named programs · 6 · from sources
what they call their work
BlueCard Program
Provides members with access to healthcare services from top providers nationwide through the Blue Cross Blue Shield network, increasing flexibility for care outside California and Arizona
Cedar Health Centers
Provides bilingual primary care services including pediatric care, health screenings, immunizations, and preventive checkups with low copays at physical locations for Western Growers Health members ages 2 and up
Health Management and Wellness
Chronic condition management and wellness programs for diabetes, hypertension, high cholesterol, asthma, depression, and maternal health, delivered by registered nurses and licensed therapists focusing on the five pillars of health
Mexico Cross-Border Program
Exclusive network providing medical and dental services in border cities of Mexico (Mexicali, Tijuana, San Luis, Los Algodones) at significantly reduced costs compared to U.S. prices, with many services available at $0 copay
Pharmacy Benefits Management
On-site clinical pharmacists work with members, doctors, and pharmacies to manage medication needs and provide $0 copay access to Tier 1 generics at over 5,000 Walmart and Costco pharmacies nationwide
Telemedicine Services (Teladoc Health)
24/7 access to virtual healthcare including doctor visits, therapy sessions, dermatology consultations, and chronic condition coaching, with most services available at $0 cost depending on plan
activities · 10 clusters
what they do
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Telehealth Consultations & Virtual Care 12 activities
- 24/7 access to cross-border primary careOffers 24/7 access to general and family practice services for members enrolled in the cross-border health care program.
- Chronic Condition Management and Wellness ProgramsOffers chronic condition management and wellness services in partnership with Pinnacle Health Management, delivered by registered nurses, care coordinators, and licensed behavioral therapists, and provides telemedicine services via Teladoc Health for 24/7 access to doctors, therapists, and specialists.
- Chronic Condition Management and Wellness ServicesProvides chronic condition management and wellness services in partnership with Pinnacle Health Management, delivered by registered nurses, care coordinators, and licensed behavioral therapists.
- Chronic condition management and telemedicine servicesOffers chronic condition management and wellness services through registered nurses, care coordinators, and licensed behavioral therapists in partnership with Pinnacle Health Management, and provides 24/7 telemedicine access to doctors, therapists, and specialists via Teladoc Health.
- Chronic condition management and wellness programsOffers chronic condition management and wellness services in partnership with Pinnacle Health Management, delivered by registered nurses, care coordinators, and licensed behavioral therapists.
- Chronic condition management and wellness servicesOffers chronic condition management and wellness programs in partnership with Pinnacle Health Management, delivered by registered nurses, care coordinators, and licensed behavioral therapists.
- Pharmacy benefit and chronic care managementProvides pharmacy benefit management through on-site licensed clinical pharmacists who collaborate with members and providers, and offers chronic condition management and wellness services in partnership with Pinnacle Health Management, delivered by registered nurses, care coordinators, and licensed behavioral therapists.
- Telemedicine ServicesOffers telemedicine services to members via Teladoc Health, providing 24/7 access to doctors, therapists, and specialists through phone, computer, or app.
- Telemedicine servicesOffers 24/7 telemedicine access to doctors, therapists, and specialists via Teladoc Health, available by phone, computer, or app for members.
- Telemedicine services via Teladoc HealthProvides 24/7 telemedicine services to members through Teladoc Health, enabling access to doctors, therapists, and specialists via phone, computer, or app.
- Telemedicine services via Teladoc HealthProvides members with 24/7 telemedicine access to doctors, therapists, and specialists through phone, computer, or app via a partnership with Teladoc Health.
- Telemedicine services via Teladoc HealthProvides 24/7 telemedicine access to doctors, therapists, and specialists through Teladoc Health, available via phone, computer, or app for members.
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Agricultural Worker Health Benefits Administration 11 activities
- Claims and appeals administrationProcesses written appeals for denied claims or disapproved authorizations and administers health claims onsite using a proprietary Health Claims Processing System through regional centers in Irvine and Fresno.
- Health Claims AdministrationAdministers health claims using a proprietary Health Claims Processing System with regional centers in Irvine and Fresno, processes written appeals for denied claims, and provides pharmacy benefit management through on-site licensed clinical pharmacists.
- Health Plan AdministrationAdministers health insurance plans tailored for agricultural businesses and their employees, including processing claims, managing employee benefit data, and providing online access to plan information, ID cards, and explanations of benefits.
- Health claims and pharmacy benefit administrationAdministers health claims through a proprietary Health Claims Processing System with regional centers in Irvine and Fresno, and provides pharmacy benefit management via on-site licensed clinical pharmacists who collaborate with members and providers.
- Health insurance plan administration for agricultural businessesProvides tailored health insurance plans for agricultural employers and their employees, including claims administration via an onsite proprietary Health Claims Processing System with regional centers in Irvine and Fresno.
- Health insurance plan administration for agricultural employersProvides tailored health insurance plans and benefits administration for agricultural businesses and their employees, including claims processing via proprietary systems based in Irvine and Fresno.
- Health insurance plans for agricultural businessesProvides tailored health insurance plans for agricultural businesses and their employees, with over 65 years of experience serving agricultural workers and communities.
- Health insurance plans for agricultural businessesProvides tailored health insurance plans for agricultural businesses and their employees, with a history of serving agricultural workers and communities for over 65 years.
- Onsite health claims processing and pharmacy benefit managementAdministers health claims through a proprietary Health Claims Processing System with regional centers in Irvine and Fresno, and provides pharmacy benefit management via on-site licensed clinical pharmacists who collaborate with members and providers.
- Providing Health Insurance PlansOffers health insurance plans specifically designed for agricultural businesses and their employees, including medical, dental, vision, and prescription services.
- Tailored health insurance plans for agricultural businessesProvides health insurance plans specifically designed for agricultural businesses and their employees, with over 65 years of service to agricultural workers and communities.
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Health Benefits Online Access Portal 9 activities
- Member-facing digital health management platformEnables plan participants to access online tools including HealthView for reviewing explanations of benefits, checking claims status, accessing claims history, submitting appeals, coordinating benefits, enrolling in plans, and downloading ID cards.
- Member-facing digital health management toolsEnables plan participants to access explanations of benefits, check claims status, review claims history, download enrollment and appeals forms, and use a provider directory via the HealthView online portal.
- Member-facing online account and claims managementEnables plan participants to access appeals, coordination of benefits, enrollment forms, provider directories, explanations of benefits, claims status, and claims history through HealthView and other online tools.
- Online and phone-based provider support systemProvides health care providers with 24/7 access to patient eligibility, claim status, benefit plan information, and deductibles through an online portal and a free interactive voice response system.
- Online and phone-based provider support systemsProvides health care providers with 24/7 access to patient eligibility, claim status, benefit plan information, and deductibles through an online portal and a free interactive voice response system.
- Online and phone-based provider support systemsProvides health care providers with 24/7 access to patient eligibility, claim status, deductibles, and benefit plan information through an online portal and a free interactive voice response system.
- Online and phone-based provider support systemsProvides health care providers with 24/7 access to patient eligibility, claim status, benefit plan information, and account details through an online portal and a free interactive voice response system.
- Online member self-service portal (HealthView)Provides plan participants with online access through HealthView to review explanations of benefits, check claims status, access claims history, download enrollment and appeals forms, and access a provider directory for medical, dental, vision, and prescription services.
- Online participant self-service portal (HealthView)Provides plan participants with online access to review explanations of benefits, check claims status, access claims history, download enrollment and appeals forms, and access a provider directory for medical, dental, vision, and prescription services.
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Low-Cost Medical Access in Mexico 8 activities
- Cross-Border Healthcare Services in MexicoProvides medical and dental plan services in major border cities in Mexico, including operating an exclusive network of licensed medical facilities, offering free transportation from the border, and running the Healthy Families Medical Center in Mexicali, to enable members to access quality care at lower costs.
- Cross-border health care program in MexicoProvides access to quality, low-cost medical, dental, vision, and prescription services in Mexico through an exclusive network of licensed facilities and providers, including the Healthy Families Medical Center in Mexicali, with free transportation from the border and 24/7 access to general and family practice services.
- Cross-border health care program in MexicoProvides access to quality, low-cost medical and dental care in major border cities in Mexico through an exclusive network of licensed facilities and providers, including the Healthy Families Medical Center in Mexicali, with services offered in English and Spanish.
- Cross-border health care program in MexicoProvides members with access to quality, low-cost medical, dental, vision, and prescription services in Mexico through an exclusive network of licensed facilities, including the Healthy Families Medical Center in Mexicali, with free transportation from the border and 24/7 access to primary care services.
- Cross-border health care program in MexicoProvides agricultural workers and their families with access to quality, low-cost medical, dental, vision, and pharmacy services in Mexico through an exclusive network of licensed providers and facilities, including the Healthy Families Medical Center in Mexicali, with free transportation from the border and 24/7 access to primary care services.
- Cross-border health care program in MexicoProvides access to quality, low-cost medical and dental care in Mexico through an exclusive network of licensed facilities and providers, including the Healthy Families Medical Center in Mexicali, with services in English and Spanish, free border transportation, and 24/7 general and family practice access.
- Facilitating Cross-Border Healthcare in MexicoProvides medical and dental plan services in major border cities in Mexico through an exclusive network of licensed medical facilities and providers, including the Healthy Families Medical Center in Mexicali, offering quality care at lower costs, free transportation from the border, and 24/7 access to general and family practice services.
- Free transportation for cross-border careProvides free transportation services from the border for members accessing health care in Mexico.
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Mobile and Fixed Community Medical Clinics 7 activities
- Direct Healthcare Services through Cedar Health CentersOperates Cedar Health Centers in Salinas, Watsonville, Santa Maria, and Oxnard, California, providing low-cost, high-quality patient care services including primary care, preventive care, onsite prescription drugs, laboratory testing, and X-ray services to employees and eligible dependents aged two and older, in English and Spanish.
- Operating Cedar Health CentersOperates Cedar Health Centers in Salinas, Watsonville, Santa Maria, and Oxnard, California, providing low-cost, high-quality patient care services in English and Spanish to employees and eligible dependents aged two and older, including onsite prescription drugs, virtual visits, disease management, preventive care, primary care, laboratory testing, and X-ray services.
- Operation of Cedar Health Centers in CaliforniaOperates health centers in Salinas, Watsonville, Santa Maria, and Oxnard, California, delivering low-cost, high-quality primary care services in English and Spanish to members and dependents ages two and older, including onsite pharmacy, lab, X-ray (Watsonville), virtual visits, preventive care, and disease management.
- Operation of Cedar Health Centers in CaliforniaOperates health centers in Salinas, Watsonville, Santa Maria, and Oxnard, California, delivering low-cost, high-quality primary care services including onsite prescription drugs, virtual visits, disease management, preventive care, laboratory testing, and X-ray services (at Watsonville) to members and dependents ages two and older in English and Spanish.
- Operation of Cedar Health Centers in CaliforniaOperates health centers in Salinas, Watsonville, Santa Maria, and Oxnard, California, delivering low-cost, high-quality primary care, preventive services, lab testing, X-rays (Watsonville only), pharmacy, virtual visits, and disease management to members and dependents ages two and older in English and Spanish.
- Operation of domestic health centers in CaliforniaOperates Cedar Health Centers in Salinas, Watsonville, Santa Maria, and Oxnard, California, delivering low-cost, high-quality primary care, preventive services, disease management, virtual visits, onsite pharmacy, lab testing, and X-ray services (at Watsonville) in English and Spanish to members aged two and older.
- Operation of domestic health centers in CaliforniaOperates Cedar Health Centers in Salinas, Watsonville, Santa Maria, and Oxnard, California, delivering low-cost, high-quality primary care, preventive services, lab testing, X-rays (Watsonville only), pharmacy, virtual visits, and chronic disease management in English and Spanish to members aged two and older.
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Employer Health Benefits Management Support 7 activities
- Employer Resource CenterOffers a free online employer resource center (WERC) with one-on-one training for employers to manage health benefits, including updating employee information, processing terminations, viewing claims, generating reports, and printing ID cards.
- Employer Resource and TrainingOffers a free online employer resource center (WERC) with one-on-one training for employers to manage health benefits.
- Employer resource and benefits management platformOffers a free online Employer Resource Center (WERC) with one-on-one training, enabling employers to manage employee health benefit data, process terminations, view claims, generate reports, print ID cards, and update employee information.
- Employer resource and benefits management supportOffers a free online Employer Resource Center (WERC) with one-on-one training and tools for employers to manage health benefits, including updating employee data, processing terminations, viewing claims, generating reports, and printing ID cards.
- Employer resource and benefits management supportOffers a free online Employer Resource Center (WERC) with one-on-one training, enabling employers to manage employee health benefit data, update information, process terminations, view claims, generate reports, and print ID cards.
- Employer resource and benefits management systemOffers a free online Employer Resource Center (WERC) with one-on-one training and tools for employers to manage health benefits, including updating employee data, processing terminations, viewing claims, generating reports, and printing ID cards.
- Employer support and benefits management toolsOffers a free online Employer Resource Center (WERC) with one-on-one training and tools for employers to manage employee health benefit data, update information, process terminations, view claims, generate reports, and print ID cards.
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Health Benefits Customer Support Services 5 activities
- Customer and participant support servicesProvides customer service support to plan participants Monday through Friday from 7 a.m. to 5:30 p.m. PST, and maintains a 24/7 automated system for access to frequently requested account information.
- Customer service support for participants and providersProvides customer service support to plan participants and providers during business hours (Monday–Friday, 7 a.m. to 5:30 p.m. PST) via phone, and operates a 24/7 automated system for access to frequently requested participant information.
- Member and participant customer support servicesProvides customer service support to plan participants Monday through Friday (7 a.m. to 5:30 p.m. PST) via phone, a 24/7 automated system for frequently requested information, and online issuance of permanent and temporary ID cards.
- Member claims and enrollment support servicesProcesses written appeals for denied claims or disapproved authorizations, issues permanent and temporary ID cards via an online portal, and provides customer service support to participants Monday through Friday, 7 a.m. to 5:30 p.m. PST, with a 24/7 automated system for basic information access.
- Participant customer service and ID issuanceProvides customer service support to plan participants Monday through Friday (7 a.m. to 5:30 p.m. PST), operates a 24/7 automated information system, and issues permanent and temporary ID cards through an online portal.
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Health Plan & Reimbursement Rate Management 4 activities
- Administration of small and large group health plan ratesMaintains small group health plan rate increases averaging 0% to 3.5% and large group rate increases averaging 4.5% for 2025 renewals.
- Health plan rate stabilizationMaintains small group health plan rate increases averaging 0% to 3.5% and large group rate increases averaging 4.5% for 2025 renewals.
- Stable health plan rate renewals for group plansMaintains small group health plan rate increases between 0% and 3.5%, and large group rate increases at 4.5% for 2025 renewals.
- Stable health plan rate renewals for group plansMaintains small group health plan rate increases between 0% and 3.5%, and large group rate increases averaging 4.5%, for 2025 renewals.
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Community Pharmacy Services 1 activity
- Pharmacy benefit and clinical pharmacy servicesProvides pharmacy benefit management through on-site licensed clinical pharmacists who collaborate with members and providers to optimize medication use and support treatment plans.
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Uncategorized 15 activities
- $0 copay access to Tier 1 generic medicationsOffers $0 copay access to Tier 1 generic medications at over 5,000 Walmart and Costco pharmacies nationwide, effective January 1, 2025.
- $0 copay access to generic medications at national pharmacy chainsOffers plan members $0 copay access to Tier 1 generic medications at over 5,000 Walmart and Costco pharmacies nationwide, effective January 1, 2025.
- Chronic Condition Management and Wellness ProgramsOffers chronic condition management and wellness services in partnership with Pinnacle Health Management, delivered by registered nurses, care coordinators, and licensed behavioral therapists.
- Claims appeals processingProcesses written appeals from health benefit plan enrollees regarding denied claims or disapproved authorizations.
- Claims appeals processingProcesses written appeals from health benefit plan enrollees for denied claims or disapproved authorizations.
- Cross-Border Healthcare Services in MexicoProvides medical and dental plan services in major border cities in Mexico, including operating an exclusive network of licensed medical facilities, offering free transportation from the border, and running the Healthy Families Medical Center in Mexicali for members to access quality care at lower costs.
- Direct Healthcare Services through Cedar Health CentersOperates Cedar Health Centers in Salinas, Watsonville, Santa Maria, and Oxnard, California, providing low-cost, high-quality primary care, preventive care, disease management, onsite prescription drugs, laboratory testing, and virtual visits to participants aged two and older in English and Spanish.
- Participant ID card issuanceIssues permanent and temporary ID cards to health plan participants through an online portal.
- Pharmacy Benefit ManagementProvides pharmacy benefit management through on-site licensed clinical pharmacists who collaborate with members and providers, and offers $0 copay access to Tier 1 generic medications at over 5,000 Walmart and Costco pharmacies nationwide.
- Pharmacy Benefit Management and Medication AccessProvides pharmacy benefit management through on-site licensed clinical pharmacists and offers $0 copay access to Tier 1 generic medications at over 5,000 Walmart and Costco pharmacies nationwide starting January 1, 2025.
- Pharmacy benefit managementProvides pharmacy benefit management through on-site licensed clinical pharmacists who collaborate with members and providers to optimize medication use.
- Provider and Participant Support ServicesOffers customer service support to plan participants and healthcare providers, including 24/7 interactive voice response systems, online portals for eligibility and claim status, and a provider directory for medical, dental, vision, and prescription services.
- Providing Member and Provider SupportOffers customer service support via phone during business hours and through a 24/7 automated system, provides online access to patient eligibility, deductibles, claim status, benefit plan information, appeals, coordination of benefits, enrollment forms, and allows participants to review explanations of benefits and check claims status online.
- Providing Prescription Medication AccessProvides $0 copay access to Tier 1 generic medications at over 5,000 Walmart and Costco pharmacies nationwide starting January 1, 2025.
- Telemedicine ServicesProvides telemedicine services to members via Teladoc Health, offering 24/7 access to doctors, therapists, and specialists through phone, computer, or app.
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financials · form 990 · fy2021
the money
revenue
Total revenue$204.51M
Contributions & grants$00%
Program service revenue$197.70M97%
Investment income$4.81M2%
Other revenue$2.00M
expenses
Total expenses$194.88M
Program expenses—
Admin / overhead—
Fundraising—
Salaries & benefits$14.29M
Grants paid out$0
Largest expense lineCompensation
balance sheet
Total assets$115.49M
Cash$69.65M
Investments$40.64M
Liabilities$53.40M
Net assets$62.09M
Liquid reserves6.8 mo
3 years on record · 2019–2021 · YoY revenue -3.1%
leadership · form 990 part vii · fy2021
who runs it
paid leadership · 9
| Name | Title | Hours/wk | Compensation |
|---|---|---|---|
| DAVID PUGLIA | PRESIDENT AND CEO | 20 | $710K |
| DAVID ZANZE | EXECUTIVE VICE PRESIDENT | 22 | $541K |
| WARD KENNEDY | SENIOR VICE PRESIDENT/CFO | 12 | $409K |
| JONATHAN ALEXANDER | VP LEGAL & COMPLIANCE COUNSEL | 34 | $335K |
| LESSLIE D WILLIAMS | VP INSURANCE OPERATIONS | 28 | $272K |
| LAWRENCE J LABRIOLA | VP UNDERWRITING | 38 | $261K |
| CLAUDIA DABOUB | AVP - INSURANCE OPERATIONS | 28 | $224K |
| MICHAEL T WILLIAMS | CIO | 24 | $222K |
| KATHY NGUYEN | BUSINESS PROCESSES AND SYSTEM DEV. | 14 | $188K |
board members · 7
- DAVID GILL — CHAIRMAN
- DENNIS JOHNSTON — TRUSTEE
- JOHN D'ARRIGO — VICE CHAIRMAN
- PAM BENGARD — TRUSTEE
- RONALD RATTO — TRUSTEE
- THOMAS MINNICH — TRUSTEE
- TREY RODRIGUEZ III — TRUSTEE
relationships · 20
who they work with
- Anthem Partner — Network partner providing medical and dental providers for Western Growers Health plans
- Anthem Partner — Partnered to provide medical plan coverage and network access for Western Growers Health members.
- Blue Cross Blue Shield of Arizona Partner — Partnered to provide medical plan coverage and network access for Western Growers Health members.
- BlueCard Program Network — Provides members access to a national network of healthcare providers through participation in the BlueCard Program.
- Cedar Partner — Network partner providing medical providers for Western Growers Health plans
- Cedar Health Centers Partner — Operates health centers exclusively for Western Growers Health members.
- Cedar Health Centers Partner — Provides bilingual primary care services with $0 copay and extended hours for members.
- Centers for Medicare and Medicaid Services Government — Regulatory body referenced for balance billing complaint resolution
- Costco Partner — Partner pharmacy network providing $0 copay access to Tier 1 generic medications for members without requiring a membership.
- Craig Barton Partner — Regional Sales Director for Northern California & Central Coast, providing support to benefits consultants.
- Delta Dental Partner — Network partner providing dental providers for Western Growers Health plans
- Elevance Health Partner — Service provider that notified Western Growers Health of a cybersecurity incident
- First Health Network Partner — Provides non-emergency health care coverage for members traveling outside California and Arizona.
- Healthy Families Medical Center Partner — State-of-the-art facility in Mexicali providing pharmacy, lab, X-ray, and primary care services to Western Growers Health members.
- Jillian Urban Partner — Regional Sales Director for Southern California & Arizona, providing support to benefits consultants.
- Peter Mehta Partner — Regional Sales Director for Central California, providing support to benefits consultants.
- Pinnacle Health Management Partner — Collaborates to deliver chronic condition management and wellness services to members.
- Teladoc Health Partner — Provides telemedicine services to Western Growers Health members.
- VSP Partner — Network partner providing vision providers for Western Growers Health plans
- Walmart Partner — Partner pharmacy network providing $0 copay access to Tier 1 generic medications for members.