Provider Benefits

Provider Health Benefits

The IHSS Public Authority is offering Medical, Dental, and Vision to eligible IHSS providers at no cost. In order to be eligible for these medical benefits, provider must be paid by Solano County IHSS for at least 65 hours per month for two consecutive months.

How to enroll

Once providers meet the criteria and become eligible, we will automatically send them the application form. They need to fill out the form and submit within 30 days. Enrollment applications will be accepted on a first-come, first-served basis. If they are determined eligible they will be placed on a waiting list until an opening in the plan becomes available. Currently we have a waiting list that is about 2 years old and contains about 500 people.

Please remember that the eligibility criteria of being paid for 65+ hours for two consecutive months must be maintained.  Monthly reports from the State use pay periods from two months to report monthly paid hours.  For example: The March report uses the February 16-28 and March 1-15 pay periods.  Eligibility is based upon these pay periods.  It is very important to continue to turn in your timesheets within five days after the end of each time period to maintain uninterrupted eligibility.

Health Benefits available for eligible IHSS Providers include:

 

Description of Benefits  (*Shaded benefits below share in $50,000 PP/PCY Max)

Doctor’s Office Visit Indemnity Benefit

$85 per visit
     $50,000* PP/PCY Max.
For Example:   
   
- If the office visit cost is $100, Symetra will pay $85 and you pay the difference of $15
    - If the office visit cost is $85 or less you pay nothing

Hospital Indemnity Benefit


$1,500 daily hospital room and board up to 30 days per person, per calendar year.
 
    $50,000* PP/PCY Max
$3,000 daily ICU
    $50,000* PP/PCY Max


Surgical Benefit


$5,000 PP/PCY Max

Outpatient DXL
Lab Benefit

X-Ray

Major Diagnostic
Testing


$15 per procedure
    $50,000*PP/PCY Max
$35 per procedure
    $50,000*PP/PCY Max
 $200 per procedure
    $50,000*PP/PCY Max 

Preventive Care

$150 per visit (includes routine exams, medical treatment).
$150 maximum per person, per calendar year.

Emergency Room Benefit

$200 per visit
    $600 PP/PCY Max

Ambulance Benefit
GroundTransportation
Air Transportation
Total number of allowed occurrences

$1000 per occurrence
$2000 per occurrence

    5 PP/PCY Max
Additional Accident Benefit
Occurrence
Up tp $1000

3 PP/PCY Max

Prescription Drugs
Generic Co-pay
Brand Name Co-pay


$5 co-pay
$20 co-pay for name brand 
     $3,000 maximum benefit per person, per calendar year.

Vision  Plan
Per Exam
Glasses/Contacts every 2 years


$50 per exam, PP/PCY
$100/glasses, $75/Contacts

Dental Plan
Annual Maximum
Basic
Major
Orthodontia Visit


$1500 PP/PCY Max
    $100
    $400
    $250

Pharmacy Discount Program

A discount off usual and customary charges may be given to eligible person when prescriptions are purchased through a contracting pharmacy.



If you have any qustions about your health plan, please call insurance company Symetra at 800-497-3699.
If you have any questions about your benefits eligibility or your waiting list status, please call Public Authority benefits specialist at 707-784-8054. 

IHSS Care providers who work less than 80 hours per month MAY qualify for the County's low-income health care program. 
Please visit http://mypath2health.org/ for more information.