iHerb offers three medical plan options through Blue Shield of CA and pays 100% of the plan premiums. That means you pay no medical plan costs out of your paycheck. When deciding which medical plan is right for you and your family, it is important to consider which plan will offer the right balance of out-of-pocket costs and network flexibility.
The Blue Shield of CA Network Plan provides coverage through in-network doctors. You will select a primary care physician (PCP) who refers you to specialists, as needed. You are responsible for copays when you receive services. Coverage for out-of-network providers is not available with this plan. If you seek treatment from an out-of-network provider, you will be responsible for the full cost of treatment. Find an in-network provider at Blue Shield of CA.
Note: This plan is available to employees in California only.
The Blue Shield of CA Traditional Plan offers the flexibility to choose an in-network or out-of-network provider each time you need care. Keep in mind, you will save money when you visit in-network providers. Find an in-network provider at Blue Shield of CA.
The Consumer Choice Plan is a PPO with a larger annual deductible and qualifies for a tax-advantaged Health Savings Account (HSA), which can be used to reimburse for qualified medical expenses and lower taxable earnings. All team members actively at work and are enrolled in the Consumer Choice Plan will be eligible for a $100 contribution each month. It will be processed through payroll and will be reflected on the first scheduled paycheck of the month and the amount will be taxable.
| Plan Features | Network Plan (CA only) |
Traditional Plan | Consumer Choice Plan | ||
|---|---|---|---|---|---|
| In-Network Only | In-Network | Out-of-Network | In-Network | Out-of-Network | |
| Annual Deductible | |||||
| Per Person Per Family |
$250 $500 |
$500 $1,000 |
$1,000 $2,000 |
$2,000 $3,300*/$4,000 |
$4,000 $5,600*/$8,000 |
| Out-of-Pocket Maximum | |||||
| Per Person Per Family |
$2,500 $5,000 |
$3,000 $6,000 |
$6,000 $12,000 |
$6,650 $13,300 |
$13,300 $26,600 |
| Medical Coverage | |||||
| Doctor’s Office Visits | $20 copay | $25 copay | 40% after deductible | 20% after deductible | 50% after deductible |
| Preventive Care Visit | No charge | No charge | Not covered | No charge | 50% after deductible |
| Specialist Visit | $20 copay $30 copay for self-referral |
$30 copay | 40% after deductible | 20% after deductible | 40% after deductible |
| Telemedicine Visit | No charge | No charge | Not covered | $60 copay (until deductible met) | Not covered |
| Outpatient Surgery | $100 copay | 20% after deductible | 40% after deductible | 20% after deductible | 40% after deductible |
| Inpatient Hospital (per stay) | $250 copay | $250 copay + 20% | 40% after deductible | 20% after deductible | 40% after deductible |
| Emergency Room | $100 copay | $100 copay + 20% | 20% after deductible | ||
| Urgent Care | $20 copay | $25 copay | 40% after deductible | 20% after deductible | 40% after deductible |
| Labs and X-rays | No charge | 20% after deductible | 40% after deductible | 20% after deductible | 40% after deductible |
| Retail Prescription Drugs (30-day supply) | |||||
| Generic | $15 copay | $15 copay | 25% + $15 copay | $15 copay | 25% + $15 copay |
| Brand Formulary | $30 copay | $30 copay | 25% + $30 copay | $30 copay | 25% + $30 copay |
| Non-Formulary | $45 copay | $45 copay | $25% + 45 copay | $45 copay | 25% + 45 copay |
| Mail-Order Prescription Drugs (90-day supply) | |||||
| Generic | $45 copay | $45 copay | Not covered | $45 copay | Not covered |
| Brand Formulary | $90 copay | $90 copay | Not covered | $90 copay | Not covered |
| Non-Formulary | $135 copay | $135 copay | Not covered | $135 copay | Not covered |
*There is an individual deductible embedded in the family deductible. An individual with family coverage can begin receiving coinsurance benefits by meeting the individual deductible of $3,300 in network / $5,600 out of network before the meeting the family deductible. See the plan document for details.
Annual medical and dental checkups help you stay healthy. Take care of yourself and your family by using your free in-network preventive care benefits each year. Preventive care visits allow you to take action early and keep treatable health issues from becoming chronic conditions.
Call your doctor and dentist to schedule your FREE annual checkup today! Need to find a doctor?
Visit the Blue Shield of California website: Blue Shield of CA.
Looking for ways to keep more dollars in your pocket? Mail order pharmacy is a great way to save time and money by having your medications delivered to your door. For medications taken regularly (such as high blood pressure or diabetes medicine), ask your doctor to provide you with a 90-day prescription.
Specialty drugs for chronic illnesses are filled through CVS Caremark. If specialty drugs are needed, contact CVS Caremark at 800-237-2767 or visit CVS Caremark Specialty RX.
Feeling under the weather? Free telemedicine services save you money while giving you control of when and where you access care services. Teladoc’s virtual visits give you direct access to a licensed medical professional who can treat common conditions, such as allergies, cold or flu symptoms, earaches, rashes, pinkeye, sinus infections, and more.
HMO & PPO Teladoc visit cost: $0 copay
Register: Teladoc
Call: 800-835-2362 (800-Teladoc)
To find a Blue Shield of CA provider or hospital in your area, please visit Find A Doctor.
This website highlights some of your benefit plans. Your actual rights and benefits are governed by the official plan documents. If any discrepancy exists between this communication and the official plan documents, the plan documents will prevail. The company reserves the right to change any benefit plan without notice. Benefits are not a guarantee of employment.
For benefit questions & claims assistance, contact TouchCare at 866-486-8242 or assist@touchcare.com.
For HR related questions, contact the HR Service Desk.
