This page features plan details for 2023 IEHP DualChoice (HMO D-SNP) You may also call Health Care Options at 1-800-430-4263. Insurance companies and job-based health plans must provide you with: This information helps you make apples-to-apples comparisons when youre looking at plans. ]]>*/, An agency within the U.S. Department of Labor, 200 Constitution AveNW Summary of Benefits and Coverage (SBC) Templates, Instructions, and Related Materials - for plan years beginning on or after 4/1/17. ~_5Id+(f c*pF03 cF3m-26Yc> !c YJya%XL NOTE: Information about the cost of this plan (called the premium) will be provided separately. L.A. Care Covered Platinum 90 HMO Evidence of Coverage. Other languages can be selected below. important to review plan coverage, costs, and benefits before you enroll. Please check the plans formulary for specific drugs covered. If you or your has limited income, Medi-Cal provides health coverage for no or low-cost. Learn more here, including how to apply. This is only a summary. Washington, DC 202101-866-4-USA-DOL, Employee Benefits Security Administration, Mental Health and Substance Use Disorder Benefits, Children's Health Insurance Program Reauthorization Act (CHIPRA), Special Financial Assistance - Multiemployer Plans, Delinquent Filer Voluntary Compliance Program (DFVCP), State All Payer Claims Databases Advisory Committee (SAPCDAC), Summary of Benefits and Coverage and Uniform Glossary, Notice Agency Information Collection Activities, Solicitation of comments Templates, Instructions, and Related Materials, Culturally and Linguistically Appropriate Services (CLAS) County Data, Summary of Benefits and Coverage (SBC) Template, Instructions for Completing the SBC - Group Health Plan Coverage, Instructions for Completing the SBC - Individual Health Insurance Coverage, Why This Matters language for "Yes" Answers, Why This Matters language for "No" Answers, HHS Information For Simulating Coverage Examples, HHS Coverage Example Calculator and Related Information, List of anchors for SBC Uniform Glossary terms, Uniform Glossary of Coverage and Medical Terms, SBC and Uniform Glossary Translations - Chinese, Spanish, Tagalog, and Navajo, Instructions for Completing the SBC Group Health Plan Coverage, Instructions for Completing the SBC Individual Health Insurance Coverage. This is why we at the Riverside County Department of Social Services offers a variety of ways for you to keep up to date with our programs and services! The SBC shows you how you and the plan would share the cost for covered health care services. Youll also find access to services for those in crisis here. for details. The SBC shows you how you and the plan would share the cost for covered health care services. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Please click here to learn more about our departments various programs, what they can do for you, and how to contact us. Our mission is to help our residents find a path to financial independence. /*-->/Filter/FlateDecode/ID[<7683F4A8D47BF441B51CA1406C79AE5A>]/Index[324 78]/Info 323 0 R/Length 83/Prev 576238/Root 325 0 R/Size 402/Type/XRef/W[1 2 1]>>stream (=eVXPjZ=klnA0` 9bI1TE!~ZScs3$! .paragraph--type--html-table .ts-cell-content {max-width: 100%;} Medicare has neither approved nor endorsed any information on this site. [CDATA[/* >