The Plan provides quality medical coverage for you and your eligible dependents. Your Plan partners with Blue Shield of California with the goal of controlling your out-of-pocket costs while expanding the network of contracted providers available.
Once eligible, you can schedule appointments with Blue Shield of California network providers for you and your covered dependents.
TIP: Remember to present your Blue Shield of California identification card to your medical provider before receiving benefits. Verify that the providers and facilities participate in the PPO network.
Visit www.blueshieldca.com/networkppo to search Blue Shield of California’s extensive provider network or use the Blue Shield of California mobile app.
REMINDER: Some physicians and anesthesiologists working in a PPO hospital or emergency room may not be part of your Plan’s network.
What the Plan Pays
After you meet your calendar year medical deductible, most covered services are paid based on the Blue Shield of California PPO network rate or allowable charge, whichever applies.
The Blue Shield of California PPO network rate is the amount a participating provider agrees to accept in payment for specific services. The participating provider cannot charge above the PPO network rate. In most cases, the Plan pays 100% of the PPO network rate. In some cases, the Plan pays an allowable charge instead of the PPO Network Rate. See the Summary Plan Description or contact the Fund Office for more information.
TIP: Choose PPO network providers (doctors, hospitals, labs) that participate in the Blue Shield of California PPO network. If you use out-of-network providers, your out-of-pocket costs may be higher. Search for PPO providers at www.blueshieldca.com/networkppo or by using the Blue Shield of California mobile app.
REMINDER: Call 9-1-1 if you experience a life-threatening emergency. Or go to an emergency room immediately. If it’s not an emergency, look for the nearest PPO network urgent care center. Your out-of-pocket costs will be more affordable.
Click here for Frequently Asked Questions about the medical plan.
