Plans and Providers
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?|
|Does the plan provide the following optional benefits:|
|Health Plan Statistics:|
|Total number of HFP members *||10,465||72,161||120,890||36,897|
|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.