 Browse our library of forms for easy access to general plan information, enrollment applications and more. Everything you need to service your group - right at your fingertips. MEBT EMPLOYER AND EMPLOYEE FORMS  1-50 Employee Health Questionnaire - SHARP HMOGROUP HEALTH There are five different Blue Shield PPO plans available that provide both an in-network and out-of-network benefit. Blue Shield of California Blue Shield PPO $10 / $250 Blue Shield PPO $25 / $500 Blue Shield PPO $20 / $1,500 Blue Shield PPO $10 / $3,000 Blue Shield Prescription Coverage Blue Shield PPO HSA/HRA Compatible $2,250For San Diego County and Southern Riverside County, there are two HMO plans available through Sharp Healthcare. GROUP DENTAL The PPO plan provides an in-network and out-of-network benefit, as well as a limited orthodontic benefit. GROUP LONG TERM DISABILITY Each employee who enrolls in any of the above health plans also receives Long Term Disability. GROUP LIFE Each employee who enrolls in any of the above health plans also receives $25,000 of life insurance. Summary of Benefits GROUP VISION Each employee who enrolls in any of the above health plans also receives coverage for eye exams through VSP at no cost. A participant may choose to add coverage for lenses, frames and contacts on a voluntary basis. GROUP EMPLOYEE ASSISTANCE PROGRAM Each employee who enrolls in any of the above health plans receives this valuable coverage at no cost. |