Self Insured Schools of California (SISC) General Information

Self Insured Schools of California (SISC)

SISC covers districts all over the state and their combined annual budget totals $2.5 billion dollars. They are now the largest public school pool in the U.S.

Landing Page

https://www.vida.com/sisc/

Verification

First/Last name, SSN (last 4), and email address

Programs and Devices Breakdown

• For full details on programs offered, please refer to this Vidapedia Card
• For full details on devices offered, please review Device Eligibility Google Doc

Effective 12/1/2025

We are adding  our Clinical Obesity Management (T3) program to the standard benefit for SISC.

• This program provides a structured pathway for accessing medications and services specifically for clinical obesity. (Medical Weight Loss)
• It includes the Sole Prescriber rule, which is a standard feature designed to streamline the prescribing process and ensure care coordination by a designated VMP  for this specialized treatment. (Use Case 3)

  Eligibility Criteria for New Program- Anthem and Blue Shield HMO members only  over the age of 18 (Excluding 65+) are eligible 

Topic: Lab Order Workflow for SISC HMO Members

🛑 CRITICAL AGENT WARNING SISC HMO members must use their Primary Care Provider (PCP) for lab orders. If a member uses a lab order written directly by a Vida provider, insurance will NOT cover the cost, and the member will be responsible for 100% of the bill.

The Process: How to Guide the Member

Since Vida providers are outside the HMO network for ordering labs, the member must act as the bridge between Vida and their HMO PCP.

Step 1: Vida Provider Recommendations

• The Vida provider determines which labs are needed and generates a "Lab Request" or order in the Vida app.

Step 2: Member Action (The Bridge)

• The member must download the Vida lab order and take it to their assigned HMO PCP.

• The member asks their PCP to rewrite or re-order these specific labs under the HMO plan.

Step 3: The Lab Visit

• The member goes to the lab using the PCP’s order (NOT the Vida order).

Step 4: Closing the Loop

• The member obtains the results and uploads a photo/screenshot to the Vida app so the Vida provider can review them.

Population

• 200,000+ eligible members.

Additional information on eligibility:

• PPO and HMO members under BCS or Anthem
  • Also, based on districts that opt-in to Vida (not all districts are included)

• Kaiser population is not eligible
• Medicare population is not eligible
• HSA Group population is  eligible (as of 10/1/2025)
• Covered lives:
  • employees, spouses, dependents 18+

Onboarding and Enrollment Details

https://support.vida.com/hc/en-us/articles/360045672893-SISC-Onboarding-and-Enrollment-Processes-

FAQ

• What segment is this org in?
  • Employer
• When did we launch with this org?
  • 4/1/2020
• Are Spouses/Dependents Eligible?
  • Yes, and they must be 18+ years or older.
• Are Retirees Eligible?
  • Retirees over 65 are not eligible
• Is the org on the eligibility file?
  • Yes
• When does Vida receive an updated Eligibility File?
  • Weekly - Fridays
• Do we offer Phone and/or Email support?
  • We offer both phone and email support.
• Is VSC outreach involved?
  • No.
• Are there incentives?
  • Yes: https://support.vida.com/hc/en-us/articles/4416125247507-SISC-2022-Onsite-Screening-Incentive-Guidelines