Employee Benefits

California Water Service Group and its subsidiaries offer medical, dental, and vision insurance to employees. General health benefit information is provided below. Additional and/or alternate benefits are available in some locations. Providers, members, and dependents of members can manage claims through the California Water Service Health Care Plan portal.

Medical

Plan name California Water Service Healthcare Plan (self-insured and self-funded)
Policy number Use insured's employee ID
Calendar year deductibles $100 per person
$300 per family
Hospitalization Basic Benefits Basic covers first $3,000 at 100%; no deductible for inpatient hospitalizations and outpatient surgery hospitalizations. Balance paid under Major Medical.
Major Medical Balance at 80% after satisfying annual deductible
In-patient hospitalization Precertification must be obtained for all inpatient hospitalizations and outpatient surgical procedures. Benefits may be reduced without such authorization. Call HealthSmart Care Management Solutions at 877-202-6379. Emergency admissions must be certified within 48 hours.
Outpatient services No pre-approval required for any outpatient services
Mental health In-Patient Same coverage as hospitalization
Out-Patient 80%
Prescriptions Name brand 80%
Generic 90%
Health Trans Contract
Birth control Prescription only at 80%
Accidents Basic benefits First $300 at 100%; no deductible;
must seek medical attention within 48 hours of accident
PPO networks HealthSmart
MultiPlan
Discount applied when bill is paid
Chiropractic & acupuncture $1,500 per calendar year maximum;
first visit max paid to $150;
second through 46th visit; Max paid $30
Physical therapy Paid at 80%

Dental


Plan name
California Water Service Company Dental Plan
(self-insured and self-funded)
Administrator Delta Dental of California
PO Box 997330
Sacramento, CA 95899-7330
1-800-765-6003
Group number 16001
Calendar year deductibles $50 per person
$150 per family
Annual maximum $4,500 per person per three-year period (1/1/12 to 12/31/14, etc.)
Benefits 80% of reasonable and customary (R & C) charges, including crowns, dentures
Prophylaxis, bite-wing x-rays, and sealants Must be separated by five months; deductible waived
Full-mouth x-rays Every two years
Prosthetic replacements:
(crown, dentures, caps, etc.)
Every five years
Pre-authorizations Are not required, but will be provided
Orthodontic Paid at 50%; up to $2,000 lifetime max

Vision


Plan name
California Water Service Healthcare Plan
(self-insured and self-funded)
Policy number Use insured's employee ID
Benefit $450 paid at 100%; no deductible;
covers a three-year period (1/1/12 to 12/31/14, etc.)
Eye exams Paid under medical plan; subject to medical plan deductible
Coverage for Lenses Over-the-counter reading glasses
Frames Prescription sunglasses
Contacts Laser keratotomy
Service agreements

In the event there is a difference between these descriptions and plan documents, the official plan will govern.