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 | ccpnhpn.com | 800-763-7732 |
| Physician's Choice Medical Group | physicianschoicemedicalgroup.com | 888-560-8799 |
Anthem Blue Cross Traditional HMO
Contact Anthem: 855-839-4524
Blue Shield Access+ HMO
Contact Blue Shield: 800-334-5847
Blue Shield Trio HMO
Contact Blue Shield: 800-334-5847
United Healthcare HMO
Contact UnitedHealthcare: 877-359-3714
- Visit website
- Online Provider Directory
- OptumRx Prescription Information
- 2024 Summary & Glossary
- 2024 Evidence of Coverage
- UnitedHealthcare Behavioral Health Provider website
Access code: 'Calpers' - UnitedHealthcare Chiropractic and Acupuncture Provider - Optum Physical Health websiteSelect UnitedHealthcare Signaure Value in Plan/Product dropdown menu
Systemwide HMO Offerings
Additional HMO plan options available with Kaiser Permanente, Sharp Health Plan, and Western Health Advantage based on service zip code. Visit link below for additional details and contact information.
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.
| 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 | caremark.com | 866-346-7200 | Mail Order Pharmacy manager for Blue Shield Access+ HMO and Blue Shield Trio HMO |
| OptumRx | optumrx.com/calpers | 855-505-8110 | Pharmacy manager for United Healthcare HMO, and Anthem Traditional HMO) |