Insurance Plans

HMO

Company	Surrogacy Coverage	County
		Los Angeles	Orange	San Diego	Riverside	San Bernardino	Ventura
Anthem Blue Cross	No (?)	YES	YES	NO	YES	YES	NO
Blue Shield	Lien	YES	YES	YES	YES	YES	YES
Health Net	No	YES	YES	YES	YES	YES	NO
Kaiser	Lien	YES	YES	YES	YES	YES	YES
LA Care	No	YES	NO	NO	NO	NO	NO
Molina Health Care	Lien	YES	YES	YES	YES	YES	NO
SHARP Health Plan	Lien	NO	NO	YES	NO	NO	NO

EPO

Company	Surrogacy Coverage	County
		Los Angeles	Orange	San Diego	Riverside	San Bernardino	Ventura
Anthem Blue Cross	No (?)	NO	NO	NO	NO	NO	YES
Oscar Health Plan	Covered	YES	YES	NO	NO	YES	NO

PPO

Company	Surrogacy Coverage	County
		Los Angeles	Orange	San Diego	Riverside	San Bernardino	Ventura
Blue Shield	Lien	YES	YES	YES	YES	YES	YES
Health Net	No	YES	YES	YES	YES	YES	NO

Exclusions And Limitations

Anthem Blue Cross HMO

Your Anthem Blue Cross HMO Plan

Other Services Not Covered

• Surrogate Mother Services. For any services or supplies provided to a person not covered under the plan in connection with a surrogate pregnancy (including, but not limited to, the bearing of a child by another woman for an infertile couple).

Blue Shield PPO

Evidence of Coverage and Health Service Agreement

Reductions – Surrogacy Arrangement
If you enter into a Surrogacy Arrangement and you or any other payee are entitled to receive payments or other compensation under the Surrogacy Arrangement, you must reimburse Blue Shield for Covered Services you receive related to conception, pregnancy, delivery, or postpartum care in connection with the Surrogacy to the maximum extent allowed under California Civil Code Section 3040. This Surrogacy Arrangement section does not affect your obligation to pay your Cost Share for these Covered Services. After you surrender a baby to the legal parents, the legal parents are financially responsible for any services that the baby receives. You are not obligated to reimburse Blue Shield for any services that the baby receives.

By receiving Covered Services in connection with a Surrogacy Arrangement, you automatically assign to Blue Shield your right to receive payments that are payable to you or any other payee under the Surrogacy Arrangement, regardless of whether those payments are characterized as being for medical expenses. To secure our rights, we will also have a lien on those payments and on any escrow account, trust, or any other account that holds those payments. Those payments and amounts in any account that holds those payments will first be applied to satisfy our lien. The assignment and our lien will not exceed the total amount of your obligation to Blue Shield under the preceding paragraph.

Within 30 days after entering into a Surrogacy Arrangement, you must send written notice of the arrangement, including all of the following information:

• Names, addresses, and telephone numbers of the other parties to the
  Surrogacy Arrangement;
• Names, addresses, and telephone numbers of any escrow agent or trustee;
• Names, addresses, and telephone numbers of the intended parents and any
  other parties who are financially responsible for Covered Services the baby
  (or babies) receive, including names, addresses, and telephone numbers for
  any health insurance that will cover services that the baby (or babies)
  receive;
• A signed copy of any contracts and other documents explaining the
  Surrogacy Arrangement; and
• Any other information we request in order to satisfy our rights.

Please send this information to:

Blue Shield of California
Surrogacy Mailbox
P.O. Box 3008
Lodi, Ca 95241-1912

You must complete and send Blue Shield all consents, releases, authorizations, lien forms, and other documents that are reasonably necessary for us to determine the existence of any rights we may have under this Surrogacy Arrangement section and to satisfy those rights. You may not agree to waive, release, or reduce our rights under this Surrogacy Arrangement section without our prior, written consent.

If your estate, parent, guardian, or conservator asserts a claim against a third party based on the Surrogacy Arrangement, your estate, parent, guardian, or conservator and any settlement or judgment recovered by the estate, parent, guardian, or conservator will be subject to our liens and other rights to the same extent as if you had asserted the claim against the third party. Blue Shield may assign our rights to enforce our liens and other rights.

Sharp Health Plan HMO

2019 Member Handbook Health Maintenance Organization (HMO)

Maternity and Pregnancy Services
The following services are not Covered Benefits:

• Testing, services or supplies for conception by a surrogate who is not enrolled in Sharp Health Plan. If the surrogate is enrolled in Sharp Health Plan, medical expenses related to the pregnancy will be covered by the Plan, subject to the lien described in the “What Happens if you Enter Into a Surrogacy Arrangement?” section of this Handbook.

What Happens if You Enter Into a Surrogacy Arrangement?
A surrogacy arrangement is one in which you agree to become pregnant and to surrender the baby to another person or persons who intend to raise the Child. You must pay us for any amounts paid by the Plan for Covered Benefits you receive related to conception, pregnancy, delivery or newborn care in connection with a surrogacy arrangement (“Surrogacy Health Services”). Your obligation to pay us for Surrogacy Health Services is limited
to the compensation you are entitled to receive under the surrogacy arrangement.

By accepting Surrogacy Health Services, you automatically assign to us your right to receive payments that are payable to you or your chosen payee under the surrogacy arrangement, regardless of whether those payments are characterized as being for medical expenses. To secure our rights, we will also have a lien on those payments. Those payments shall first be applied to satisfy our lien. The assignment and our lien will not exceed the total amount of your obligation to us under the preceding paragraph.

Within 30 calendar days after entering into a surrogacy arrangement, you must send written notice of the arrangement, including the names and addresses of the other parties to the arrangement, and a copy of any contracts or other documents explaining the arrangement, to:

Sharp Health Plan Customer Care
Attn: Third Party Liability
8520 Tech Way, Suite 200
San Diego, CA 92123-1450

You must complete and send us all consents, releases, authorizations, lien forms and other documents that are reasonably necessary for us to determine the existence of any rights we may have under this “What Happens if You Enter Into a Surrogacy Arrangement?” section and to satisfy those rights. You must not take any action prejudicial to our rights.

If your estate, parent, guardian, or conservator asserts a claim against a third party based on the surrogacy arrangement, your estate, parent, guardian, or conservator and any settlement or judgment recovered by the estate, parent, guardian, or conservator shall be subject to our liens and other
rights to the same extent as if you had asserted the claim against the third party. We may assign our rights to enforce our liens and other rights.

Oscar Health Plan of California – EPO Plan

Oscar Health Plan of California – Subscriber Agreement and Combined Evidence of Coverage and Disclosure Form

WHAT IS NOT COVERED (EXCLUSIONS) – MEDICAL

• Surrogacy: Services or supplies provided to a person not covered under this Agreement in connection with a surrogate pregnancy including, but not limited to, the bearing of a child by another woman for an infertile couple.