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California Baptist University

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Kaiser

Health Net

Your Medical Plan

We will continue to offer three plans through Kaiser and Health Net. With a PPO plan, you do not need to choose a primary care physician (PCP). You have the option to go out-of-network for services, but you will receive a higher level of benefit coverage when you see an in-network provider. If you see an out-of-network provider, you will need to file a claim for reimbursement for the services rendered. You still have the option to choose the Kaiser HMO or the Health Net EOA plan. Remember, with Kaiser, you do not need to choose a PCP; however, you must receive all of your medical care from Kaiser providers and facilities. The Health Net EOA plan uses a traditional HMO network, but gives you an option to use the PPO network for office visits only.

Kaiser HMO

Under the Kaiser HMO, you do not need to choose a PCP; however, you must receive all of your medical care from Kaiser providers and facilities.

  • No annual deductibles
  • $1,500 individual out-of-pocket maximum
  • $3,000 family out-of-pocket maximum
  • You pay $20 copay for office visits
  • You pay $20 copay for specialist visits
  • You pay $20 copay for urgent care visits
  • You pay $100 copay for emergency room visits
  • You pay $250 per admission/procedure for inpatient and outpatient services
  • Preventive care is covered at 100%

Health Net EOA

The Health Net EOA plan uses a traditional HMO network, but gives you an option to use the PPO network for office visits only.

  • No annual deductible
  • $1,500 individual out-of-pocket maximum
  • $3,000 two-party out-of-pocket maximum
  • $4,500 family out-of-pocket maximum
  • You pay $20 copay for office visits ($40 for PPO network)
  • You pay $20 copay for specialist visits ($40 for PPO network)
  • You pay $100 copay for emergency room visits
  • You pay $250 per admission/procedure for inpatient and outpatient services
  • Preventive care is covered at 100%

Health Net PPO

The PPO plan is a traditional health plan with deductibles, coinsurance and copays. Below is a summary of the in-network benefits. Out-of-network benefits are available, however, benefits are reduced.

  • $500 individual deductible
  • $1,500 family deductible
  • $3,000 individual out-of-pocket maximum
  • $9,000 family out-of-pocket maximum
  • You pay $20 copay for primary care doctor visits
  • You pay $20 copay for specialist visits
  • You pay $100 copay, then 20% after deductible for emergency room visits
  • You pay 20% coinsurance after deductible for inpatient and outpatient services
  • Preventive care is covered at 100%
Compare Plans »
Employee Cost per Pay Period
Coverage Level Kaiser HMOHealth Net EOAHealth Net PPO
Employee Only $28.00$28.00$133.67
Employee + Spouse $157.50$157.50$411.06
Employee + Child(ren) $143.50$143.50$328.32
Employee + Family $258.50$258.50$580.67
Deductible

The amount you owe for health care services before your health insurance or plan begins to pay.

Coinsurance

The portion of eligible expenses that plan members are responsible for paying, most often after the deductible is met. It's usually determined as a percentage of the total cost.