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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 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).

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.

PPO Monthly Rates 2020 vs 2019
Plan Year PERS Select PERS Choice PERS Care PORAC*
1 Party 2020
2019
$0.00
$0.00
$20.00
$30.78
$222.88
$195.89
$0.00
$40.00
2 Party 2020
2019
$0.00
$0.00
$113.00
$131.56
$518.76
$461.78
$0.00
$225.00
3+ Party 2020
2019
$0.00
$0.00
$178.20
$200.43
$705.69
$629.71
$59.00
$288.00

Cal Poly's 2019 monthly contribution: 1 Party-$734; 2 Party-$1,398; 3+ Party-$1,788
Bargaining Unit 6, SETC (Trades), pay slightly less: -$5.00/-$10.00/-$20.00
*Bargaining Unit 8, SUPA (Police) only, mat enroll in PORAC