Medical Insurance

Medical, including Critical Illness

The FRMS offers a variety of comprehensive and competitively priced medical plan options through Blue Shield of California and Kaiser Permanente. Additionally, agencies that enroll in FRMS’s medical plans are automatically covered under the group critical illness insurance offered through The Hartford. Fire districts that enroll in medical plans will also have access to an annual wellness stipend to be used towards the district’s wellness activities and equipment, as well as access to 24/7 mobile access to mental health resources through Cordico.

Please contact our office for a quote.

Blue Shield of California – EPO, PPO, High-Deductible PPO:

Plan Type/Network: Blue Shield of California PPO Network

Administered by: Health Now Administrators

Pharmacy Benefit Manager (PBM): EmpiRx Health

• Basic PPO – $1,000 deductible, $30 office visit copay, 80% coinsurance
• Premium PPO – $500 deductible, $15 office visit copay, 90% coinsurance
• Basic EPO – $500 deductible, $30 office visit copay, 80% coinsurance
• Premium EPO –  $0 deductible, $15 office visit copay
• HSA 2000 PPO – $2,000 deductible, 70% coinsurance, HSA/HRA compatible

Blue Shield of California – Trio HMO (Limited Network):

Plan Type: Blue Shield of California Trio HMO

Administered by: Blue Shield of California

Pharmacy Benefit Manager (PBM): Blue Shield of California

• Trio HMO – Eligibility requirements apply. Please contact our office to request more information.

Kaiser Permanente – HMO:

Plan Type/Network: Kaiser Permanente

Administered by: Kaiser Permanente

Pharmacy Benefit Manager (PBM): Kaiser Permanente

• Basic Deductible HMO (Low) – $500 deductible, $20 office visit copay, $10 chiropractic visit copay (20 visit max)
• Premium HMO (High) – $0 deductible, $15 office visit copay, $10 chiropractic visit copay (20 visit max)

Kaiser 2023-2024 COVID-19 Services Amendment – Effective 11-12-2023

The Hartford – Critical Illness (Available at no cost with Medical):

Agencies that enroll in FRMS’s medical plans are automatically covered under the group critical illness insurance offered through The Hartford.

• Critical Illness insurance can provide a lump-sum benefit upon diagnosis of a covered illness that can be used however you choose – from expenses related to treatment to deductibles or day-to-day costs of living such as the mortgage or your utility bills.
• Covered Illness includes Cancer, heart attack, heart failure/transplant, stroke, coronary artery bypass graft, end-stage renal failure, major organ failure/transplant, and paralysis
• Guaranteed Issue Amount: $5,000 (Primary/Self); 25% of primary insured coverage for dependent child(ren)

Wellness Stipend Program (Available to Fire Districts with Medical)

Each Fire District participating in the FRMS medical program will be allotted a wellness stipend based upon the number of fire personnel enrolled in the FRMS medical program as of January 1^st of each calendar year.

The district wellness stipend must be used towards the Fire District’s wellness activities, equipment, and/or supplies that directly benefit the wellness of firefighters and emergency personnel during the plan year (there is no carryover of monies to the following year).

Once the Fire District decides on the wellness activities, events, programs, or equipment/supplies, a detailed explanation along with a Fire District generated invoice (see the Fire District Wellness Stipend Program Invoice Form) are to be completed. The explanation documentation along with the completed invoice should be submitted via email to FDACEBABilling@keenan.com , and copy (cc) Dawn Almanzor, dalmanzor@keenan.com . Reimbursements will be made directly to the Fire District. Learn More & Complete Invoice

Cordico Mental Health Resource (Available to Fire Districts with Medical)

The FRMS has partnered with Cordico to provide 24/7/365 access to powerful first responder wellness tools in-hand, on-demand, and confidential through mobile app. This benefit is included at no additional cost when participating in the FRMS medical program.

The app includes Self-Assessments, Cancer Awareness, Employee Assistance Program & more.

Plan Documents

• 2024 Important Notices
• Summaries of Benefits and Coverage

Resources

• HealthNow Online Benefit Portal
  • Access your claims, eligibility, temporary health plan ID card, and other valuable plan information 24/7 through myHNAS. You’ll find important documents, links to health-related resources, and answers to frequently asked questions.
• EmpiRx Health – Member Portal
• EmpiRx Health Mail Order Pharmacy (for Blue Shield of California members)
• Cordico Wellness App (TBD)