PPO - Preferred Provider Organizations

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Preferred Provider Organizations (PPOs).

A PPO is a form of managed care, but it is more similar to a traditional "fee-for-service" type plan. PPOs contract with doctors, hospitals, and other providers to provide services for an agreed-upon charge. You may choose to use a doctor outside their network, but you will pay a higher co-payment. These plans are available statewide and some are available outside of California.

Unlike an HMO, where a primary care physician directs all your care, a PPO allows you to select a provider and a specialist without referral. There are annual deductibles to meet before the plan will pay benefits and you are responsible for a certain percentage of the charges (co-payments). The plan pays the balance up to the agreed-upon amount.

Rates

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) below 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.

PPO Monthly Rates 2018
PERS Select PERS Choice PERS Care PORAC*
1 Party $0.00 $0.00 $51.19 $9.00
2 Party $0.00 $71.32 $175.38 $163.00
3+ Party $0.00 $116.82 $252.09 $204.00

Cal Poly's 2018 monthly contribution: 1 Party-$725; 2 Party-$1,377; 3+ Party-$1,766
Bargaining Unit 6, SETC (Trades), pay slightly less: -$5.00/-$10.00/-$20.00
*Bargaining Unit 8, SUPA (Police) only, mat enroll in PORAC

Prescription Information

Vendor Website Phone Description
OptumRx chp.optumrx.com 855-505-8110 Pharmacy manager for PERS Choice, PERS Select, PERS Care