About PRISM

Healthcare Resources During Catastrophic Events

As catastrophic events continue to impact Public Agencies throughout California, the EIA and our Carrier Partners want to make sure our Member entities and any displaced employees know how to obtain support and assistance with their employee benefit needs during displacement or crisis. While the information below comes from the carriers who partner with the EIAHealth and Employee Benefits programs, it applies to all subscribers of these carriers, regardless of their participation in the EIA specific Employee Benefit programs.

Blue Shield of California

  • Members who need immediate, but non-emergency, assistance should call the customer service phone number, 1.800.393.6130 (TTY: 711).

  • Members who may have lost or misplaced their identification card can print a new card on our website at blueshieldca.com. Alternatively, members can use the Blue Shield of California mobile app to access their ID card on their mobile device.

  • Blue Shield Medical Care Solutions will reach out to members in care and disease management programs in mandatory evacuation areas to ensure continuity of care.

  • Magellan Health, Blue Shield’s contracted managed care plan for behavioral health services, is providing free access to resources, materials and counseling services through its dedicated hotline: 1.800.327.7451.

  • Teledoc has activated the natural disaster hotline for general medical care at no cost for individuals in California affected by the ongoing fires: 1.855.225.5032 and https://www.teladoc.com/disaster-hotline.
    • This service is available to any individual impacted during the emergency, and is not tied to current Teladoc membership, client or health plan accounts
    • Current Teladoc members must use the hotline to receive services free of charge. If they contact Teledoc through their normal channels or group set up, they will be charged the standard visit fee based on their eligibility.
    • Individuals registered through this mechanism will not be associated with a paying group, and will need to re-register with their existing group account to use Teladoc in the future.

2019 Blue Shield Displaced Member - LA County Fire

2019 Blue Shield Displaced Member - Sonoma County Fire

2019 Blue Shield Teledoc Natural Disaster

Anthem

  • Members who need immediate, but non-emergency, assistance should call the customer service phone number on their Anthem card or 1.833.285.4030.
  • Anthem has relaxed time limits for prior authorization, pre-certification and referral requirements.  In addition, they have suspended early refill limits for prescriptions and extended filing deadlines for claims.
  • Anthem health plan members who have been impacted can access Anthem’s Employee Assistance Program (EAP) which provides support services to help with stressful situations and financial or legal concerns. These services will be offered at no cost and are available 24/7 at 1.877.208.8240.
  • Anthem is allowing replacement of medical equipment or supplies.

These relaxed medical and pharmacy guidelines are effective from October 25, 2019 through December 2, 2019, unless further extended.

Express Scripts (ESI)

  • Members requiring assistance can contact ESI at 1.800.282.2881.

  • ESI will replace lost or damaged home delivery prescriptions. Members are not charged a copay or shipping costs for the replacement prescription upon confirmation by Express Scripts the order was lost or damaged.

  • ESI home delivery pharmacy orders can be shipped to a temporary alternate address. Members who desire to have their prescription redirected are instructed to call the patient care contact center (the telephone number on the back of their member identification card) and request their order be mailed to a temporary address. This applies to new orders, refills of existing prescriptions on file with Express Scripts and, in some instances, orders already placed.

  • If a member is unable to receive their order by mail, prescriptions can be transferred to a retail pharmacy for dispensing. The retail pharmacy can contact the ESI Pharmacy Help Desk phone number on the back of the member/patient’s respective ID card.

  • ESI will continue to make doctor calls and drug utilization review (DUR) calls and every effort is made to complete those calls. Orders will not be cancelled and returned unfilled to the member. The home delivery pharmacies hold these orders in-house until the member/prescriber has been reached.

Kaiser

Members can access any Kaiser Permanente facility if being displaced by the fires. However if members need to talk with someone to schedule an appointment or need advice, Kaiser Permanente members can contact our Appointment and Advice Call Center:  

  • Northern California: 1.866.454.8855 (24 hours a day, 7 days a week)
  • Southern California: 1.833.574.2273 (Advice 24/7, Appointments during local business hours)

Members who need a prescription or refill can go to any open Kaiser Permanente pharmacy.  If you would like your non-urgent prescriptions mailed to you, you can order them online at our refill page or call our pharmacy department.  Please note, it may take 3-5 days to deliver your prescriptions via mail.

If there is no nearby Kaiser Permanente pharmacy or if other assistance is needed, members can call the Kaiser Permanente Pharmacy Call Center at:

  • Northern California: 1.888.218.6245 (M-F 8am-8pm, Sat. 8am-6pm, Sun. 9am-6pm)
  • Southern California: 1.866.206.2983 (M-F 7am-7pm)

To replace an ID card or for other Kaiser Permanente questions and concerns, members can call the main Member Services line at 1-800-464-4000. Members should mention that they have been affected by the fires to ensure nothing is sent to their home address.

Delta Dental

  • Members with special situations, or with extenuating circumstances resulting from the wildfires, may call their Delta Dental customer service center for assistance: 1.888.335-8227. Members should also contact customer service if there is no dentist in their area due to this emergency. The online customer service form can be found on the Delta Dental website: https://www.deltadentalins.com.

  • Delta Dental is working to maintain the timely payment of claims and offer assistance in obtaining dental records if needed.

  • Delta Dental is ensuring members do not owe unreasonable costs at an out-of-network dentist. Also to reimburse out-of-network claims for Medicare and Medicaid enrollees.

2019 Delta Dental Cal Fire Update

VSP

  • Any VSP member who has lost or broken their eyewear due to the recent fires can call Member Services Support Line at 1.800.877.7195 to have their VSP benefits reinstated regardless of eligibility.
  • Individuals without VSP coverage can contact their local American Red Cross chapter and request a VSP Global Eyes of Hope gift certificate.

MES Vision

  • MES Customer Service Department can be reached at (800) 877-6372 or TTY/TDD: 1.877.735.2929.

  • MES has relaxed time limits for prior authorization, precertification, or referrals and requests for medically necessary contact lenses are expedited to provide a response within three (3) business days of receipt.

  • MES will extend the filing deadline an additional six (6) months – for a total of eighteen (18) months – from the date of service for all claims from members or participating providers in designated state of emergency disaster areas through the end date of the disaster period.

  • MES will grant early eligibility for services for members in designated state of emergency disaster areas allowing subscribers to get exams and/or eyewear before the regularly scheduled eligibility dates through the end date of the disaster period.

  • MES will allow use of a non-network provider if a network provider is unavailable due to the state of emergency, or if a member is out of the area due to displacement.

  • MES Customer Service Department has been trained to assist members with vision care needs if they are impacted by a designated state of emergency.

2019 MES Notice to Members Due to State of Emergency

Voya (participants in EIA Voya program only)

Included with the CSAC EIA Voya life and disability plan is the ComPsych® GuidanceResources® program, an Employee Assistance Program (EAP).  This program offers confidential emotional support with access to counselors, work-life solutions, legal guidance, and financial resources.

CSAC-EIA plan members can access this plan 24/7 by calling 1.877.533.2363 and using group name CSAC-EIA and group number 316407.

VOYA EAP Guidance Resources

Cigna (participants in EIA Cigna program only)

Included with the CSAC EIA Cigna life and disability plan is the Life Assistance Program (LAP).  This program offers confidential emotional support with access to counselors (up to 3 face-to-face sessions), legal guidance, financial services, parenting guidance, and assistance locating child/senior/pet care.

Members can access this plan 24/7 by calling 1.800.538.3543 or by visiting www.cignabehavioral.com/cgi.

CIGNA LAP Resources

MHN

MHN EAP services for employees include counseling sessions (face-to-face, telephonic and web-video), child/eldercare assistance, and financial, legal, identity theft recovery and daily living services.  Services are available 24/7 via the employer’s dedicated MHN phone number or on the web at www.members.mhn.com using the employer’s company code.

In addition to EAP services for employees, member entities can access Critical Incident Stress Debriefing (CISD) services through MHN EAP at no additional cost (up to 20 hours per incident).  CISD is provided in a group setting, allowing employees to process emotions and concerns in a guided environment with a mental health professional.  This service is an additional level of support to employees who may be experiencing anxiety or stress in the workplace and are unsure about where to find resources and support.

2019 MHN Coping with the Wildfires

 

For more information, please contact Sidney DiDomenico or Heather Evans in the EIA Employee Benefits department.