Human Resources Service Center

Types of Medical Plans

HMO (Health Maintenance Organization)

An HMO is a specific type of healthcare plan that sets guidelines under which doctors a patient can see. Traditionally, the monthly premium is higher than a PPO plan but there are less out-of-pocket expenses to the employee when the plan is used. The patient must choose a primary care physician (PCP) who is a member of the HMO. Referrals from the PCP are usually required when seeking services by a specialist. Unless an emergency, services provided by non-member providers are the patient’s full responsibility.

There is one HMO plan available in this area* (see the service area map)

Blue Shield Access+ HMO, Group Number W0051411

Mail-Order Prescription Instructions

Effective 1/1/2021 you need to go through your Blue Shield account to access the mail-order (90-day) prescription benefits.

  • Log into your Blue Shield of California account(opens in new window)
  • Click on the "Be Well" tab
  • Click on the "Pharmacy" box
  • Scroll down to the Pharmacy networks - click on "Mail service pharmacy" box
  • You will get a pop-up that indicates you are leaving blueshieldca.com website - click "Continue"
  • You will be directed to the CVS Caremark website and you can place a new mail-order prescription or re-order past prescriptions

Please note: If you have not re-ordered a previous prescription in 2021, you will need to place a new order (previous refill requests from your doctor will still be in effect), as previous prescriptions will have a new Rx number.

Also, you have new RxBIN and RxPCN numbers for in-pharmacy (local) prescriptions. These will be found on your new Blue Shield member card(s). Your doctor and local pharmacy will need these new numbers for your account(s).

If you have any questions or difficulties, please contact CVS Caremark directly at (866) 346-7200.

PPO (Preferred Provider Organization)

A PPO plan gives the patient more flexibility to see the provider of their choice. If the provider is “in-network”, the plan will pay more. Monthly premiums are less, but when the plan is used, you may incur more expenses than with an HMO. View Anthem Blue Cross CalPERS Benefits Medical Plans(opens in new window) for 2021 Summary of Benefits for Care, Select and Choice plans.

PPO plans available in this area are*:

PERSCare, Group Number KB030A

PERSCare 2021 Summary of Benefits (PDF)

PERS Select, Group Number SB010A

PERS Select 2021 Summary of Benefits (PDF)

PERS Choice, Group Number CB010A

PERS Choice 2021 Summary of Benefits (PDF)

*Depending on your home address, other plans may be available to you. Contact the Benefits office if you would like to discuss your options.

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