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HMO - Health Maintenance Organizations

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Health Maintenance Organizations (HMOs)

An HMO offers health benefits, including preventive care, with no deductibles or maximums, and minimal co-payments. You will choose a primary care physician (PCP) within a network of contracting doctors. The PCP coordinates your care, including referrals to specialists. If you go outside of the HMO without a referral (except for emergency services), you will be responsible for the total cost of services. To find out more about how to use your HMO plan please refer to the ABCs of Using a HMO

Local HMO Networks

Note: For 2021: Employees enrolled in Blue Shield Trio will have access to Physician's Choice Medical Group (in San Luis Obispo)providers. Employees enrolled in United Healthcare will have access to Coastal Communities Physician Network providers; all other plans have access to both networks depending upon their Primary Care Physician.
Network Website Phone
Coastal Communities Physician's Network ccpnhpn.com 800-763-7732
Physician's Choice Medical Group physicianschoicemedicalgroup.com 888-560-8799

Plans & Rates Comparisons

Health Plans are administered by the California Public Employee's Retirement System (CalPERS) calpers.ca.gov

Please refer to each Plan’s Evidence of Coverage (EOC)for the exact terms and conditions of coverage. In case of a conflict between the summaries provided on this page and the Plan’s EOC, the EOC determines the benefits and coverage.

HMO Monthly Rates 2021
Plan Year Anthem Traditional Blue Shield Access + United Health Care Blue Shield Trio HMO
1 Party 2021 $422.32 $140.96 $0.00 $0.00
2 Party 2021 $921.64 $358.92 $0.00 $0.00
3+ Party 2021 $1,235.83 $504.30 $27.59 $0.00

Cal Poly's 2021 monthly contribution: 1 Party-$798; 2 Party-$1,519; 3+ Party-$1,937
Bargaining Unit 6, SETC (Trades), pay slightly less: -$5.00/-$10.00/-$20.00
*Bargaining Unit 8, SUPA (Police) only, may enroll in PORAC

Prescription Information

Vendor Website Phone Description
CVS Caremark caremark.com 866-346-7200 Mail Order Pharmacy manager for Blue Shield Access+ HMO and Blue Shield Trio HMO
OptumRx chp.optumrx.com 855-505-8110 Pharmacy manager for United Healthcare HMO, and Anthem Traditional HMO)
OptumRx Frequently Asked Questions