera. This program is designedto help members with prediabetes lose weight, adopt healthy habits,and significantly reduce their risk of developing diabetes.Programs* vary by region and may include: Weight Watchers Healthslate Jenny Craig Noom Retrofit Skinny Gene Project and moreTake a 1-minute quiz to see if you qualify at Solera4Me.com/SISC.*Program availability subject to change.
9Added Value ProgramsHip, Knee, and Spine Surgical Options Available at No Cost*Carrum HealthAnthem PPO members can access Carrum Health’s surgerybenefit that provides exclusive access to “Centers ofExcellence” at Scripps Hospital in San Diego, CA.Patients receive: Personalized “Concierge” support Access to top-quality surgeons at Scripps Co-insurance and deductibles waived Travel expenses covered for patient and one companionEligible procedures include: Hip Replacement Knee Replacement Cervical Spinal Fusion Lumbar Spinal FusionThis benefit is exclusive to Scripps Hospital and must beaccessed through Carrum Health. Visit Carrum.me/SISC orcall 1-888-855-7806 to learn more.*Per IRS guidelines for HSA plans, this benefit is subject to deductible for members enrolled in the following plans: Minimum Value, Anchor Bronze, HSA-A and HSA-B.
10Added Value ProgramsExpert Medical Opinions Available at No CostAdvance MedicalAnthem PPO and HMO and Kaiser Permanente memberscan get answers to healthcare questions and medicalopinions from world-leading experts in their fields of specialtythrough Advance Medical. Members can speak directly with aspecialist once their case is established.Advance Medical can help members when they: Are dealing with complex medical conditionsAre considering surgery or a major procedureHave questions about managing a health conditionWant a second opinion on a documented diagnosis ortreatment planVisit Advance-Medical.net/SISC or call 1-855-201-9925 tolearn more.
11Added Value ProgramsDiscounted Gym MembershipsAnthem and Kaiser PermanenteMembers have access to a 25 gym membership( one-time 25 enrollment fee) at a broad network ofparticipating facilities through American Specialty Health’sActive & Fit Direct program.Visit ActiveandFitDirect.com to locate facilities and enroll.Members may also call American Specialty Health directly at1-844-646-2746 for more information.
12Added Value ProgramsEmotional Wellness App Available to all Employees at No CostmyStrengthLike a virtual gym for your mind, myStrength providespersonalized online resources to help members handlelife’s ups and downs, and feel more positive.Highly interactive, individually-tailored applicationsempower myStrength users to address depression,anxiety, stress, substance use, chronic pain and sleepchallenges, while also supporting the physical andspiritual aspects of whole-person health.Members have access to positivity training tools,inspirational videos, articles and quotes, a daily moodtracker and step-by-step eLearning programs.www.anthemeap.comCompany Code: SISC
13Added Value ProgramsCounseling Services Available to all Employees at No CostAnthem EAPAll employees and everyone in their household haveaccess to up to 6 free and confidential* counselingsessions per issue through Anthem EAP.Anthem EAP features 24/7 telephone access toclinicians and can assist participants in: Finding work-life balanceParenting a child with special needsDealing with addiction and recoverySetting retirement goalsGetting mental health resources and informationJust about anything else life throws at you1-800-999-7222www.anthemeap.comCompany Code: SISC
14Added Value ProgramsCounseling Services Available to all Employees at No CostAnthem EAPSISC member district employees and those in theirhousehold can take advantage of counseling services atno cost through Anthem EAP. Participants receive up to 6confidential, in-person or video counseling sessions witha licensed professional. This also program features: 24/7 telephone access to cliniciansGuidance and support on accessing counselingthrough non-Anthem medical plansOnline tools, information, and resources and more1-800-999-7222www.anthemeap.comCompany Code: SISC
15Added Value ProgramsFinancial Services Available to all Employees at No CostAnthem EAPSISC member district employees and those in theirhousehold may consult with financial experts throughAnthem EAP. Participants receive unlimited access tofinancial experts knowledgeable in a wide range oftopics. Support may include consultation on the followingtopics: Bankruptcy preventionComprehensive financial fitnessDebt reduction and managementFinancial planningHousing education and purchasingAnd more1-800-999-7222www.anthemeap.comCompany Code: SISC
16Added Value ProgramsChildcare Resources Available to all Employees at No CostAnthem EAPSISC member district employees and those in theirhouseholds may receive support with childcareresources through Anthem EAP. Participants receivereferrals for everything from child care centers andfamily day care homes to camps, schools, tutors, andmore through Anthem EAP.Support may include: Resources for gifted and special needs childrenAccess to an online library with articles and tipson parenting and child rearingInformation on health, wellness, and pany Code: SISC
17Added Value ProgramsElder Care Resources Available to all Employees at No CostAnthem EAPSISC member district employees and those in theirhousehold may receive support with elder careresources through Anthem EAP. Participants receiveconfidential caregiver support services provided 24/7via phone or online through Anthem EAP.Support may include: Qualified Elder Care consultations alwaysavailableLocal community resources and assistanceArticles on caregiving, insurance, and end-of-lifedecisions available onlineReferrals for in-home care providers, assistedliving providers, and skilled nursing facilities1-800-999-7222www.anthemeap.comCompany Code: SISC
18Flu VaccinesAvailable at No CostAnthem members:Free flu shots are available at any participating pharmacy,including Costco (1-800-774-2678/Costco.com) andexcluding Walgreens.
Anthem EAP. SISC member district employees and those in their household may receive support with elder care resources through Anthem EAP. Participants receive confidential caregiver support services provided 24/7 via phone or online through Anthem EAP. Support may include: Qualified Elder Care consultations always available
