Medical plans are offered through ASCIP
(Alliance of Schools for Cooperative Insurance Programs)
2023 Benefit Comparison.pdf
HMO vs. PPO plans – what are the differences?
Key Terms
Deductible - the amount you pay each year before your plan starts to pay.
Copay - a flat fee you pay for covered services like doctor visits.
Coinsurance - your share of health plan costs (a percentage of total costs) after meeting your deductible.
Out-of-Pocket Maximum - the most you have to pay out-of-pocket each year for health care services. once this amount is reached, insurance will pick up 100% of any subsequent qualifying expenses.
Premium - The amount you pay to belong to a health plan.
In Network - Providers who have agreed to render services at a negotiated rate
Out of Network - Providers who have not agreed to provide services at the negotiated rate. Members can still see these providers, but may experience higher fees, balance billing for the difference between the charged fee and the negotiated rate as well as different deductible out of pocket maximum.
Who is SISC?
You may see SISC on many of the plan documents. ASCIP partners with SISC (Self Insured School of California) to administer its billing and eligibility functions for Anthem and Blue Shield HMO and PPO plans. This partnership ensures that ASCIP districts benefit from the negotiating leverage of the larger SISC pool while still having access to the local support and unique programs offered through ASCIP.
