Frequently Asked Questions

1. Can I buy insurance from CHPS?
2. What does CHPS actually do?
3. Why should I get my health services from participants in the CHPS network?
4. How do I pick a doctor?
5. What if I need a doctor who's not listed?
6. What's the fine print?

Can I buy insurance from CHPS?

If you are an employer of 2 or more employees, you may qualify to purchase a health plan through CHPS. Individuals are not able to directly purchase from CHPS. However, you and your employer are free to investigate the products offered through CHPS by choosing the CHPS Affordable Health Plans button on our home page. Some plans offer premiums as low as $40 per month, depending on the group, industry and the amount an employer is able to pay for each employee.

Most of the products offered through CHPS are different than traditional health insurance offered through the major national companies. CHPS health plans focus on benefits that ease the out of pocket costs for wellness, preventive and early intervention care that often helps avoid catastrophic health conditions. All of CHPS plans offer benefits for inpatient and emergency care. However, the annual and lifetime maximums are typically lower than standard catastrophic or "major medical" coverage.

What does CHPS actually do?

CHPS offers access to low cost health benefit options for employers of 2 - 100+ employees. These low cost health plans are made available through designated brokers in Siskiyou County.
Within the health plan options, CHPS provides additional services to assist client businesses with health benefit plan administration. For example, CHPS provides services to self-insured employers. Self-insured employers generally pay most of their employees' health care bills directly, rather than paying premiums to an insurance company. CHPS' services on behalf of its self-insured clients include: p>

1) Processing of claims

2) Review of proposed treatment plans for

consistency with current medical standards

3) Access to a network of contracted facilities

and professionals with whom we have negotiated 

competitive fees

4) Various other plan administration functions  

Additionally, CHPS mission includes supporting community health outreach for uninsured and under-insured community members in Siskiyou County. To this end, a portion of CHPS proceeds will go to support the educational and direct health service activities of the Siskiyou Health Partnership.

Why should I get my health services from participants in the CHPS network?

Participating clinicians and facilities have agreed to limit their fees for CHPS enrollees, usually to well below their usual fees. What's more, when you obtain services within the CHPS network, your employer's benefit plan will pay the claims at the highest level available. By making services more affordable, we help you to get the care you need.

How do I pick a doctor?

First, we recommend that you choose a primary care clinician to coordinate your care, and to help you decide if and when you need more specialized services. Coordination of care is very important in helping you get healthy and stay healthy. Primary care clinicians include:

• pediatric physicians, who just work with children and young adults;
• internal medicine physicians (also known as "internists"), who just work with adults;
• family physicians, who work with all ages;
• family nurse practitioners and physician assistants, who can provide routine ongoing care that does not require the direct involvement of a physician.

When a health-related question or problem arises that is not an emergency, contact your primary care clinician's office. Of course, in a true emergency you should obtain care immediately. Participating clinicians and facilities have agreed to submit their bills directly to CHPS.

What if I need a doctor who's not listed?

If you need to see a physician in a specialty that's not listed, call or e-mail us and we can attempt to work out an arrangement with a physician in that specialty. If you need services outside of Siskiyou, Shasta and Jackson counties, CHPS has developed relationships with a statewide provider network called Interplan, and with a national provider network called MultiPlan. To find a clinician or facility within California, contact Interplan at 800-444-4036 or online at www.interplancorp.com. To find a clinician or facility outside of California, contact Multiplan at 800-546-3887, or on the web at www.multiplan.com.

What's the fine print?

You are responsible for understanding your own coverage. Your coverage is subject to the terms of your employer's Evidence of Coverage, which you can obtain from your human resources office. We strongly encourage you to read and understand it. The Evidence of Coverage includes important information such as: what services are covered and what services are specifically excluded from coverage, limitations on coverage, procedures for certifying that proposed treatments are consistent with current standards and thereby eligible for coverage, etc.