Medical Benefits

Medical Insurance Plans

SFSU employees that are benefits-eligible may enroll in one of several medical plans for themselves and their eligible dependents:

Health Maintenance Organizations (HMOs)

Employees select a primary care physician who coordinates all care including referral to specialists.

 

Anthem Blue Cross Traditional HMO California and Anthem Blue Cross Select HMO California

Dedicated to delivering quality care and great value.

Both plans offer 360° Health, a program that helps members become involved in their health and wellness.  

For more information, call (855) 839-4524.

 

Blue Shield Access+ HMO (Limited to specific counties)

Access to more than 11,000 personal physicians and 300 hospitals.

No annual deductible; co-payment at each physician visit.

For more information, call (800) 334-5847.

 

Health Net Salud y Mas California and Health Net SmartCare California

Budget-friendly HMO plans with a tailored list of quality providers for selected California counties.

Ideal for employees who want one primary care physician to coordinate all their medical care. 

For more information, call (888) 926-4921.

 

Kaiser

Integrated health care system.

No annual deductible; co-payment at each physician visit.

For more information, call (800) 464-4000.

 

Sharp Performance Plus California

Local HMO plan serving residents of San Diego.

Commitment to healthcare delivered in a convenient and cost-effective manner. 

For more information, call (855) 995-5004.

 

United Healthcare Alliance HMO California

Quality patient-centered healthcare at lower costs.

Distinct network of providers offers collaborative care and health management. 

For more information, call (877) 359-3714.

 

Western Health Advantage HMO

It offers an affordable health plan with a quality network and flexibility.

Access to Mercy Medical Group, Woodland Clinic, Hill Physicians, North Bay Healthcare, and Meritage Medical Network.​

For more information, call (888) 942-7377.

 

Preferred Provider Organization (PPO)

PERSChoice and PERSCare (administered by Anthem Blue Cross of California) 

Choose your health care providers and pharmacy without a referral.

It offers significant savings through a preferred provider network (doctors and hospitals that agree to charge a pre-negotiated rate for everyone on the plan). Non-network providers may be used, but co-payments will be higher.

PERSChoice pays 80 percent of the allowable amount (in-network), member pays 20 percent; cop-pays are applicable.

PERSCare pays 90 percent of the allowable amount (in-network), member pays 10 percent; co-pays are applicable.

Annual deductibles must be met before some benefits apply.

For more information, call (877) 737-7776.

 

PERSSelect (administered by Anthem Blue Cross of California)

The same level of benefits as PERSChoice at a lower monthly premium cost.

Not available or out-of-state.

Access a list of preferred providers through the PERSSelect network.

For more information, call (877) 737-7776.

 

Prescription Drug Information

OptumRx
  • Is the Pharmacy Benefit Manager  effective January 1, 2017, for PERS Select/Choice/Care PPO, Anthem Blue Cross HMO, Health Net HMO, United Healthcare HMO
  • For more information, call (855) 505-8110