South Bay
General Agency Insurance Services
Employee Health Benefits
2025-2026 Annual Open Enrollment Ends 10/31/2025
HMO
SmartCare Gold $30
In Network Out of Network
Deductible Individual
Deductible Family
OOP Max Individual
OOP Max Family
Coinsurance
PCP Visit Copay
Specialist Visit Copay
Rx Deductible Ind./Family
Rx Retail
$0
$0
$7,250
$14,500
0%
$30
$50
In Network: None
$20/$50/$70
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
HMO
SmartCare Silver $55
In Network Out of Network
Deductible Individual
Deductible Family
OOP Max Individual
OOP Max Family
Coinsurance
PCP Visit Copay
Specialist Visit Copay
Rx Deductible Ind./Family
Rx Retail
$0
$0
$9,200
$18,400
50%
$55
$90
$500/$1000
$20/50% $250 max
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
PPO
Gold 500/20
In Network Out of Network
Deductible Individual
Deductible Family
OOP Max Individual
OOP Max Family
Coinsurance
PCP Visit Copay
Specialist Visit Copay
Rx Deductible Ind./Family
Rx Retail
$500
$1000
$7800
$15600
30%
$20
$40
$250/$500
​
$15/$40/$70 after Rx Deductible (Tier 1 N/A)
$2000
$4000
$15,600
$31,200
50%
50% (after ded.)
50% (after ded.)
None
N/A
PPO
Silver 2250/60
In Network Out of Network
Deductible Individual
Deductible Family
OOP Max Individual
OOP Max Family
Coinsurance
PCP Visit Copay
Specialist Visit Copay
Rx Deductible Ind./Family
Rx Retail
$0
$0
$9,200
$18,400
50%
$55
$90
$500/$1000
$20/50% $250 max
$4500
$9000
$18,200
$36,400
50%
50% (after ded.)
50% (after ded.)
None
N/A
Calculate your Premium
Step 1:
Download an Application
or Waive Coverage
Step 2:
or
To enroll in your employer's group health plan, you must complete and sign your employee health insurance application by 10/28/2025.​
​
If you do not wish to enroll in RHUMC's group health plan, please click Decline and complete a mandatory waiver.​​
​​
Send your signed application or waiver using the link below.
​
Thank you for cooperation.
​
Step 3:
Upload Completed
Form
Call (310) 954-9100 for assistance.