This program is administered
by the Managed Risk Medical Insurance Board (MRMIB).

Frequently Asked Questions about Health Plans

The information on this chart was provided by each plan. For more information, see the plan descriptions in the Handbook.	Alameda Alliance for Health	Anthem Blue Cross EPO	Anthem Blue Cross HMO	CalOptima
Are members required to have a Primary Care Physician (PCP)?	Yes	No	Yes	Yes
Are members required to get a referral from a PCP before going to a specialist?	Yes	No	Yes	Yes
How many times in a benefit year does the plan allow a member to change his/her PCP?	12	Unlimited	12	12
On average, how soon can a member be seen for a routine visit after requesting an appointment? (in weeks)	2 weeks	2 weeks	2 weeks	2 weeks
On average, how soon does it take to be seen if follow up care is necessary? (in weeks)	2 weeks	1 week	1 week	1 week
Does the plan offer a prescription drug mail-in program?	Yes	Yes	Yes	No
What types of physicians are offered as PCPs in this plan?
General Practice	Yes	Yes	Yes	Yes
Family Practice	Yes	Yes	Yes	Yes
Pediatrician	Yes	Yes	Yes	Yes
Obstetrics/Gynecologist (OB/GYN)	Yes	Yes	Yes	Yes
Internal Medicine	Yes	Yes	Yes	Yes
Does the plan provide the following optional benefits:
Biofeedback	No	Yes	No	No
Acupuncture	No	Yes	No	Yes
Chiropractic	No	Yes	No	Yes
Health Plan Statistics:
Total number of HFP members *	10,465	72,161	120,890	36,897
Other:
Does the plan require its members to use Binding Arbitration to resolve disputes? **	No	Yes	Yes	No
If yes, does Binding Arbitration include Medical Malpractice?	N/A	Yes	Yes	N/A

* This number represents the insurance plan's membership as of January 1, 2011.
** To get additional information about each insurance plan’s dispute resolution provisions, call the plan or refer to the plan’s Combined Evidence of Coverage and Disclosure Form or Certificate of Insurance Booklet, which is available upon request from each health, dental, and vision plan.

NOTE: These summaries are for information only. This is not a contract. For a detailed and precise statement of benefits and exclusions, please refer to the plan’s Combined Evidence of Coverage and Disclosure Form or Certificate of Insurance Booklet.