Human Resources - Medical Benefits

The District offers medical benefits for you and your eligible dependent(s). There are ten (10) medical plans offered through CalPERS in which to select from. There are currently seven (7) HMO plans and three (3) PPO plans. To enroll or make changes to your health plan, please complete the Health Benefits Plan Enrollment Form (HBD-12)PDF document. For help with completing form HBD-12, download the instructions.

Note: See below for a brief description of each plan.

 


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.

HEALTH PLAN PREMIUMS

Since health care costs vary throughout California, regional pricing adjusts premiums to reflect the actual cost of health care in your specific region. Without regional pricing, if you live in a low-cost region you would be paying premiums in excess of your market rates. So, regional pricing ensures that your CalPERS premiums are appropriate for where you live and are competitive throughout California.

To determine your health plan premiums follow the steps below:

Step One - Determine Your Coverage Region
First, enter your zip code to determine your region and which health plans are available. Then, move on to Step Two.

Step Two - Determine Your Regional Health Plan Rate
Once you know your region and the health plans available, you can review your region's rate chart to find the premiums for the available health plans.

Dated: 7-23-15