For All Members:
- CAR MEMBER Privacy Notice
- General Guidelines Effective 11-1-24
- Qualifying Events
- C.A.R. Group Health Plan Administration and Fees
For C.A.R. Group Insurance Program Members:
Thank you for your participation in the C.A.R. Insurance Plan. Below are important policy notices that you should read, print and retain for safekeeping.
2025 CAR Required Notices
- CAR Anthem Required Notices (Combined)
- CAR Kaiser Required Notices (Combined)
- CAR MetLife Required Notices (Combined)
- CHIP Notice
Required Notices Include:
-
- HIPAA Notice of Special Enrollment Rights
- Newborns’ and Mothers’ Health Protection Act
- Women’s Health & Cancer Rights Act
- Patient Protections Notice
- No Surprises Act Notice
- Anthem Creditable Coverage Notice
- Anthem Non Creditable Coverage Notice
- Kaiser Creditable Coverage Notice
2025 Medicare/CMS Creditable Coverage Notices
- 2025 Anthem Creditable Coverage Notice
- 2025 Anthem Non-Creditable Coverage Notice
- 2025 Kaiser Creditable Coverage Notice
2024 Anthem Evidence of Coverage Documents (2025 Documents Pending)
HSA Plans
- Anthem Bronze PPO 6700-0% HSA 9KG9
- Anthem Bronze PPO 6000-45% HSA 9KGF
- Anthem Silver PPO 2100-30% HSA 9B29 Self Only
- Anthem Silver PPO 2100-30% HSA 9B35 Family
- Anthem Silver PPO 2600-35% HSA 9KGL Self Only
- Anthem Silver PPO 2600-35% HSA 9KFG Family
PPO Plans
- Anthem Bronze PPO 70-6600-35% 9B1W
- Anthem Bronze PPO 40-6200-40% 9KG2
- Anthem Silver PPO 55-2500-45% 9B1X
- Anthem Silver PPO 50-2200-40% 9B2Q
- Anthem Silver PPO 55-1950-35% 9KGQ
- Anthem Silver PPO 45-1750-40% 9KFJ
- Anthem Gold PPO 35-1000-20% 9KFU
- Anthem Gold PPO 30-750-20% 9KFK
- Anthem Gold PPO 30-500-20% 9KF1
- Anthem Gold PPO 25-30% 9B25
- Anthem Platinum PPO 15-250-10% 9B20
- Anthem Platinum PPO 15-40-10% 9B2V
HMO Plans
2025 Kaiser Evidence of Coverage Documents will be uploaded when received from the carrier.
MetLife Dental and Vision Evidence of Coverage
- MetLife VALUE Dental Plan
- MetLife SELECT Dental Plan
- MetLife CHOICE Dental Plan
- MetLife Enhanced Vision Plan
- MetLife Basic Vision Plan
MetLife Life and AD&D Insurance Certificates
2025 Summary of Benefits & Coverage (SBC)
Anthem Summary of Benefits & Coverage (SBC)
HSA Compatible SBCs – (Be sure to visit C.A.R.’s HSA partner – Bend HSA)
- Anthem Bronze PPO 6700_0% w_HSA PrevRx_CA_PPO_Small Group_84VR
- Anthem Bronze PPO 6000_45% w_HSA PrevRx_CA_PPO_Small Group_84UR
- Anthem Silver PPO HSA_H 2600_3300_5200 35% PrevRx_CA_PPO_Small Group_84T7 SINGLE
- Anthem Silver PPO HSA_H 2600_3300_5200 35% PrevRx_CA_PPO_Small Group_84T6 FAMILY
- Anthem Silver PPO HSA_H 2100_3300_4200 30% PrevRx_CA_PPO_Small Group_84S2 SINGLE
- Anthem Silver PPO HSA_H 2100_3300_4200 30% PrevRx_CA_PPO_Small Group_84SD FAMILY
Bronze Plan SBCs
- Anthem Bronze PPO 70_6600_35%_CA_PPO_Small Group_84QG
- Anthem Bronze PPO 40_6200_40%_CA_PPO_Small Group_84PV
Silver Plan SBCs
- Anthem Silver PPO 55_2500_45%_CA_PPO_Small Group_84P5
- Anthem Silver PPO 50_2200_40%_CA_PPO_Small Group_84NR
- Anthem Silver PPO 55_1950_35%_CA_PPO_Small Group_84NG
- Anthem Silver PPO 45_1750_40%_CA_PPO_Small Group_84MX
Gold Plan SBCs
- Anthem Gold PPO 35_1000_20%_CA_PPO_Small Group_807B
- Anthem Gold PPO 30_750_20%_CA_PPO_Small Group_806Z
- Anthem Gold PPO 30_500_20%_CA_PPO_Small Group_805T
- Anthem Gold PPO 25_30%_CA_PPO_Small Group_8058
Platinum Plan SBCs
- Anthem Platinum PPO 15_250_10%_CA_PPO_Small Group_8047
- Anthem Platinum PPO 15_40_10%_CA_PPO_Small Group_803Z
HMO Plan SBCs
Kaiser Permanente Plans
- HSA Plans
- HMO Plans
- Kaiser Bronze 60 HMO 5800-60
- Kaiser Silver 70 HMO 2900-65
- Kaiser Silver 70 HMO 2500-55
- Kaiser Silver 70 HMO 2300-65
- Kaiser Silver 70 HMO 1900-65
- Kaiser Gold 80 HRA HMO 2250-35
- Kaiser Gold 80 HMO 1000-40
- Kaiser Gold 80 HMO 250-35
- Kaiser Gold 80 HMO 0-35
- Kaiser Platinum 90 HMO 250-30
- Kaiser Platinum 90 HMO 0-20
- Kaiser Platinum 90 HMO 0-10
If you have any questions about your health plan or would like a copy of these documents mailed to you, please call RealCare at (800) 939-8088, Option 2