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Kern Health Care Network
Kern County Health Benefits
The County of Kern Point of Service (POS) Employee Medical Plan is the County's oldest and most fully featured employee medical plan option. The County of Kern POS plan has the most expansive network of the available employee medical plan options and is the only plan to include both in-network and out-of-network coverage. For those employees or dependents not residing in Kern County, the County of Kern POS plan also offers statewide and nationwide coverage through the Anthem Blue Cross and Blue Cross/Blue Shield networks.
As of October 1, 2013, the County of Kern POS plan will have completed the transition to the new third-party administrators and new provider network. Zenith American Solutions will provide claims administration, Clinix Healthcare will provide authorization services, and Burns Consulting Associates will administer the County’s new, independent provider network, the Kern Health Care Network. Catamaran (formerly Catalyst Rx) will still manage your pharmacy benefits.
Beginning September 23, 2013 POS members should use their New Member ID Card for seeking services under the POS Plan; card(s) will be mailed by the week of September 16. Also note that the new phone number 1-855-KERNPOS, or 1-855-537-6767, will also be active beginning September 23, 2013.
Please note: Authorizations that were issued by Managed Care Systems that show a termination date of September 30, 2013 will be honored by the plan for 90 days from date of issue. No action is required of the member to extend POS authorizations beyond September 30, 2013.
Summary of Benefits and Coverage (PDF)
Local POS Member Benefits
¹ After deductible has been met. R&C = Reasonable and Customary charges.
² Over 2 years old
This is a summary of the most-frequently-asked-about benefits. This chart does not explain benefits, out-of pocket maximums, exclusions, or limitations, nor does it list all benefits. For a complete explanation, please refer to the Summary Plan Description. (PDF)
For information on dental and vision coverage, visit Kern County Health Benefits
Out-of-Area (OOA) Member Benefits (click to expand/hide)
**Out of Area Plan enrollment is limited to POS plan members who reside outside of Kern County or in Frazier Park, Pine Mountain, Lebec, Lake of the Woods, Pinon Pines, Tejon, Mojave, Rosamond, Boron, Edwards, Willow Springs, Desert Lake or California City. With Out-of-Area enrollment, the member directs care instead of care being directed by a Kern County PCP. In-network benefits are obtained by using contracted providers on the national network or as directed by the plan administrator.
Prescription benefits for the County of Kern POS plan are administered by Catamaran. (Details on the Catalyst Rx/Catamaran name change) (PDF)
Catamaran Member Services Website
The POS prescription benefit includes generic, brand-name, and specialty medications. POS members can fill their prescriptions at Kern Medical Center pharmacies at reduced copays for generic and preferred name-brand medications and, through the POS Plan’s Over-the-Counter (OTC) prescription benefit, you can also receive some OTC non-sedating antihistamines (NSA) and Proton Pump Inhibitor (PPI) medications for $0 copay with a physician’s prescription.
* If no generic available. Higher cost if generic is available.
Mail Order Frequently Asked Questions (PDF)
Mail Order Registration and New Prescription Order Form (PDF)
Mail Order Prescription Fax Form (PDF)
FAQ about the 2013 POS Plan Changes (PDF)
Out-of-Area (OOA) Enrollment (PDF)
Prior Authorization List (PDF)
Sample Member Cards (PDF)
Summary Plan Description (PDF)
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