Health Insurance

Once you are enrolled in the plan, you will receive an email notifying you of your Member ID Number. Use this number to download your insurance ID card from https://sjcc.mycare26.com (opens in new tab). If you need medical treatment before you receive notice that your ID card is active, please contact Relation at 800-537-1777.

Carry your ID card with you at all times! You will need your card when you visit the campus health center, physician’s office, urgent care, or hospital.

Download the Benefits at a Glance (Guide to Your Plan) (opens in new tab).

In-network means providers such as doctors, specialists, and hospitals that accept this insurance plan. Note: Sometimes it is also called “PPO” or “Preferred” network. The network for this plan is Cigna PPO – Open Access Plus, Open Access Plus Tiered.

If you use an in-network provider, covered medical services are paid by the insurance company at a higher rate (90–100%) of the Preferred Allowance. If you use an out-of-network provider, meaning a provider who is not in-network, covered medical expenses are paid at a lower rate (70% or more) of Usual, Reasonable, and Customary Charges.

To find an in-network provider:

1. Visit www.aetna.com/docfind/custom/passport (opens in new tab).
2. Enter your location and range, then click “Search”.
3. Select the Passport to Healthcare® Primary PPO, then click “Continue”.
4. Type the name, specialty, or type of provider you’re looking for into the search bar, or click the corresponding category.
5. Select a provider from the list, and call to make an appointment.

Always check with the doctor or medical facility directly to confirm that they accept Aetna Passport to Healthcare® Primary PPO Network before you receive treatment. It is best to locate an in-network physician, urgent care center, and emergency room near you before you get sick.

• $250,000 maximum benefit per injury or sickness
• Most physician visits and hospital charges, paid at 100% (after copay) of Preferred Allowance when you use an in-network provider; or 80% (after deductible) of Usual, Reasonable, and Customary Charges when you use an out-of-network provider
• Specific emergency benefit expenses
• Surgery, in- and out-patient
• Tests, procedures, and laboratory services, such as X-rays
• Physical therapy, chiropractic care, acupuncture
• Maternity and prenatal care
• Prescription drugs

Limitations and exclusions may apply. There is a six (6) month preexisting condition limitation of $5,000. Please see the Plan Summary at https://sjcc.mycare26.com/ (opens in new tab) for more details regarding benefits, terms, conditions, and exclusions of the insurance plan as underwritten by Allied World Assurance Company, Ltd. If there are any discrepancies between this document and the Policy, the Policy will govern.

Do not go to the hospital for minor illnesses or injuries! If you need to see a doctor immediately and cannot wait for a scheduled appointment, please go to an urgent care center. Hospital emergency rooms typically charge 2–3 times more than a doctor’s office or urgent care center. Use an urgent care center instead of an emergency room to save time and money.

Here are some in-network urgent care centers close to campus:

Valley Health Center – Moorpark
2400 Moorpark Avenue
San José, CA 95128
888-334-1000

SCVMC Outpatient Department
751 South Bascom Avenue
San José, CA 95128
408-885-5000

Action Urgent Care
1432 W San Carlos Street, Suite 10
San José, CA 95126
408-913-1163

After your visit, an in-network physician or provider will send a bill to the claims administrator, Relation Insurance Services. If the medical provider does not file a claim on your behalf, you will need to submit a claim for reimbursement. Follow these steps:

1. Download a claim form and fill it out completely. Claim forms are available at https://sjcc.mycare26.com/ (opens in new tab) under Claims in the USE YOUR INSURANCE section.
2. Include your member number (as shown on your ID card) on the claim form.
3. Attach itemized bills for X-rays, laboratory charges, etc.
4. Send your claim form and all bills pertaining to this claim to Relation at the address below. Try to have all itemized bills attached to the same claim form.

The address and fax number to submit claims are as follows:

Relation Insurance Services
P.O. Box 6040
Agoura Hills, CA 91376-6040
Fax: 818-735-3567

Fill out the form completely so your claim will be processed promptly. Keep copies of all documents you submit for claims. To check the status of a submitted claim, call Relation at 800-468-4343.