PPO - Preferred Provider Organizations

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 non-contracting doctor, but you will pay a higher co-payment (40% vs 20%) 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 a referral. There are annual deductibles to meet before the plan will pay benefits, (other than doctor visits), and you are responsible for a certain percentage of the charges (co-insurance). The plan pays the balance up to the contracted amount.

To find out more about how to use your PPO plan please refer to ABCs of Using a PPO

Plan & Rate Comparison

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

• 2021 Health Premium Rates and Summary of Covered Services

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.

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, mat enroll in PORAC

Prescription Information