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Medical Coverage

Medical Coverage

Clovis Unified School District utilizes a self-insured Preferred Provider Organization (PPO) Plan that is administered by HealthNow Administrative Services (HNAS).

Within California, the Plan utilizes providers apart of the highly-regarded Blue Shield Tandem PPO Network. Members outside of California can utilize providers in the Blue Shield Blue Card Network. To receive the maximum allowance of benefits available for covered service, members should receive services from in-network providers.

The Health Plan year runs from September 1st to August 31st. For a detailed explanation of covered services under the Plan, please click the link for the CUSD Summary Plan Document located under Resources.

Because CUSD has self-insured benefits, the District utilizes a third-party administrator called HealthNow Administrative Services (HNAS) to assist in administering the health plan.

HNAS provides members with services including but not limited to benefit quotes, payments of claims, provider look-ups, and printing insurance ID cards.

Inquiring members can utilize the HNAS Member Services number located conveniently on the back of the Blue Shield Insurance card for future assistance.

 

Red outline of a laptop with a magnifying glass on the screen with the words: "Access the myHNAS Member Portal"

A chart outlining co-payment and out-of-pocket maximums for different types of medical visits.

 

Care for Covered Urgent and Emergency Services Outside the BlueCard Service Area

If you are outside of the BlueCard® Service Area, you may be able to take advantage of Blue Shield Global Core when accessing Out-of-Area Covered Health Care Services. Blue Shield Global Core is unlike the BlueCard Program available within the BlueCard Service Area in certain ways. For instance, although Blue Shield Global Core assists you with accessing a network of inpatient, outpatient, and professional providers, the network is not served by a Host Blue. As such, when you receive care from providers outside the BlueCard Service Area, you will typically have to pay the provider and submit the claim yourself to obtain reimbursement for these services.

If you need assistance locating a doctor or hospital outside the BlueCard Service Area you should call the service center at 1-800-810-BLUE (2583) or call collect at 1-804-673-1177, 24 hours a day, seven days a week. 

Provider information is also available online at BCBS: select “Find a Doctor” and then “Blue Shield Global Core”.

Submitting a Blue Shield Global Core Claim

When you pay directly for services outside the BlueCard Service Area, you must submit a claim to obtain reimbursement. You should complete a Blue Shield Global Core claim form and send the claim form along with the provider’s itemized bill to the service center at the address provided on the form to initiate claims processing. Following the instructions on the
claim form will help ensure timely processing of your claim. The claim form is available from Customer Service, the service center or online at BlueCross BlueShield Global Core.  It is also available on this web page.

If you need assistance with your claim submission, you should call the service center at 1-800-810-BLUE (2583) or call collect at 1-804-673-1177, 24 hours a day, seven days a week.

  • Because CUSD has self-insured benefits, the District utilizes a third-party administrator called HealthNow Administrative Services (HNAS) to assist in administering the health plan.

    HNAS provides members with services including but not limited to benefit quotes, payments of claims, provider look-ups, and printing insurance ID cards.

    Inquiring members can utilize the HNAS Member Services number located conveniently on the back of the Blue Shield Insurance card for future assistance.

     

    Red outline of a laptop with a magnifying glass on the screen with the words: "Access the myHNAS Member Portal"

  • A chart outlining co-payment and out-of-pocket maximums for different types of medical visits.

     

  • Care for Covered Urgent and Emergency Services Outside the BlueCard Service Area

    If you are outside of the BlueCard® Service Area, you may be able to take advantage of Blue Shield Global Core when accessing Out-of-Area Covered Health Care Services. Blue Shield Global Core is unlike the BlueCard Program available within the BlueCard Service Area in certain ways. For instance, although Blue Shield Global Core assists you with accessing a network of inpatient, outpatient, and professional providers, the network is not served by a Host Blue. As such, when you receive care from providers outside the BlueCard Service Area, you will typically have to pay the provider and submit the claim yourself to obtain reimbursement for these services.

    If you need assistance locating a doctor or hospital outside the BlueCard Service Area you should call the service center at 1-800-810-BLUE (2583) or call collect at 1-804-673-1177, 24 hours a day, seven days a week. 

    Provider information is also available online at BCBS: select “Find a Doctor” and then “Blue Shield Global Core”.

    Submitting a Blue Shield Global Core Claim

    When you pay directly for services outside the BlueCard Service Area, you must submit a claim to obtain reimbursement. You should complete a Blue Shield Global Core claim form and send the claim form along with the provider’s itemized bill to the service center at the address provided on the form to initiate claims processing. Following the instructions on the
    claim form will help ensure timely processing of your claim. The claim form is available from Customer Service, the service center or online at BlueCross BlueShield Global Core.  It is also available on this web page.

    If you need assistance with your claim submission, you should call the service center at 1-800-810-BLUE (2583) or call collect at 1-804-673-1177, 24 hours a day, seven days a week.

Resources

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  • The information available through the below link is provided in good faith to comply with the Machine-Readable Files (MRF) provision of the Transparency in Coverage Final Rule (TCFR). These files are extensive collections of data to be ingested and read by machines and are not intended for consumer/member use. 
     

         Access Files

     

    To learn more about the TCFR and the MRF provision, refer to this Centers for Medicare & Medicaid Services page.