The District offers medical benefits for you and your eligible dependent(s). There are six (6) medical plans offered through CalPERS in which to select from. There are currently three (3) HMO plans and three (3) PPO plans.
Note: See below for a brief description of each plan.
2008 Health Plan Updates for Blue Shield of California and Kaiser Permanente.
Changes do not apply to CalPERS Medicare plans.
- Eliminate all co-pays for preventive care office visits including periodic health exams, maternity care, pre/post natal care, immunizations, well baby visits, hearing evaluations, allergy testing, and allergy treatment. (Blue Shield will have no co-pay for allergy testing; Kaiser will still charge a $15 co-pay for allergy testing.)
- Increase other office visit co-pays by $5 (from $10 to $15)
- Standardize co-pays for urgent care to $15 (currently $25 - Blue Shield, $10 for Kaiser)
- Create an annual out-of-pocket maximum for Blue Shield of $1,500 for an individual and $3,000 for a family, excluding pharmacy and certain other co-payments and expenses. (These maximums have been in effect at Kaiser.)
HEALTH PLAN DESCRIPTIONS
- Blue Shield Access+ HMO
The Blue Shield Access+ Plan is a HMO Plan with no deductibles. There is a $15 co-payment per office visit and a $5 co-payment per generic and $15 per brand name prescription. This plan offers self-referral to specialists using the Access+ Specialist referral feature, and other programs and value-added services. Includes employee and eligible dependents.
- Blue Shield NetValue HMO
The Blue Shield NetValue Health Plan is a new HMO high-performance physician network (HPN) plan option that offers you the same quality of care as Blue Shield Access+Plan, but uses a smaller panel of physicians. The benefit to you is that you can save money by choosing this new plan over the standard plans.
- Kaiser Permanente
The Kaiser Permanente Plan is a HMO Plan with no deductibles. There is a $15 co-payment per office visit and a $5 co-payment per generic and $15 per brand name prescription. Includes employee and eligible dependents.
- PERS Care /Anthem Blue Cross
The PERSCare Plan is a PPO Plan (Preferred Provider Plan). There is a $500/yr member deductible and a $1,000/yr family deductible. When you receive services from an in network provider the plan covers 90% when services are received from an out of network provider the plan covers 60%. Plan pays after yearly deductibles have been met. Maximum out-of-pocket per calendar year is $2,000 per member and $4,000 per family when services are received from a Preferred Provider.
- PERS Choice /Anthem Blue Cross
The PERS Choice Plan is a PPO Plan (Preferred Provider Plan). There is a $500/yr member deductible and a $1,000/yr family deductible. When you receive services from an in network provider the plan covers 80% when services are received from an out of network provider the plan covers 60%. Plan pays after yearly deductibles have been met. Maximum out-of-pocket per calendar year is $3,000 per member and $6,000 per family when services are received from a Preferred Provider.
- PERS Select / Anthem Blue Cross
PERS Select utilizes the Blue Cross Select PPO high-efficiency provider network, which is a subset of physicians who are currently in the Blue Cross PPO network utilized by PERS Choice and PERS Select. PERS Select offers you lower monthly rates, yet provides the same comprehensive PERS Choice benefits.