CSEBO proudly offers its Members a menu of plans to choose from through Anthem Blue Cross. All of CSEBO's medical plans offer a full-suite of condition management programs, TeleMedicine and 24/7 physician lines:

Helpful Terms:

Deductible

Copays

Coinsurance

Out-of-Pocket Maximum

The amount you pay in full for services before the plan can pay for your costs.

Copays are the fees you pay when you go to the doctor or fill a prescription.

The plan pays the rest.

Coinsurance is the percentage you pay for care for services beyond the scope of your copay after your deductible is met.

The plan pays the rest.

The maximum you will pay for medical or prescription expenses in a calendar year. If the maximum is reached, you will be covered at 100% for the remainder of the calendar year.

For more information on commonly used terms, please visit our Uniform Glossary.

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Additional Information by Plan Type

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Every plan has a prescription drug formulary, or list of drugs that are covered under the plan. CSEBO's plans all share the same formulary but are differentiated by tiers. Tiers are broken down in ascending order by member cost share, starting with the lowest member cost share:

  1. Tier 1: Generic drugs; generally have the lowest cost share for members.
  2. Tier 2: Brand drugs, contained on the formulary and are preferred; these drugs have a higher cost share for members.
  3. Tier 3: Brand drugs, not on the formulary, and are non-preferred; these drugs have a higher cost share than Tier 2 drugs.
  4. Tier 4: Specialty drugs, classified as high-cost, high complexity and are often injected or infused; these drugs have the highest cost share for members.

To access CSEBO's prescription drug formulary, please follow this link and utilize the reference guide below:

Plan Name National 3-Tier Formulary National 4-Tier Formulary Essential 4-Tier Formulary 
PPO 90 X    
PPO 80 X    
Wellness PPO     X
CDHP 90   X  
CDHP 80   X  
CDHP 60   X  
HMO 10 X    
HMO 30   X  

https://www11.anthem.com/ca/pharmacyinformation/

Preventive Rx for CDHP Plans

All Anthem CDHP plans include Preventive Rx. Preventive Rx covers drugs that may keep you healthy because they may prevent illness and other health conditions. This list covers drugs at no-cost, regardless of whether the deductible has been met, to members for certain conditions listed. Please review the attached list here.

        - Preventive Care
        - Preventive v Diagnostic Care
        - When to Use the ER
        - 24/7 Nurse Hotline
        - Anthem Discounts
        - ConditionCare
        - Future Moms
        - LiveHealth Online
        - LiveHealth Online FAQ

Member Services: 1-800-227-3771

Coverage While Traveling: 1-800-810-2583

Anthem HMO Resources

Member Services: 1-800-759-3030

Coverage While Traveling: 1-800-810-2583

Anthem PPO Resources

Member Services: 1-866-207-9878

Coverage While Traveling: 1-800-810-2583

The Anthem Wellness PPO encourages wellness for the whole family by offering wellness "credits" for completing a list of wellness activities to lower the overall deductible.

       - Wellness PPO Description
       - Wellness PPO Deductible Credit Claim Form

       - PPO 90
       - PPO 80
       - Wellness PPO
       - HMO 10
       - HMO 30
       - CDHP 90
       - CDHP 80
       - CDHP 60