Chinese Community Health Plan

2017 Individual and Family

Chinese Community Health Plans

Chinese Community Health Plan (CCHP) serves San Francisco and northern San Mateo counties. CCHP grew out of the first and only Chinese hospital in the United States and now offers health services for Medi-Cal, Medicare Advantage Plan, individual and family plans along with small group health plans. (See: CCHP History) CCHP is not just for individuals of Chinese or Asian heritage, but is open all residents and employers living in their service territory.

Summary of Benefits for Standard Benefit Design Plans

Standard benefit desgin plans are sold through Covered California and Off-Exchange.

Bronze_CCHP_2017_IFP_BenefitHighlights (97 KiB)
Gold_CCHP_2017_IFP_BenefitHighlights (95 KiB)
Min_Coverage_CCHP_2017_IFP_BenefitHighlights (96 KiB)
Platinum_CCHP_2017_IFP_BenefitHighlights (95 KiB)
Silver 87 CCHP 2017 IFP BenefitHighlights (96 KiB)
Silver 94 CCHP 2017 IFP BenefitHighlights (96 KiB)
Silver_70_CCHP_2017_IFP_BenefitHighlights (96 KiB)
Silver_73_CCHP_2017_IFP_BenefitHighlights (96 KiB)

Off-Exchange Summary of Benefits Health Plans

This plans are only available direct from CCHP. They are not available through Covered California with the premium assistance. They include health plans Active Choice, Amber, Copay25, and Jade.

2017 Rates for San Francisco and San Mateo Counties

San Francisco CCHP 2017 IFP RateSheet (184 KiB)
San Mateo CCHP 2017 IFP RateSheet (184 KiB)

Chinese Community Health Plan is one of three private regional health plans participating in Covered California and offering individual and family plans (IFP) off-exchange. The other regional HMOs are Sharp Health plan in San Diego and Western Health Advantage in the North Bay/Sacramento area. These regional health plans, all Health Maintenance Organizations (HMO), typically serve one to four counties and are not state wide.

2016 Multiple on and off exchange plans

In addition to the Bronze through Platinum metal tier plans offered through Covered California, CCHP also offers individual and family plans off the exchange. The off-exchange plans are Jade (Platinum), Copay 25 (Gold), and Amber (Silver). While CCHP is primarily an HMO, they do offer a PPO Silver level plan off-exchange called ActiveChoice with a $2,500 medical deductible and coverage for out-of-network health care services. Monthly premium rate sheets are available at the bottom of the post.

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Jade simple drug formulary

Another interesting twist is that their Gold Copay 25 plan has lower primary care and specialist visit copayments than their Platinum Jade plan. In addition, the off-exchange Jade plan has its own two-tier drug formulary as opposed to the traditional four-tier formularies found on their other off-exchange and Covered California health plans. The two-tier drug formulary means that the prescription medication has either a generic or brand name drug copay after the pharmacy deductible. This is simpler than the multi-tier drug formularies that split drugs into generic, non-preferred generic, brand name and non-preferred brand name prescriptions.

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Tiered facility coinsurance

CCHP has their pediatric dental plans administered by Delta Dental. The Jade, Amber and ActiveChoice PPO plan have a tiered facility cost sharing structure. The copayment and coinsurance is less expensive if you have an “in” or “out” patient procedure done at Chinese Community Hospital as opposed to one of the other participating hospitals in the CCHP network.

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Summary of Benefits for off-exchange plans

CCHP ActiveChoice PPO Summary of Benefits, 2014
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CCHP Summary of Benefits Amber, 2014
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CCHP Summary of Benefits Copay 25, 2014
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CCHP Summary of Benefits Jade, 2014
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Evidence of Coverage documents

The Evidence of Coverage is the rule book for how the health plan operates. It includes the exclusions to coverage and how the covered benefits are administered between the plan and the member.

CCHP Evidence of Coverage ActiveChoice PPO, 2014
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CCHP Evidence of Coverage Amber, 2014
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CCHP Evidence of Coverage Copay 25, 2014
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CCHP Evidence of Coverage Jade, 2014
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Covered California Evidence of Coverage

These Evidence of Coverage documents are for the health plans that are also sold through Covered California, but may be purchased off the exchange directly from Chinese Community Health Plan.

CCHP Platinum Evidence of Coverage
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**Gold EOC available soon**

CCHP Evidence of Coverage Silver, 2014
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CCHP Evidence of Coverage Bronze, 2014
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Network of CCHP providers

Chinese Community Health Plan offers an online doctor/hospital search tool or you can download their provider directory. All the providers listed are “in-network” for the ActiveChoice PPO plan.

CCHP Provider Directory 2014

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Hospitals affiliated with CCHP include –

Chinese Hospital

845 Jackson St., San Francisco

California Pacific Medical Center

California Campus
3700 California St. San Francisco
Davies Campus
45 Castro St., San Francisco
Pacific Campus
2333 Buchanan St., San Francisco
St. Luke’s Campus
3555 Cesar Chavez Ave., San Francisco

St. Francis Memorial Hospital

900 Hyde St., San Francisco

St. Mary’s Medical Center

450 Stanyan St., San Francisco

Mills-Peninsula Medical Center

1501 Trousdale Dr., Burlingame

Seton Medical Center

1900 Sullivan Ave., Daly City

Seton Medical Center – Coastside

600 Marine Blvd., Moss Beach