CaliforniaChoice Portfolio & Network Glossary

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CaliforniaChoice Small Group Plans & Networks

Description

HMO

HMO plans available with 7 carriers:

  • Anthem Blue Cross HMO: CaliforniaCare HMO (Full) or Select HMO networks
  • Health Net HMO: Full, WholeCare, Salud y Mas, or CommunityCare HMO networks
  • Kaiser Permanente HMO: Full HMO network
  • Sharp Health Plan HMO: Performance or Premier HMO networks
  • Sutter Health Plus HMO: Full HMO network
  • UHC HMO: SignatureValue, Advantage, Alliance, or Harmony HMO networks
  • WHA HMO: Full HMO network
PPO

PPO plans available in the Anthem Blue Cross's Prudent Buyer (Full), Advantage, and Select PPO networks.

HSA

HSA-compatible plans available with 6 carriers:

  • Anthem Blue Cross EPO HSA: Prudent Buyer (Full) PPO network
  • Anthem Blue Cross PPO HSA: Prudent Buyer (Full) or Select PPO networks
  • Cigna + Oscar EPO HSA: LocalPlus network
  • Kaiser Permanente HMO HSA: Full HMO network
  • Oscar: Full Oscar network
  • Sharp Health Plan HMO HSA: Performance HMO network
  • Sutter Health Plus HMO HSA: Full HMO network
  • WHA HMO HSA: Full HMO network
HSP (Health Service Plan)

HSP plan (PCP selection required, in-network self-referrals permitted) available in the Health Net PureCare HSP network.

EPO

EPO plans (in-network only, no PCP required) available with 2 carriers:

  • Anthem EPO: Prudent Buyer PPO network
  • Oscar EPO: Full EPO network
   

Other Important Information

Description

Portfolio (All Plans)

Single, Double, Triple, and Total Choice (all 4 tiers) options available.

Formulary

  • Anthem Blue Cross: Select Formulary
  • Cigna + Oscar: Express Scripts High Performance Formulary for Cigna + Oscar 
  • Health Net: Essential Rx Drug List or "Affordable Care Act Exchange Drug List"
  • Kaiser Permanente: California Marketplace Formulary
  • Oscar:  Oscar Formulary
  • Sharp Health Plan: Sharp Health Plan Drug List
  • Sutter Health Plus: Sutter Health Plus Formulary
  • UnitedHealthcare: California Small Group 4-Tier
    HMO and PPO Prescription Drug List
  • WHA: Preferred Drug List Four-Tier Prescription Drug Plan

Pediatric Dental Networks

  • Anthem: Prime Dental
  • Cigna + Oscar: Liberty
  • Health Net: Dental Benefits Provider
  • Kaiser: Delta Dental DeltaCare USA
  • Oscar: Liberty
  • Sharp: Access Dental 
  • Sutter: Delta Dental DeltaCare USA
  • UHC: CA Select Managed Care DHMO
  • WHA: Delta Dental DeltaCare USA

Pediatric Vision Networks

  • Anthem: Blue View/EyeMed
  • Cigna + Oscar: Davis
  • Health Net: EyeMed
  • Kaiser: Kaiser Permanente
  • Oscar: Davis Vision
  • Sharp: VSP
  • Sutter: VSP Choice
  • UHC: Spectera
  • WHA: MES Vision

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