Medical
CENTURY 21 Affiliated provides group health insurance through CaliforniaChoice Health Plan with five (5) HMO options and one (1) PPO option. Under the HMO plan, you must see a provider within network for coverage. Under the PPO plan, participants are encouraged to see In- Network providers; however, some Out-of-Network providers and services may be covered.
For more information on the health insurance and to find in-network providers, visit https://www.calchoice.com/ then select “Provider Search”.
OPTION
HMO
HMO
HMO
Bronze HMO A
Silver HMO A
Gold HMO B
Plan Name
Network Name
Kaiser Permanente
Kaiser Permanente
Kaiser Permanente
Benefits
In-Network
Non-Network
In-Network
Non-Network
In-Network
Non-Network
Deductible Ind/Family
$5,800 / $11,600
N/A
$2,300 / $4,600
N/A
$250 / $500
N/A
$19 / (Tier’s 2 -4) 40% up to $500
$20 / $100 / $100 / 20% up to $250
$15 / $40 / $40 / 20% up to $250
RX Benefit
Not Covered
Not Covered
Not Covered
PCP Office Visits
$60 Copayment
Not Covered
$65 Copayment
Not Covered
$35 Copayment
Not Covered
Specialty Office Visits
$95 Copayment
Not Covered
$100 Copayment
Not Covered
$55 Copayment
Not Covered
Chiropractic Services
$15 Copay – Max 20/yr
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Preventive Exams
$0 Copayment
Not covered
$0 Copayment
Not Covered
$0 Copayment
Not Covered
Urgent Care
$60 Copayment
Not Covered
$65 Copayment
Not Covered
$35 Copayment
Not Covered
Emergency Room
40% coinsurance
45% coinsurance
$250 Copayment
Hospital Services
40% coinsurance
Not Covered
45% coinsurance
Not Covered
$600/Day up to 5-days
Not Covered
Out-of-Pocket Maximum
$8,850 / $17,700
N/A
$8,750 / $17,500
N/A
$7,800 / $15,600
N/A
Employee Monthly Premiums
Age Based Plans
Rates will vary by participant age. Please contact Human Resources for more information.
Out-of-Pocket Maximum includes Deductible, Rx, Office, Urgent Care & Emergency Room Copays
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