Plan Features & Highlights

Kaiser Senior Advantage

The maximum out-of-pocket for Kaiser Senior Advantage to Medicare retirees with Medicare will be reduced from $1,500 to $1,000 per person.

United Health Care

The UHC plan's hearing aid allowance will increase from $500 to $2,500 per three year period. See the UCH flyer to learn more about this benefit.

Progyny Fertility and Family Building for Anthem PPO

Fertility and family building coverage will be available to all employees and spouses enrolled in the Anthem Classic PPO. Coverage will include fertility treatments such as IVF and IUI, fertility medication, sperm or egg freezing, adoption, surrogacy, and doula benefits. Most benefits are included as components of Smart Cycles. Participants are eligible for two Smart Cycles per lifetime. In addition, participants are eligible for up to $20,000 reimbursement for adoption or surrogacy per lifetime. Participants are also eligible for up to $1,000 reimbursement per child for doula services. Smart Cycle benefits are subject to the same deductible and copay cost sharing as the medical plan in which the participant is enrolled. Click on the Progyny Overview Video , review the Progyny Member Guide, visit the Progyny website or call 866-461-4990 to learn more about this benefit.

View additional flyers to learn more about the benefits offered through Progyny:

Progyny Benefits Overview, Surrogacy Benefit Overview, Adoption Benefit Overview, Doula Benefit Overview, IVF, LGBTQ Family Building Options, Egg Freezing Planning for your Future Family, Progyny Provider Network, Progyny Patient Care Advocates, and Smart Cycles.

Hinge Health Virtual Physical Therapy for Anthem PPO

Hinge Health will provide a well-rounded virtual physical therapy program for acute or chronic conditions. Benefits include live video visits with a physical therapist, visits with a certified health coach to address underlying causes, and/or a tablet with sensors to provide feedback on movements during therapy. Benefits vary based on applicability, as determined by intake assessment. Hinge Health benefits are provided at no cost and are exempt from deductibles in the Anthem Classic PPO plan. Click on the Hinge Health Overview Video or see the Hinge Health Flyer to learn more about this benefit.

Carrum Health for Anthem PPO

If you ever need surgery in the future, please remember to check out the Carrum Health Benefit. This optional surgery benefit for Anthem PPO participants provides a second opinion and, if surgery is needed, travel for you and a companion to the top surgeon at a world-class surgical facility. Learn more at carrum.me/acwajpia , watch this video, or view the Carrum Flyer.

Hear Carrum Health Testimonials and Knee Replacement Testimonials.

Oncology Guidance for Anthem PPO

Carrum Health, JPIA’s concierge and second opinion surgery partner, has expanded to offer oncology services. Oncology Guidance will provide those newly diagnosed with cancer with a registered oncology nurse to guide them through their journey for up to 48 months. In partnership with world-renowned cancer centers Memorial Sloan Kettering and City of Hope, an oncologist will review the diagnosis and treatment plan, consulting directly with the treating physician. This benefit is available for all types of cancer, excluding non-melanoma skin cancer. Oncology Guidance is provided at no cost.

Breast Cancer Treatment for Anthem PPO

Carrum Health's journey further into the oncology space has led to their partnership with the world-renowned City of Hope Cancer Center. Comprehensive treatment bundles include coordinated care, radiation, chemotherapy, and surgery. This benefit is available to participants with a first-time non-metastatic breast cancer diagnosis. Due to the need for repeat visits, participants must live within 60 miles of a City of Hope location in Southern California. Breast cancer treatment bundles through Carrum are provided at no cost. See the Carrum Health Flyer for more information about this benefit.

Maintenance Medications for Anthem Plans

Maintenance medications are subject to a requirement to be obtained through mail order after two retail fills. In 2020, Walmart, Costco, and Sam’s Club were added as alternatives to mail order to obtain 90-day maintenance medication refills. Retail alternatives for 90-day maintenance refills will expand to include Albertsons, Vons, Pavilions, Safeway and Ralphs.

Anthem PPO Mail Order Pharmacy Benefit

The Anthem PPO's mail order and specialty pharmacy benefit manager's name will change from MedImpact Direct to Birdi. You will notice a different name on mailed packages, but everything else will remain the same. Your ID card is still valid. The phone number and website are the same. Existing refills are still on file.

See the MedImpact flyers and brochures for more information: MedImpact Summary Plan Description, MedImpact Formulary List, MedImpact Safe Harbor List, MedImpact Preferred Drug List and MedImpact Mail Order Retail Alternatives
*Please note, all flyers and information is still listed as MedImpact, however, the name will change to Birdi.

Anthem HMO Mail Order Pharmacy Benefit

The Anthem HMO's mail order and specialty pharmacy benefit manager's name will change from IngenioRx to CarelonRx. You will notice a different name on mailed packages, but everything else will remain the same. Your ID card is still valid. The phone number and website are the same. Existing refills are still on file.

Vision Benefit Enhancements

Kaiser The VSP vision plan has been enhanced to increase the frame allowance from $180 to $200, and will now include VSP Light Care. VSP members with LightCare can now use their frame allowance, in lieu of prescription glasses, towards their choice of plano ready-made sunglasses or blue light filtering glasses and plano sunglasses.

Ginger App for Kaiser

Kaiser members are now eligible for Ginger, a mental health and wellbeing app. This app offers educational content and 24/7 text-based coaching sessions with certified coaches. Ginger provides emotional support to cope with some of life's most common challenges from stress and low moods to issues with work, relationships, and sleep. Once the benefit is activated, it is available for 90 consecutive days in a rolling 12-month period. Review the Ginger Flyer to learn more about this benefit.

Modern Health for Kaiser HMO and Anthem PPO/HMO

Modern Health is a mental health and wellbeing benefits platform that solves the mental healthcare “access” problem by bringing one-on-one coaching, therapy, and mental health resources to your phone or tablet, typically within 48 hours of request. Click on the Modern Health Webinar (Pre-recorded) to learn more about this benefit.

View additional Modern Health Flyers:

Getting started with Modern Health, Invite your dependents to Modern Health, Modern Health FAQ, Circles-Live Community Sessions, and Welcome to Modern Health

Plan Provider Flyers

Kaiser Flyers:

Click Here
Anthem Flyers: Click Here
United Healthcare Flyers: Click Here