IEHP Covered

IEHP Covered plans have been certified as Qualified Health Plans (QHPs) by Covered California, the state’s health insurance marketplace. Coverage includes 10 categories of Essential Health Benefits required by the Affordable Care Act (“ACA”):

• Ambulatory patient services (outpatient care you get without being admitted to a hospital).
• Emergency services.
• Hospitalization (like surgery and overnight stays).
• Pregnancy, maternity, and newborn care (both before and after birth).
• Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy).
• Prescription drugs.
• Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills).
• Laboratory services.
• Preventive and wellness services and chronic-disease management.
• Pediatric services, including dental and vision care for members through age 18 years (this does not include adult dental and vision coverage).

For adults who are interested in purchasing dental coverage, stand-alone dental plan options can be selected on the Covered California marketplace when purchasing medical coverage. Information on adult vision plans is available on the Covered California marketplace: Adult Vision | Covered California™.

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Plan Premiums

The IEHP Covered plan subscriber is responsible for payment of monthly plan premiums to IEHP. The first plan premium amount must be paid to IEHP no later than the last day of the month in which the plan is effective. For example, the first premium must be received by January 31 for an effective date of January 1.

After the first plan premium payment, the full monthly premium payment is due on or before the first day of each coverage month.

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Plan premiums are payable by the subscriber and are based on number of covered individuals.

Plan premiums must include those members whose coverage starts during the month and those members whose coverage terminates during the month. Refer to the “Newly Acquired Dependents” section of Evidence of Coverage (EOC) regarding coverage of newly born or newly adopted children.

Premium payments can be made by any one of these options: monthly automatic deduction from a personal checking account, check, cashier’s check, money order, debit card or credit card, or general purpose pre-paid debit card. Premium payments by a paper (check, cashier’s check, or money order) must be mailed to:

IEHP

P.O. Box 511399

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Los Angeles, CA 90051-7954

To make a payment by phone, call IEHP Member Services at 1-855-433-IEHP (4347) (TTY 711)

and dial 1. You can also pay in-person with cash by going to IEHP offices at 10801 6th Street, Rancho Cucamonga, CA 91730.

Plan premiums may be changed by IEHP effective January 1st of each year with at least 60

calendar days written notice to the subscriber prior to the date of such change.

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