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TABLE OF CONTENTS
Your Health, Well-Being & Security. .............................................................................................................. 2
Eligibility & Enrollm
e
nt ................................................................................................................................ 3
Making the Most of Your Benefits Program..................................................................................................... 4
Blue Shield HMO – Gold Access+ HMO 500/35 ............................................................................................. 5
Blue Shield HMO – Silver Access+ HMO 1700/55 ......................................................................................... 6
Blue Shield PPO Silver Full PPO 1300/45..................................................................................................... 7
Blue Shield Tools & Resources...................................................................................................................... 8
Kaiser HMO................................................................................................................................................. 9
Kaiser Tools & Resources............................................................................................................................ 10
Kaiser Permanente HMO Medical Plan Child Dental Plan (Children Only) ..................................................... 11
Standard Dental PPO ................................................................................................................................. 11
Standard Dental......................................................................................................................................... 12
Standard Vision ......................................................................................................................................... 13
Life / AD&D Insurance ................................................................................................................................ 14
Disability Insurance.................................................................................................................................... 15
Travel Assistance ....................................................................................................................................... 16
Employee Assistance Program (EAP) ........................................................................................................... 16
Ben IQ ...................................................................................................................................................... 17
Mobile Apps .............................................................................................................................................. 17
Important Plan Notices and Documents ....................................................................................................... 18
Notes ........................................................................................................................................................ 27
For Assistance ........................................................................................................................................... 28
Statement of Material Modifications
This enrollment guide constitutes a Summary of Material Modifications (SMM) to the Pacific Southwest Realty
Health Plan. It is meant to supplement and/or replace certain information in the SPD, so retain it for future
reference along with your SPD. Please share these materials with your covered family members.
Medicare Part D Notice:
If you (and/or your dependents) have Medicare or
will become eligible for Medicare in the next 12 months, a federal law gives
you more choices about your prescription drug coverage. Please see the
Annual Notices on 18-19 for more details.