UNDERSTANDING YOUR BENEFITS
Unrivaled Brands health plans are built on choice, offering you the opportunity to make decisions about what will best meet your and your family’s health and financial needs.
Unrivaled Brands medical plan options are administered by Cigna + Oscar and Kaiser HMO and are designed to help you maintain your health through preventive care services, access to an extensive network of providers, and affordable prescription medication.
You can choose from three flexible plan options:
- Kaiser HMO – CA only
- Cigna + Oscar Gold PPO
- Cigna + Oscar Platinum PPO
Please log on to unrivaled.ease.com to review medical costs specifically for you and your family.
KAISER HEALTH MAINTENANCE ORGANIZATION (HMO)
Kaiser HMO is a type of health insurance plan that limits coverage to doctors, hospitals, and pharmacies that participate in the Kaiser Permanente HMO network only. There is no coverage if you go to out-of-network providers, except for emergency services. A Kaiser HMO requires you to live or work in its service area to be eligible for coverage with Kaiser.
CIGNA+OSCAR PPO PLAN
The Cigna+Oscar Open Access Plus PPO plans are a National PPO Network within and out-of-network benefits. Plans have a deductible to meet first for certain services with coinsurance. Physicians services and prescriptions have copays.
Step 1: Navigate to hioscar.com - Click the "Find a Doctor " button located on the right hand corner
Step 2: Select "Find doctors & drugs”
Step 3: Selected "Search network," the page will navigate to the following screen
Step 4: The provider search tool will now be on your screen! You can edit the default zip code to match your exact search.
Note: Out of Area members will still use the search tool based on where their group is located; just change the zip code to reflect where you would like to receive service.
Step 5: You can also use the provider search tool to search for prescription drugs. Start typing, and most common drug names will auto-populate.
Kaiser Medical Summary
Plan Benefits | Kaiser Silver 70 2500/55 |
| IN-NETWORK ONLY | |
| Annual Deductible | $2,500 ind. $5,000 family |
| Out-of-Pocket Maximums | $8,750 ind. $17,500 family |
| Preventive Care | No charge |
| Primary Office Visit | $55 copay (ded waived) |
| Specialist Office Visit | $90 copay (ded waived) |
| Virtual Care | No charge |
| Diagnostic Lab & X-ray | $90 copay |
| Advanced Diagnostic Imaging | $300 after deductible |
| Urgent Care | $55 copay (ded waived |
| Inpatient Hospital Stays | 35% coinsurance after deductible |
| Outpatient Surgery | 35% coinsurance after deductible |
| Emergency Room | 35% coinsurance after deductible (waived if admitted) |
| Chiropractic Care | $55 copay |
| Prescription Drugs- 30 day supply | |
| Prescription Drug Deductible $300/$600 Prescription Drug Deductible applies to Tier 2-4. RX Deductible waived for Tier 1 |
|
| Tier 1 - Generic | $19 copay |
| Tier 2 - Preferred Brand | $85 copay |
| Tier 3 - Non- Preferred | $85 copay |
| Tier 4 - Brand Specialty | 30% coinsurance |
Learn more about your Kaiser Wellness Tools
Use these interactive tools and reference guides to find answers to your health questions and help guide your decisions with your care team.
Total health and wellness resources
Take control of your total health with mental health services, resources for addiction and recovery, self-care apps, community resources, and healthy living guides.kp.org/livehealthy.
Self-care videos
Watch a wide variety of video lessons to help control ongoing conditions and maintain good physical and mental health. kp.org/video.
Health topics
Explore more than 4,000 health topics to learn the basics about medical conditions, symptoms, and treatment options. Plus, assess your health concerns with an interactive symptom checker.kp.org/health.
Recipes
Get inspired to prepare delicious, healthy dishes. Browse recipes by category —like vegetarian dishes, soups, or desserts — or by what’s in season. foodforhealth.kp.org.
Drug encyclopedia
Learn about prescription and over-the-counter drugs — how they work, possible side effects, and more.kp.org/medications.
The Active & Fit Direct program gives you access to 16,000+ fitness centers and exercise studios,4,000+ digital workout videos, the option to enroll your spouse/domestic partner,** and more, so you can get fit at the gym or at home. No long-term cotract! Learn more: kp.org/choosehealthy.
CIGNA + OSCAR MEDICAL SUMMARY
Plan Benefits | Cigna + Oscar Gold $1350 | Cigna + Oscar Platinum $250 |
||
| IN-NETWORK | OUT-OF-NETWORK | IN-NETWORK | OUT-OF-NETWORK | |
| Annual Deductible (Individual / Family) | $1,350 / $2,700 | $2,700 / $5,400 | $250 / $500 | $1,000 / $2,000 |
| Out-of-Pocket Maximums (Individual / Family) | $8,950 / $17,900 | $17,100 / $34,200 | $5,000 / $10,000 | $8,800 / $17,600 |
| Preventive Care | 100% | covered 50% after deductible | Covered at 100% | covered 50% after deductible |
| Primary/Specialist Office Visit/Acupuncture | $45 copay | covered 50% after deductible | $20/ $45 copay | covered 50% after deductible |
| Diagnostic Lab & X-ray | 20% coinsurance | covered 50% after deductible | 10% coinsurance | covered 50% after deductible |
| Advanced Diagnostic Imaging | 40% coinsurance after deductible | covered 50% after deductible | 40% coinsurance after deductible | covered 50% after deductible |
| Urgent Care | $50 copay | covered 50% after deductible | $25 copay | covered 50% after deductible |
| Inpatient Hospital Stays | 20% coinsurance after deductible | covered 50% after deductible | 10% coinsurance after deductible | covered 50% after deductible |
| Outpatient Surgery | 20% coinsuranceafter deductible | covered 50% after deductible | 10% coinsurance after deductible | covered 50% after deductible |
| Emergency Room | First Visit: $550/visit after deductible; Subsequent Visits: $750/visit after deductible (waived if admitted) | First Visit: $200/visit after deductible; Subsequent Visits: $400/visit after deductible (waived if admitted) |
||
| Virtual Care Visits | No charge | covered 50% after deductible | No charge | covered 50% after deductible |
| Chiropractic Care | $30 copay | covered 50% after deductible | $30 copay | covered 50% after deductible |
| 30 day supply | ||||
| Rx deductible (Individual / Family) | $300 / $600 | Not covered | None | Not covered |
| Generic | $15 copay | $5 copay | ||
| Preferred Brand Name | $55 copay after Rx deductible | $35 copay | ||
| Non- Preferred Brand | $95 copay after Rx deductible | $75 copay | ||
| Specialty Drugs | 30% coinsurance up to $250 max copay after Rx deductible | 30% coinsurance up to $250 max copay | ||
| 90 day supply | ||||
| Rx deductible $300 / $600 | Not covered | N/A | Not covered | |
| Generic | $45 copay | $15 copay | ||
| Preferred Brand Name | $165 copay | $105 copay | ||
| Non- Preferred Brand | $285 copay | $225 copay | ||
| Specialty Drugs | 30% coinsurance up to $250 after Rx deductible | 30% coinsurance up to $250 | ||