RUSD EPO & PPO Plans

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• How to Register- Lucent Health Portal  - View your card (print a copy), claims, deductible and more...

• How to Register- Lucent Health Mobile App - View your card (show providers on your phone), claims, deductible and more... 

• How your Member Healthcare ID Works - See how to navigate how your medical ID card works

The RUSD EPO (Exclusive Provider Organization) health plan is administered by Lucent Health and offers members access to medical care through a select number of medical groups, specialists, and facilities "in-network" throughout CALIFORNIA.  

Local medical groups include, but not limited to: 

• Riverside Medical Clinic

• Raincross Medical Group

• Prime Care of Riverside

• Beaver Medical Group

• Redlands-Yucaipa Medical Group

• Loma Linda University Medical Center 

• St. Jude/St. Joseph Heritage Healthcare

• CHOC Children's Specialists

*This listing is subject to change without notice due to contracts between the provider's office and Lucent Health. Always verify if your provider or referral is "in-network*

The RUSD EPO health plans give you the flexibility to choose your doctor, specialists and facilities that are approved health care professionals participating in the Anthem Blue Cross PPO (Prudent Buyer) Large Group Network (only).  This is an in-network only plan.  While there is freedom to choose your own in-network personal doctor or doctors to help coordinate your care, if services are rendered with a provider that is not in the network, your care will not be covered except in emergencies and you will be responsible for 100% of the cost.  Therefore, employees must be diligent to research and ensure the provider and referrals are in-network providers.  

This is a "No referral specialists care" plan that allows you to see any provider or specialist without a referral as long as the provider participates in the Anthem Blue Cross PPO (Prudent Buyer) Large Group Network (only). Pre-certification may be necessary for hospitalizations and certain types of outpatient care. 

Helpful Tip: All providers must send all claims to Anthem to the address located on the front of your Medical ID card. If claims are not sent directly to Anthem the claim will not be processed correctly. Providers will need to check your eligibility through Lucent Health NOT Anthem. If the provider contacts Anthem for eligibility they will not recognize the Member ID# and you will show not eligible. 

Please be sure to verify and confirm that the doctor or specialist that you wish to see is in-network by calling Lucent Health directly at (888) 650-6566, refer to instructions by clicking on How to Find a Provider or contact the Benefits Department at (951) 788-7135 x80612  

This plan has a calendar year deductible of $100 for individual and $300 for family.   

The RUSD HDHP EPO (High Deductible Health Plan Exclusive Provider Organization) Plan, administered by Lucent Health offers members access to medical care through a number of medical groups "in-network" throughout CALIFORNIA. 

This health plan gives you the flexibility to choose your doctor, specialists and facilities that are approved health care professionals participating in the Prudent Buyer CA Only (only).  This is an in-network only plan.  While there is freedom to choose your own in-network personal doctor or doctors to help coordinate your care, if services are rendered with a provider that is not in the network, your care will not be covered except in emergencies and you will be responsible for 100% of the cost.  Therefore, employees must be diligent to research and ensure the provider and referrals are in-network providers.  

This is a "No referral specialists care" plan that allows you to see any provider or specialist without a referral as long as the provider participates in the Prudent Buyer CA Only (only). Pre-certification may be necessary for hospitalizations and certain types of outpatient care. 

Helpful Tip: All providers must send all claims to Anthem to the address located on the front of your Medical ID card. If claims are not sent directly to Anthem the claim will not be processed correctly. Providers will need to check your eligibility through Lucent Health NOT Anthem. If the provider contacts Anthem for eligibility they will not recognize the Member ID# and you will show not eligible. 

Please be sure to verify and confirm that the doctor or specialist that you wish to see is in-network by calling Lucent Health directly at (888) 650-6566, refer to instructions by clicking on How to Find a Provider or contact the Benefits Department at (951) 788-7135 x80612 

While this plan offers the EXACT same benefits and coverage as the RUSD EPO plan, the MAIN difference and most notable is that this plan has a calendar year deductible of $2,500 for individual and $2,500 for family. This plan is meant to provide employees at 70% employment, an opportunity to enroll in an affordable health plan. Please be sure to recognize the high deductible on this plan and make the best decision for you and your family.

The RUSD PPO (Preferred Provider Organization) Plan, administered by Lucent Health offers members access to medical care through any recognized provider or hospital. Each time you need care under one of the RUSD PPO Plans you can choose the doctors, specialists and other health professionals and facilities from the providers in the Anthem Blue Cross PPO (Prudent Buyer) Large Group Network to ensure the least out-of pocket expenses. Unlike, the EPO Plans, the PPO plans allow you the freedom to visit doctors or use facilities that are not part of the PPO network and still receive a benefit. However, your costs will be higher and you may need to file a claim. The PPO plan is a California only plan but allows active employees the flexibility for covering themselves or a dependent while out of state.  Out of state services would fall under the out of network costs unless stated as a true emergency. Please review the Summary of Benefits or Benefit Guidebook for more information as there may be a 20% - 40% coinsurance cost for services out of state. 

This is a "No referral specialists care" plan that allows you to see any provider or specialist without a referral! Pre-certification may be necessary for hospitalizations and certain types of outpatient care. You are your own personal health advocate and are not assigned to a Primary Care Provider/Physician (PCP). You have the freedom to choose your own in-network and out-of-network personal doctor or doctors to help coordinate your care. Again, if you choose to see a provider that is not in the network, your out-of-pocket costs will be higher and you may need to file a claim.

Helpful Tip: All providers must send all claims to Anthem to the address located on the front of your Medical ID card. If claims are not sent directly to Anthem the claim will not be processed correctly. Providers will need to check your eligibility through Lucent Health NOT Anthem. If the provider contacts Anthem for eligibility they will not recognize the Member ID# and you will show not eligible. 

For more information on coverage or plan information, please contact Lucent Health at (888) 650-6566, refer to How to Find a Provider or contact the Benefits Department at (951) 788-7135 x80612

This plan has a calendar year deductible for "In-Network" of $300 for individual and $600 for family and "Out-of-Network" of $500 for individual and $1,000 for family.

The RUSD HDHP PPO (High Deductible Preferred Provider Organization) Plan, administered by Lucent Health offers members access to medical care through any recognized provider or hospital. Each time you need care under one of the RUSD PPO Plans you can choose the doctors, specialists and other health professionals and facilities from the providers in the Anthem Blue Cross PPO (Prudent Buyer) Large Group Network to ensure the least out-of pocket expenses. Unlike, the EPO Plans, the PPO plans allow you the freedom to visit doctors or use facilities that are not part of the PPO network and still receive a benefit. However, your costs will be higher and you may need to file a claim. Out of state costs would fall under the out of network costs unless stated as a true emergency. Out of state services would fall under the out of network costs unless stated as a true emergency. Please review the Summary of Benefits or Benefit Guidebook for more information as there may be a 20% - 40% coinsurance cost for services out of state. 

Helpful Tip: All providers must send all claims to Anthem to the address located on the front of your Medical ID card. If claims are not sent directly to Anthem the claim will not be processed correctly. Providers will need to check your eligibility through Lucent Health NOT Anthem. If the provider contacts Anthem for eligibility they will not recognize the Member ID# and you will show not eligible.  

How is the HDHP PPO Plan Different? By introducing a high deductible for hospital and outpatient services, this plan maintains a very comprehensive coverage and same access to providers as the PPO plan but at a more affordable cost. This plan offers the EXACT same benefits and coverage as the RUSD PPO Plan, the MAIN difference and most notable is that this plan has a calendar year deductible for "In-Network" of $2,500 for individual and $4,000 for family and "Out-of-Network" of $4,000 for individual and $6,000 for family.

For more information on coverage or plan information, please contact Lucent Health at (888) 650-6566, refer to How to Find a Provider or contact the Benefits Department at (951) 788-7135 x80612

The Summary of Benefits and Coverage (SBC) document will help you choose and understand your health plan.  The SBC illustrates how you and the plan would share the cost for your covered health care services.  

RUSD EPO   RUSD EPO HD RUSD PPO RUSD PPO HD

                                                                    RUSD SPD January 1, 2025

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