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).

2025 Health Plan Coverage Comparison Chart

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 2025 monthly contribution: 1 Party-$1,060 2 Party-$2,039; 3+ Party-$2,551
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