Keck/Norris union employee medical plan details

USC Trojan Care EPO

Includes access to Keck Medicine of USC providers and other outstanding, carefully selected providers. This low-cost plan is specially designed for USC employees. See EPO details.

USC PPO

Includes access to Keck Medicine of USC providers (Tier 1), Blue Cross Prudent Buyer/BlueCard providers (Tier 2), and providers who are out-of-network (Tier 3). Because of this broad choice in providers, this is the most expensive plan. See PPO details.

Anthem HMO

Includes providers in Anthem’s HMO network and other selected providers. This low-cost plan does not allow you to choose a Keck Medicine of USC doctor, although some Keck doctors are in the Anthem network. See HMO details.

Anthem MyChoice HMO

Under this HMO, you must use Anthem MyChoice providers; there is no out-of-network coverage (except in an emergency). You must choose an Anthem MyChoice doctor as your primary care physician (PCP) to be your first point of contact, coordinate your care and make referrals. When you need care, you’re charged $30 per office visit ($40 for specialists, for which you must have a referral) and the plan pays the rest of the covered expense. Participants in Anthem MyChoice do not qualify for any of the healthy choices incentives; they are not charged the working spouse surcharge.

To find providers in the Anthem MyChoice HMO:

  1. Go to www.anthem.com/ca and scroll down the home page to click on Find A Doctor. You may search as a member, or click on Continue under Search as a Guest, then follow the steps below.
  2. Under “How do you get Insurance?” select Through my employer.
  3. Under “What state do you want to search in?” select the name of your state.
  4. Under “What type of care are you searching for?” select Medical.
  5. Under “Select a plan/network,” enter “Blue Cross HMO (CACare) – Large Group” then click on Continue.
  6. Using the drop-down boxes, select what type of doctor, specialty and location you’re looking for, then select Search.
  7. For more information about a provider, such as skills and training, click on the provider’s name on the screen that appears after you select Search.

MyChoice Anthem HMO Evidence of Coverage

Compare medical plan options

Here’s a quick look at the key differences between the medical plan options. For a detailed comparison of the options, you may wish to view, download or print the 2020 medical plan comparison chart (union).

USC Trojan Care EPO USC PPO Anthem HMO Anthem MyChoice HMO
Cost per paycheck $ $$$ $ no cost
Provider options Keck Medicine of USC and a custom network of carefully selected providers

Tier 1: Keck Medicine of USC

Tier 2: Anthem Prudent Buyer PPO network providers

Tier 3: Out-of-network

Only Anthem HMO network providers

Anthem MyChoice providers only
Primary care physician required to coordinate care? No No Yes Yes
Out-of-network coverage? No Yes No No
Preventive care $0 Tier 1: $0

Tier 2: $0

Tier 3: 50% of “usual and customary” charge and 100% of any additional cost over that

$0 $0
Office visit cost $20 copay

($10 copay for designated primary care physician)

Tier 1: $20 copay

Tier 2: $30 copay

Tier 3: 50% of “usual and customary” charge and 100% of any additional cost over that ($10 copay discount for designated primary care physician)

$20 copay $30 copay
Specialist visit cost $20 copay Tier 1: $20 copay

Tier 2: $30 copay

Tier 3: 50% of “usual and customary” charge and 100% of any additional cost over that

$20 copay $40 copay
Deductible (individual/family) $100 / $300 Tier 1: $100 / $300

Tier 2: $250 / $750

Tier 3: $600 / $1,800

$0 / $0 0

Compare prescription drug coverage

Your prescription drug coverage is included with your medical coverage. The amount you pay depends on the medical plan you choose, and using a network pharmacy will save you money. Make sure you know which pharmacies are in your plan’s network.

Each medical plan has its own prescription drug formulary (a list of medications, both generic and brand name, that offer the greatest overall value). The formulary determines which (and how) drugs will be covered, and how the brand-name drugs on the formulary are classified (preferred or non-preferred). Be sure to check your medications against your medical plan’s formulary, which may change.

Retail prescription drug coverage USC Trojan Care EPO

You pay:

USC PPO

You pay:

Anthem HMO

You pay:

Anthem MyChoice HMO

You pay:

Pharmacy deductible 0 0 0 $25
Generic $5 $5 $10 $10
Brand (no generic available) $25 $25 20%
($30 min., $125 max.)
$25 (formulary only)
Brand (generic available) $70 $70 45%

$50 min., $250 max.

$40
Specialty drug $125 $125 Same as above except self- administered injectable drugs $200 (not including insulin) 20% ($200 max) (formulary only)