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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

Ensure your HMO plan selection is available in your local service area: Health Plan Search by Zip Code

Local HMO Networks

Note: (San Luis Obispo) Employees enrolled in Blue Shield Trio will utilize Physician's Choice Medical Group providers. Employees enrolled in United Healthcare will utilize Coastal Communities Physician Network providers. All other plans have choice of network driven by each participant's assigned Primary Care Physician.
Network Website Phone
Coastal Communities Physician's Network 800-763-7732
Physician's Choice Medical Group 888-560-8799

Plans & Rates Comparisons

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

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 2024
Plan Year Anthem Traditional Blue Shield Access + United Health Care Blue Shield Trio HMO
1 Party 2024 $214.94 $0.00 $0.00 $0.00
2 Party 2024 $505.88 $0.00 $0.00 $0.00
3+ Party 2024 $748.64 $0.00 $0.00 $0.00

Cal Poly's 2024 monthly contribution: 1 Party-$983; 2 Party-$1,890; 3+ Party-$2,366
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 866-346-7200 Mail Order Pharmacy manager for Blue Shield Access+ HMO and Blue Shield Trio HMO
OptumRx 855-505-8110 Pharmacy manager for United Healthcare HMO, and Anthem Traditional HMO)
OptumRx Frequently Asked Questions