endstream endobj startxref .usa-footer .grid-container {padding-left: 30px!important;} This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. IEHP DualChoice (HMO D-SNP) This is only a summary. This is only a summary. That's why we offer an annual salary, eligibility for annual bonus, plus a benefits package estimated at 35% of the annual salary. IEHP DualChoice (HMO D-SNP) offers the following coverage and cost-sharing. At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. This is only a summary. 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 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. x}koH?5,H=Ht.cX(lmKIM7:XHxhGRyj'}wz/n6}~ya~Z=r~~}o~*,)7X0)K2x""-UerS/L[eo~=Kf|?~Vf\+yEr f|3),-$B:. Health Insurance Marketplace is a registered trademark of the Department of Health and Human Services. Learn more about how your agency or business can join our the team that strengthens individuals and communities. hb```f``|AX,;Xt3]. IEHP DualChoice (HMO D-SNP) A short, plain-language Summary of Benefits and Coverage (SBC), A Uniform Glossary of terms used in health coverage and medical care. Medi-Cal Dental Coverage . You can compare options based on price, benefits, and other features that may be important to you. Coverage for: Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. It is a legal document that explains your health care plan and should answer many important questions about your benefits. This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. Plan Overview. Because we respect your right to privacy, you can choose not to allow some types of cookies. is offered in the following locations. Medi-Cal (the name for Medicaid in California) offers comprehensive coverage, including mental health resources. .manual-search-block #edit-actions--2 {order:2;} Contact a plan for a Summary of Benefits. Advantage Plus gives you extra coverage for an additional monthly cost that's added to your monthly plan premium. 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. =========== TABBED SINGLE CONTENT GENERAL, People who live in our service area (Riverside and San Bernardino counties), Adults with or without children, children, seniors, and people with a disability, People who meet income guidelines and other program requirements. We can give you job training opportunities, employment assistance, and access to rewarding careers that support individuals and families. All rights reserved | About | Contact | Legal and Privacy. %vM:+&Z$RI\\?wNuVS!n} 4 %PDF-1.5 % ? Adults pay no monthly premium for Medi-Cal coverage. SBC document helps you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services. With our. .manual-search ul.usa-list li {max-width:100%;} wT].b`bd` FI? We provide access to caregivers who help at-risk adults live safely and independently in their own home. ;+ " BEXL1|VTs94'6I>gY14eTy3~XU%ytv|`^7eqI8;r`~:EA2F8~]fs:x[`EY#UA We have several customer service locations across our 7,300 square-mile county where you can find help. %%EOF 1 0 obj 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. hbbd```b`` "A$ri " %f=X$L0i&u@d{:d for details. Learn more by clicking here. A summary of benefits and coverage (SBC) is a document that all insurance companies are required to provide. 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 . Welcome to Summary of Benefits and Coverage (SBC) document posting site for Medical and Dental documents. would share the cost for covered health care services. If you need a paper copy, call 1-877-7-NYSHIP (1-877-769-7447) and select the Medical Program. 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 Previous Next ===== TABBED SINGLE CONTENT GENERAL. %H_iuaVU%]{Wr68~&=}\F7\&Ec\bY]0f"=_]1Y/;h\Mph\32$H#db:aSV7f. 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. 3 0 obj This is only a summary. You may also call Health Care Options at 1-800-430-4263. provides the following cost-sharing on drugs. 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. hYioH+ 3"> >Ivg@K, We have many resources at your disposal, such as financial assistance, housing assistance, and mental health support. 2023 Inland Empire Health Plan All Rights Reserved. ! w@!nRKb You may also call Health Care Options at 1-800-430-4263or visit www.healthcareoptions.dhcs.ca.gov. .agency-blurb-container .agency_blurb.background--light { padding: 0; } KtV See the . Please read the Evidence of Coverage for the full list of benefits. TTY users should call 1-800-718-4347. This includes cookies necessary for the website's operation. d.Y&8&MUgQ (800) 440-4347 Here you can find access to Family Resource Centers and crisis prevention services. Call the IEHP Enrollment Advisors at (866) 294-4347, Monday Friday, 8am 5pm. endstream endobj startxref TTY users should call (800) 720-4347. endobj We work with community partners and the courts to bring families together. IEHP DualChoice (HMO D-SNP) Enroll on the phone or online! The SBC shows you how you and the plan would share the cost for covered health care services. The SBC shows you how you and the plan would share the cost for covered health care services. This page features plan details for 2023 IEHP DualChoice (HMO D-SNP) However, blocking some types of cookies may impact your experience of the site and the services we are able to offer. Share via Email. Sample Completed SBC | MS Word Format. Share via Facebook. <> Your Part B premium may differ based on factors including late enrollment, income, and disability status. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. This is only a summary. We are proud to announce that we help 1 million people in Riverside County each year by offering vital services and programs that support and protect the health, safety, and wellbeing of children, adults, and families in our communities. Advantage Plus benefits and premiums . At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. IMPORTANT: This page has been updated with plan and premium data for the 2023. You may be able to get the SBC and Uniform Glossary in a language other than English upon request. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. If you or your has limited income, Medi-Cal provides health coverage for no or low-cost. Community is built on trust. Summary of Benefits and Coverage (SBC) Templates, Instructions, and Related Materials - for plan years beginning on or after 4/1/17. You have the right to an easy-to-understand summary about a health plans benefits and coverage. Click to Call 1-877-354-4611 TTY 711. 324 0 obj <> endobj ei;N. The SBC shows you how you and the plan would share the cost for covered health care services. We protect our communitys most vulnerable children and adults. Find out if you qualify for a Special Enrollment Period. Look on the Extra Help letters you get, or contact the plan to find out your exact costs. hbbd``b` + b, DqA@BT$-P/c`% <> In this booklet, you will find an overview of our plan, an easy -to -read chart of plan coverage options, and contact . hZ]o+EugE {ScX,x}@\[,l7{. 2 0 obj IEHP DualChoice (HMO D-SNP) is a HMO Plan with a Medicare contract. Before sharing sensitive information, make sure youre on a federal government site. 7500 Security Boulevard, Baltimore, MD 21244. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. %PDF-1.6 % 1175 0 obj <> endobj The site is secure. The Glossary of Health Coverage and Medical Terms will assist you with determining the benefits of each plan. L.A. Care Covered Gold 80 HMO Evidence of . NOTE: Information about the cost of this plan (called the premium) will be provided separately. 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 ? ]]>*/, An agency within the U.S. Department of Labor, 200 Constitution AveNW TAhh])f?u Vh7 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. Welcome to Inland Empire Health Plan \ Members \ Medical Benefits & Coverage Of Medi-Cal In California; main content TIER3 SUBLAYOUT. That's why we offer an annual salary, eligibility for annual bonus, plus a benefits package estimated at 35% of the annual salary. Want to speak to someone face-to-face? Apply here and learn more about benefits. ol{list-style-type: decimal;} /*-->/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 stream The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Health care is crucial for you and your family. also provides the following benefits. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. @media only screen and (min-width: 0px){.agency-nav-container.nav-is-open {overflow-y: unset!important;}} }Y+\(s1Qi}=Y1$C'oX` Instructions for Completing the SBC - Group Health Plan Coverage and Consumer Assistance Programs. [CDATA[/* >
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