About Qualcomm Premier Plans for ACO Providers

Qualcomm Premier Plans

Learn about the exclusive access members have to our network and key features of the plans

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Have a question about the Qualcomm Premier Plans? Contact the Scripps ACO operations team.

Your guide to Scripps ACO’s Qualcomm contract

Qualcomm is among an elite group of employers in the United States that’s chosen to contract directly with a health system — specifically, Scripps Health and its ACO network. Together we created two group health plans called the Qualcomm Premier Plans. They’re offered to Qualcomm’s 32,000 employees and dependents who reside in San Diego County.

Effective January 1, 2018, employees who enrolled in a Qualcomm Premier Plan have exclusive access to Scripps ACO’s custom network of providers and a concierge-level patient support team.

Key features of the Qualcomm Premier Plans

In addition to providing the network of physicians and facilities to Qualcomm Premier Plan members, the Scripps ACO must meet a variety of quality, cost and patient experience targets. This ensures Qualcomm gets the most value for their health care spend, and plan members receive a more customized and transparent health care experience, including a concierge team, published prices for frequently used services, and electronic messaging with their doctor’s office (where available).

For Scripps ACO to provide this level of service, participating physicians must meet certain obligations not normally found in PPO payer arrangements.

These include:

Guaranteeing various access and experience standards, including expedited scheduling for primary care and specialist appointments
Using an electronic health record (Scripps ACO network providers may be eligible for significant subsidies to license and install Epic EHR)
Meeting or exceeding specific quality metrics
Sharing appropriate medical record data, including quality, cost and patient satisfaction metrics
Adhering to certain evidence-based practice guidelines

We value your participation in the Scripps ACO and our Qualcomm contract. Your support and engagement are critical in ensuring we remain Qualcomm’s health care partner for years to come.

Learn more about the Qualcomm Benefit Programs that you can refer members to.

Frequently asked questions about the Qualcomm Premier Plans

Get answers to frequently asked questions about Qualcomm Premier Plans.

What is the difference between the two Qualcomm Premier Plans?

There are two Qualcomm Premier Plan products: A Qualified Deductible Health Plan (QDHP) and a PPO. Both products utilize the same exclusive Premier Plan network.

Premier QHDP

Copay for office visits: $0
In-network deductibles
Employee (EE) only: $1,500
EE + child(ren): $2,800
EE + spouse +/1 child(ren): $3,450

Premier PPO

Copay for office visits
Primary care: $30
Specialist: $50
Deductible does not apply
In-network deductibles
$350 per person, up to $700 per family (does not include copays)

How do I identify a member of a Qualcomm Premier Plan?

Qualcomm Premier Plan members have a distinct insurance card for easy identification. View the Premier QDHP (PDF, 110 KB) and the Premier PPO (PDF, 110 KB) ID cards.

How do I bill for services rendered to a member of a Qualcomm Premier Plan?

United Healthcare (UHC) is the third-party administrator for the Qualcomm Premier Plans.

You will continue to bill UHC for services rendered to Qualcomm Premier Plan members.

How will I be paid for services rendered to a member of a Qualcomm Premier Plan?

UHC will adjudicate the claims submitted for services rendered under the Qualcomm Premier Plans. Payment will be at the rate(s) specified in the “Scripps ACO Medical Group Professional

Services Agreement” that was signed by your practice.

What providers and facilities are in-network for the Qualcomm Premier Plans?

All Scripps and Rady Children’s hospitals and urgent care locations are in-network for the Qualcomm Premier Plans. The Premier Plans network includes providers from across San Diego County, including Scripps Clinic providers, Scripps Coastal providers, Scripps-affiliated independent providers, many Rady Children’s affiliated medical group providers, and the onsite Qualcomm Health Centers.

Behavioral/mental health, physical therapy, acupuncture, chiropractic care and dental services will continue to be offered through the United Healthcare network.

Learn more about the Qualcomm Premier Plans providers.

What are the referral and authorization requirements for the Qualcomm Premier Plans?

There are no referral or authorization requirements for Qualcomm Premier Plan members to seek care in San Diego County. However, members who choose to receive care from an out-of-network provider or facility are subject to significantly higher copays and/or deductibles.