Contents
Cal Poly Pomona

Health Maintenance Organizations (HMOs)

Logo "HMO Plan Information"

HMOs offer members a range of health benefits, including preventive care, for a monthly fee, with no deductibles or maximums. They also set copayments for the care you receive. The HMO will give you a list of doctors for your use in choosing a primary care physician (PCP). The PCP coordinates all your care, including referrals to a specialist. If you go outside of the HMO without a referral from the plan, you'll be responsible for the total cost of services, except for emergencies or urgent care services. HMOs are available only in designated California services areas.

The following link provides you with a summary and comparison of plan benefits and copays. Please refer to each plan’s Evidence of Coverage (EOC) booklet for the exact terms and conditions of coverage. In case of a conflict between this summary and your plan’s EOC, the EOC booklet determines the benefits that will be provided.

HMO Plan Summary & Comparison

HMO Plan Name

Group #

Contact Information & Plan Details

Anthem Blue Cross Select

CSU

1-855-839-4524
http://www.anthem.com/ca/calpershmo/

Evidence of Coverage

Anthem Blue Cross Traditional

CSU

1-855-839-4524
http://www.anthem.com/ca/calpershmo/

Evidence of Coverage

Blue Shield Access+

PH0001

1-800-334-5847
https://www.blueshieldca.com/sites/calpersmember/home.sp

Evidence of Coverage

Blue Shield NetValue

PH0010

1-800-334-5847
https://www.blueshieldca.com/sites/calpersmember/home.sp

Evidence of Coverage

Health Net Salud y Mas

TB010A

1-888-926-4921
https://www.healthnet.com/portal/home.do?

Evidence of Coverage

Health Net SmartCare

NB010A

1-888-926-4921
https://www.healthnet.com/portal/home.do?

Evidence of Coverage

Kaiser Permanente

105701-00

1-800-464-4000
http://my.kp.org/calpers/

Evidence of Coverage

Sharp (San Diego residents only)

CSU

1-855-995-5004
https://www.sharphealthplan.com/index.php

Evidence of Coverage

UnitedHealthCare

CSU

1-877-359-3714
http://calpers.welcometouhc.com/

Evidence of Coverage

Note:  CVS Caremark provides prescription Drug Services for all HMO plans above
Except Kaiser Prescription drug are available at the Kaiser Facilities.  CVS Caremark
can be reached at (888) 624-1139.  You may also visit their website at https://www.caremark.com/wps/portal