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Cal Poly Pomona

Open Enrollment 2009

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2010 Health Plan Benefit Changes

The following is a summary of some of the most important changes to your health benefits coverage effective January 1, 2010. 

View the health plan's Evidence of Coverage (EOC) booklet for a complete explanation of the benefits covered, as well as limitations and exclusions that may apply. Be sure to review this information carefully to determine whether you need to make a health plan change.

Athem Blue Cross (PERS Select, PERS Choice, and PERS Care) Basic Plans will:

  • Comply with the Mental Health Parity and Addiction Equity Act of 2008 (H.R. 1424). Mental health and substance abuse benefits will be changed to achieve full parity with medical benefits.
  • Cover medically necessary anesthesia during a colonoscopy screening (subject to prior authorization, deductibles, and co-payments).
  • Will be expanding benefits for transplants as of January 1, 2010. You may contact Anthem Blue Cross Member Services at (877) 737-7776 or visit their website at http://www.anthem.com to obtain more information regarding this benefit.

Kaiser Permanente Basic Plan will:

  • No longer cover chiropractic care; however, discounts are available up to 25% off.
  • Modify the prescription drug benefit to a $5 Generic / $15 Brand name up to a 30 day supply in the retail pharmacies, and a $10 Generic / $30 Brand name up to a 100 day supply through mail order.
  • Comply with the Mental Health Parity and Addiction Equity Act of 2008 (H.R. 1424). Mental health and substance abuse benefits will be changed to achieve full parity with medical benefits.


Blue Shield
(Access +, NetValue) Basic Plans will:

  • Comply with the Mental Health Parity and Addiction Equity Act of 2008 (H.R. 1424). Mental health benefits will be changed to achieve full parity with medical benefits. Refer to the EOC for substance abuse benefit information.
  • Apply the mail service co-payment to maintenance drugs for each subsequent 30-day supply for drugs at a participating pharmacy after 3 months. For diabetic supplies and smoking cessation therapy drugs, the non-Formulary co-payment may also apply.
  • Expand the NetValue service area to include an additional four counties:
    • San Francisco
    • Imperial
    • San Luis Obispo
    • San Mateo (designated regions)