2018 Sunnyvale Benefit Summary

Medical

It is the City’s goal to provide you with affordable, quality health care benefits. Our medical

benefits are designed to help maintain wellness and protect you and your family from major

financial hardship in the event of illness or injury. The City offers a choice of medical plans

through the CalPERS Medical Program.

HEALTH MAINTENANCE ORGANIZATION (HMO)

2018 Insurers: Anthem Blue Cross, Blue Shield, Health Net, Kaiser Permanente, Western Health

Advantage and UnitedHealthcare

Under HMO plans, most services and medicines are covered with a small copayment. Most

HMOs require you to select a Primary Care Physician (PCP) to coordinate your care and require

advance approval for some services, such as treatment by a specialist. Care must generally be

obtained from in-network providers, or you may be required to pay out of pocket for the cost of

services (except in the event of emergency or urgent care services). Not all HMO plans are

available in all California counties. To see if these plans are available in your zip code, visit the

CalPERS website at

and use the zip code finder search engine.

PREFERRED PROVIDER ORGANIZATION (PPO)

2018 Insurers: Anthem Blue Cross (PERS Choice, PERS Select, PERSCare, PORAC)

PPO plans are designed to provide choice, flexibility and value. A PPO plan is a managed care

organization of medical doctors, hospitals, and other health care providers who have contracted

with your insurer to provide health care at reduced rates to you. Participants have a choice of

using network providers or going directly to any other physician (non-network provider) without

a referral. For most services, there is an annual deductible to meet before benefits apply. You

are also responsible for a certain percentage of the charges (coinsurance), and the plan pays the

balance up to the agreed upon amount. Non-network providers are typically covered at a lower

benefit level requiring you to pay a higher percentage of the bill.