For All Members:
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.
2020 CAR Required Notices
Required Notices Include:
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- HIPAA Notice of Special Enrollment Rights
- Newborns’ and Mothers’ Health Protection Act
- Women’s Health & Cancer Rights Act
- Patient Protections Notice
- CMS Creditable Coverage Notice Anthem
- CMS Creditable Coverage Notice Kaiser
Medicare/CMS Creditable Coverage Notices
- 2020 Creditable Coverage Notice Kaiser
- 2020 Creditable Coverage Notice Anthem
- 2020 Non-Creditable Coverage Notice Anthem
Evidence of Coverage Booklets (EOC)
2020 Evidence of Coverage booklets will be available in January 2020
2019 Kaiser and Anthem EOC documents
- 2019 Kaiser Permanente Plans
- Bronze 60 HMO 6300/75 North
- Bronze 60 HMO 6300/75 South
- Bronze 60 HDHP HMO 6000/40% (HSA) North
- Bronze 60 HDHP HMO 6000/40% (HSA) South
- Silver 70 HMO 1000/55 North
- Silver 70 HMO 1000/55 South
- Silver 70 HMO 1800/55 North
- Silver 70 HMO 1800/55 South
- Silver 70 HMO 2000/45 North
- Silver 70 HMO 2000/45 South
- Silver 70 HDHP HMO 2500/20% (HSA) North
- Silver 70 HDHP HMO 2500/20% (HSA) South
- Gold 80 HMO 0/30 North
- Gold 80 HMO 0/30 South
- Gold 80 HMO 500/30 North
- Gold 80 HMO 500/30 South
- Gold 80 HRA HMO 2250/35 North
- Gold 80 HRA HMO 2250/35 South
- Platinum 90 HMO 0/10 North
- Platinum 90 HMO 0/10 South
- Platinum 90 HMO 0/15 North
- Platinum 90 HMO 0/15 South
- Kaiser Acupuncture-Chiropractic North
- Kaiser Acupuncture-Chiropractic South
- Child Dental Plan HMO Flyer 2019
- DME Benefits Flyer 2019
- 2019 Anthem Blue Cross Plans
- Anthem Bronze PPO 6600/0% w/HSA (3KDB)
- Anthem Bronze PPO 5000/45% w/HSA (3KD3)
- Anthem Bronze PPO 70/6300/35% (3KER)
- Anthem Bronze PPO 40/5600/40% (306D)
- Anthem Bronze PPO 65/4600/40% (3KJ9)
- Anthem Silver PPO 2000/25% w/HSA – RxC (Single) (3KJ5)
- Anthem Silver PPO 2000/25% w/HSA – RxC (Family) (3KF3)
- Anthem Silver PPO 50/2000/40% (3KG5)
- Anthem Silver PPO 55/1750/35% (3KH7)
- Anthem Silver PPO 40/1500/40% (3KGV)
- Anthem Silver HMO 55/2250/40% (3KL7)
- Anthem Silver HMO 55 (3KJR)
- Anthem Gold PPO 35/1000/20% (3KGM)
- Anthem Gold PPO 30/750/20% (3KGD)
- Anthem Gold PPO 30/500/20% (3KFF)
- Anthem Gold PPO 20/30% (3KF7)
- Anthem Gold HMO 25 (3KHF)
- Anthem Gold HMO 35 (306V)
- Anthem Platinum PPO 15/250/10% (3KFX)
- Anthem Platinum PPO 20/10% (3KHP)
2020 MetLife Group Dental, Vision and Life Evidence of Coverage Documents
- MetLife Evidence of Coverage – VALUE Plan
- MetLife Evidence of Coverage – SELECT Plan
- MetLife Evidence of Coverage – CHOICE Plan
- MetLife Voluntary AD&D
- MetLife Term Life and AD&D
Summary of Benefits & Coverage (SBC)
- 2020 Anthem Blue Cross Plans
- Anthem Bronze PPO 6600/0% w/HSA (52SM)
- Anthem Bronze PPO 5000/45% w/HSA (52SH)
- Anthem Bronze PPO 70/6300/35% (4HY6)
- Anthem Bronze PPO 3950/50% (NEW) (4JO8)
- Anthem Bronze PPO 40/5600/40% (4HUE)
- Anthem Bronze PPO 60/6350/40% (NEW) (4HU5)
- Anthem Silver PPO 2000/30% w/HSA – RxC (4HVU)
- Anthem Silver PPO 2000/30% w/HSA – RxC (4HW2)
- Anthem Silver PPO 55/2500/45% (4J00)
- Anthem Silver PPO 50/2000/40% (4HWY)
- Anthem Silver PPO 55/1850/35% (4HY0)
- Anthem Silver PPO 45/1750/40% (4HXN)
- Anthem Gold PPO 35/1000/20% (4HXE)
- Anthem Gold PPO 30/750/20% (4HX6)
- Anthem Gold PPO 30/500/20% (4HWE)
- Anthem Gold PPO 20/30% (4HW6)
- Anthem Platinum PPO 15/250/10% (4HWQ)
- Anthem Platinum PPO 20/10% (4HVH)
- Anthem Silver HMO 55/2250/45% (4HYF)
- Anthem Silver HMO 55 (4HTA)
- Anthem Gold HMO 35 (4HUV)
- Anthem Gold HMO 30 (4HV5)
- 2020 Kaiser Permanente Plans (Coming Soon)
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