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Medical Plans

As a full-time employee, you can enroll in an HMO or PPO plan offered through CalPERS. Options are listed below.

Medical Plan Group Number Phone
Anthem Select HMO HNB050HS (855) 839-4524
Anthem Traditional HMO HTB050HT (855) 839-4524
Blue Shield Access+ HMO W0051411 (800) 334-5847
Kaiser HMO 03 (800) 464-4000
PERS Gold PPO (Blue Shield) W0051411 (855) 633-4436
PERS Platinum PPO (Blue Shield) W0051411 (855) 633-4436
PORAC PPO (for dues-paying police officers only) 1875JD (800) 655-6397
UnitedHealthcare SignatureValue Alliance HMO 682301 (877) 359-3717
To access Summary of Coverage and Evidence of Coverage documents, please visit the following CalPERS Forms & Publications website: https://www.calpers.ca.gov/forms-publications?d=24 

Documents

Frequently Asked Questions

HMO

The Health Maintenance Organization (HMO) plans provide health care from specific doctors and hospitals under contract with the plan. You pay co-payments for some services, but you have no deductible, no claim forms, and a geographically restricted service area.

PPO

These plans operate as preferred provider organizations (PPOs). A PPO is similar to a traditional "fee-for-service" plan, but you must use the doctors in the PPO provider network or pay higher co-insurance (percentage of charges). You must usually meet an annual deductible before some benefits apply. You're responsible for a certain co-insurance amount and the plan pays the balance up to the allowable amount.

For more information, you can review an article released in the 2024 CalPERS publication, PERSpective: HMO, PPO, and EPO – What’s the Difference and Why Does It Matter?

The district provides a set annual contribution amount towards your benefits based on your medical coverage tier (Waiving benefits, Employee only, Employee +1, Employee +2 or more).  The district contribution is applied towards your medical, dental, and vision coverage. Please refer to the "Health Plan Options and Costs" sheet (available under "Cost Sheets" above) specific to your employee group for more detailed information.

HMO: When enrolling in an HMO plan, you must select a Primary Care Physician (PCP) from a list of "in-network" doctors.  The PCP will direct all your care and will provide you with a referral if you need to see a specialist.

PPO: Yes, you can choose any doctor you prefer.  However, you will save money if you choose doctors who are "in-network".  You also have the freedom to see a specialist without a referral.

Please refer to the “Find a Provider” pages of the Benefits Guide, available above.

Medical plan identification cards will arrive in 2-3 weeks from the date that you complete your health benefit enrollment in Alight/SmartBen.

Summary of Coverage and Evidence of Coverage booklets can be found on the CalPERS website. For specific plan questions, please contact the health plans directly.