OE dates are November 11th through December 11th 2022, see Health Insurance Auth form and link to online enrollment below.
To navigate to Open Enrollment in ADP:
In California, your plan has access to a network of doctors, hospitals and providers from Anthem Blue Cross of California.
In all other states, your plan has access to a network of doctors, hospitals, and providers from FirstHealth.
Your pharmacy benefit is provided by Pinnacle Rx Solutions. Please click below to obtain information about your formulary, participating pharmacies, mail order and more.
Please click on Wellness Program for more information on:
Clinica Sierra Vista and its partner Pinnacle Health Management (“PHM”) encourage members to take advantage of the voluntary Health Management (HM) program. The purpose of the program is to help educate, motivate, and empower Employees and/or their dependents to counteract the effects of one or all of the following disease states – High Blood Pressure, Diabetes and Asthma. The HM Program provides Employees and their eligible Dependents that have been identified with these disease states with free access to PHM care managers as well as patient[1]specific literature. Clinica Sierra Vista will offer a significant discount on the cost of medications prescribed to help manage or alleviate the diagnosed disease states to all participants enrolled and compliant in the program.
Program Requirements/Qualifications/Copay Discounts
All health plan members 18 and older must complete a Health Risk Assessment and biometric screening within 60 days of initial eligibility for the Plan and thereafter as instructed by the Plan. If identified with a qualifying disease state, enroll in the voluntary health management program to receive a bi-weekly health plan premium reduction. Qualifying disease states include High Blood Pressure, Diabetes and Asthma. Covered Persons enrolled in the health management program regularly meet with a professional care manager to discuss managing their condition. Program participants also receive reduced co-payments on medications used to treat their condition.
Voluntary Programs
Additionally, three voluntary/optional programs are available through the program: Mom to Be, Smoking Cessation and Weight Management. These programs are not tied to the health insurance premium reduction. To qualify for the smoking cessation program, a member self-identifies they use tobacco products and would like to enroll in the program. To qualify for the weight management program, a member must have a Body Mass Index (BMI) of 30 of higher. Weight management program enrollees are eligible to receive some medications* prescribed by their physician to help with weight management at a $0 copay. The Mom to Be program provides guidance, support and educational resources for expectant mothers and their families. To qualify you can enroll by self-identification prior to the 16th week.
NOTE: Deductible must be satisfied before Copayments apply.
Exclusions All health plan members 18 and older are eligible for the diabetes, high blood pressure, asthma, mom to be and smoking cessation programs. Only Clinica Sierra Vista employees, their spouse or domestic partner are eligible for the weight management program.
Clinica Sierra Vista dedicated line: 855.730.8646
Email Address: customerservice@pinnacletpa.com
For 24/7 access to detailed information about your benefits, eligibility, and claims:
John Hernandez
Mobile: 209.561.7455
Email: Jhernandez@pinnacletpa.com
Michelle Murphy
Office: 661.635.3050 ext 2176
Email: Michelle.Murphy@clinicasierravista.org
