Modoc. Lassen. Tehama Plumas. Butte. Sierra Nevada Placer. Yuba Sutter. El Dorado Alpine. Sacramento Amador Solano. Calaveras Marin Tuolumne

Size: px

Start display at page:

Download "Modoc. Lassen. Tehama Plumas. Butte. Sierra Nevada Placer. Yuba Sutter. El Dorado Alpine. Sacramento Amador Solano. Calaveras Marin Tuolumne"

Solomon Riley
6 years ago
Views:

1 Del Norte Siskiyou Humboldt Modoc Shasta Trinity Lassen Tehama Plumas Butte Glenn Mendocino Lake Colusa Yuba Sutter Sierra Nevada Placer El Dorado Alpine Sacramento Amador Solano Calaveras Marin Tuolumne SanJoaquin ContraCosta San Francisco» Mariposa Alameda Stanislaus SanMateo Santa Clara Merced SantaCruz Madera Sonoma Yolo Napa SanBenito Mono Fresno Inyo Tulare Monterey Kings SanLuisObispo Kern San Bernardino SantaBarbara Ventura Los Angeles Orange HMO Network Comparison Guide Riverside San Diego Imperial The allows you to view the participating medical groups/independent practice associations (PMGs/IPAs) that are part of the Anthem Blue Cross HMO (CaliforniaCare), Select Plus HMO, Select HMO,, and Vivity HMO networks. The guide, which is organized by county, also indicates if a PMG/IPA participates in the Advantage HMO plan and whether a high or low copay is assigned to it. BCABR1430C Rev. 01/16 Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

2 Definition of terms PMG/IPA Participating Medical Group (PMG) or Independent Practice Association (IPA): A group of physicians organized as a legal entity that provides services to HMO members. Prime Anthem Blue Cross identifying number for its contracted PMGs/IPAs. County The county where the PMG/IPA offers services. HMO The Anthem Blue Cross HMO (CaliforniaCare) network. Select Plus HMO This network offers more access than the Select network, while still offering a lower cost than CaliforniaCare. Select HMO This network is built around those PMGs/IPAs demonstrating the most efficient practice patterns and hospital referrals. This network is built around those PMGs/IPAs demonstrating the most efficient practice patterns and hospital referrals in selected Southern California counties: Los Angeles, Orange, Riverside, San Bernardino and San Diego. Vivity HMO Anthem Blue Cross has partnered with seven of the top hospitals in Los Angeles and Orange counties in a joint venture to create the Vivity plan offering. The Vivity network features a virtual, integrated health delivery system that provides convenient access to some of the best primary care doctors, specialists and hospitals in the region at an affordable price. Advantage HMO Empowers members to consider cost and quality before selecting their PMG/IPA. The benefit plan allows the members to select from two comprehensive medical benefit designs: Low = Low Copay Members who select a low-copay provider will have lower out-of-pocket medical expenses. High = High Copay Members who select a high-copay provider will have higher out-of-pocket medical expenses. Information is current as of January 2016 and will be updated periodically. The names of some provider groups may have changed. For the latest information, use the online provider finder at anthem.com/ca by selecting the Find a Doctor link. 2

3 Prime PMG Name County Select Plus HMO (Yes = Select Plus) No = Non-Select Plus) Alameda 0XX AFFINITY MED GRP-EDEN/SAN LEANDRO REGION Alameda Yes No No No High 0XW AFFINITY MEDICAL GROUP-ALAMEDA REGION Alameda Yes NO No No High 0XQ AFFINITY MEDICAL GROUP-BAY VALLEY REGION Alameda Yes Yes No No Low 0PG ALTA BATES MEDICAL GROUP Alameda Yes Yes No No Low 0PB HILL PHYSICIANS MEDICAL GROUP Alameda Yes Yes No No Low 0VA SUTTER EAST BAY MEDICAL FOUNDATION Alameda Yes No No No N/A 7AC SELECT NETWORK/ALAMEDA Alameda No Yes No No N/A 0XU BUTTE COUNTY NETWORK Butte Yes No No No Low Butte Contra Costa 0XS AFFINITY MEDICAL GROUP-ROSSMOOR REGION Contra Costa Yes Yes No No Low 0XY AFFINITY MEDICAL GROUP-WEST COUNTY REGION Contra Costa Yes No No No High 0JM JOHN MUIR PHYSICIAN NETWORK Contra Costa Yes No No No High 7AH SELECT NETWORK/CONTRA COSTA Contra Costa No Yes No No N/A 1CG SEBMF-DIABLO DIVISION Contra Costa Yes No No No N/A 0KQ SANTE COMMUNITY PHYSICIANS Fresno Yes No No No Low 7AA SELECT NETWORK/FRESNO Fresno No Yes No No N/A Fresno Humboldt 0KR HUMBOLDT IPA Humboldt Yes No No No Low Imperial Z5R IMPERIAL COUNTY PHYSICIANS MEDICAL GROUP INC Imperial Yes Yes No No Low 0EY BAKERSFIELD FAMILY MEDICAL CENTER Kern Yes Yes No No Low XJD DELANO MEDICAL GROUP Kern Yes No No No High 5MB DIGNITY HEALTH MEDICAL GROUP - MERCED Kern Yes Yes No No Low XJE GEMCARE MEDICAL GROUP Kern Yes No No No High Z0Z HISPANIC PHYSICIANS IPA KERN Kern Yes No No No High 0JH INDEPENDENCE MEDICAL GROUP Kern Yes Yes No No Low 7AK SELECT NETWORK/KINGS Kings No Yes No No N/A Kern Kings Los Angeles Select HMO (Yes=Select No = Non-Select) Vivity HMO (Yes =Vivity No=Non-Vivity) Advantage HMO (Low = Low Copay High = High Copay) 0MH ACCOUNTABLE HEALTH CARE IPA Los Angeles Yes Yes Yes No Low 0MT ALAMITOS IPA Los Angeles Yes Yes No No Low 0CK ALL CARE MEDICAL GROUP Los Angeles Yes Yes Yes No Low 0HZ ALLIED HEALTHCARE PROVIDERS INC Los Angeles Yes Yes Yes No Low 0HL ALLIED PHYSICIANS OF CALIFORNIA Los Angeles Yes Yes Yes No Low n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage 3

4 Prime Los Angeles 0BG ALTAMED MEDICAL GROUP- PICO RIVERA Los Angeles Yes Yes Yes No Low 0XG ANGELES IPA Los Angeles Yes Yes Yes No Low 0RH APPLECARE MEDICAL GROUP-DOWNEY REGION Los Angeles Yes Yes Yes No Low 0SI APPLECARE MEDICAL GROUP-ST.FRANCIS REGION Los Angeles Yes Yes Yes No Low 0Q1 AXMINSTER MEDICAL GROUP - SLAUSON Los Angeles Yes Yes No No Low 0AF BRIGHT HEALTH PHYSICIANS OF PIH GROUP DIVISION Los Angeles Yes No No Yes High 0XM BRIGHT HEALTH PHYSICIANS OF PIH-IPA DIVISION Los Angeles Yes No No Yes High 7SI BROOKSHIRE IPA Los Angeles Yes Yes Yes No Low 0PN CEDARS-SINAI HEALTH ASSOCIATES Los Angeles Yes No No Yes High 0UR CEDARS-SINAI MEDICAL GROUP Los Angeles Yes No No Yes High 0TS CENTINELA VALLEY IPA Los Angeles Yes Yes Yes No Low 0RB CITRUS VALLEY PHYSICIANS GROUP Los Angeles Yes Yes Yes No Low 0T7 COMMUNITY MEDICAL GROUP OF THE WEST VALLEY/CANOGA PARK/WEST HILLS Los Angeles Yes Yes No No Low 0ZM COMMUNITY MEDICAL GROUP-IPA Los Angeles Yes Yes No No Low 7MD CROWN CITY MEDICAL GROUP IPA Los Angeles Yes Yes Yes No Low 0AH DIAMOND BAR MEDICAL GROUP Los Angeles Yes Yes Yes No Low 0HA EASTLAND MEDICAL GROUP INC Los Angeles Yes Yes No No Low 0UM EMPLOYEE HEALTH SYSTEM MEDICAL GROUP Los Angeles Yes Yes Yes No Low 0N0 FACEY MEDICAL FOUNDATION, AT MISSION HILLS Los Angeles Yes Yes No No Low 0GE FAMILY CARE SPECIALISTS Los Angeles Yes Yes Yes No Low 0CS GOOD SAMARITAN MEDICAL PRACTICE ASSOCIATION Los Angeles Yes Yes No Yes Low 2RQ GREATER NEWPORT PHYSICIAN/LONG BEACH MEMORIAL Los Angeles Yes Yes No Yes Low 0P0 HARRIMAN JONES-WILLOW/HCP Los Angeles Yes Yes No No Low 0DF HEALTHCARE PARTNERS IPA-NORTHRIDGE MED GRP Los Angeles Yes Yes No No Low 7KJ HEALTHCARE PARTNERS MEDICAL GROUP-EAST Los Angeles Yes Yes No No Low 0T2 HEALTHCARE PARTNERS MEDICAL GROUP-MEMBER SER Los Angeles Yes Yes No No Low 0EZ HIGH DESERT MEDICAL GROUP Los Angeles Yes Yes No No Low YS8 PMG Name County Select Plus HMO (Yes = Select Plus) No = Non-Select Plus) Select HMO (Yes=Select No = Non-Select) Vivity HMO (Yes =Vivity No=Non-Vivity) Advantage HMO (Low = Low Copay High = High Copay) HUNTINGTON MEMORIAL/HCP NETWORK (IN VIVITY NETWORK ONLY) Los Angeles No No No Yes N/A 0GM KOREAN AMERICAN MEDICAL GROUP Los Angeles Yes Yes Yes Yes Low 0DR LAKESIDE CENTRAL VALLEY Los Angeles Yes Yes No No Low 0SY LAKESIDE GLENDALE Los Angeles Yes Yes No No Low 0CJ LAKESIDE MEDICAL-BURBANK/NORTHHOLLYWOOD Los Angeles Yes Yes No No Low 1CP LAKESIDE NORTH VALLEY Los Angeles Yes Yes No No Low 0HQ LAKESIDE SANTA CLARITA VALLEY Los Angeles Yes Yes No No Low 0YW LAKESIDE VERDUGO HILLS Los Angeles Yes Yes No No Low 0MR LAKEWOOD IPA INC Los Angeles Yes Yes Yes No Low n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage 4

5 Prime PMG Name County Select Plus HMO Select HMO Prime PMG Name County Select Plus HMO Select HMO (Yes Select Plus) (Yes=Select (Yes = Select Plus) (Yes=Select No Non-Select Plus) No Non-Select) No = Non-Select Plus) No = Non-Select) (Yes Priority Select No Non Priority Select) Vivity HMO Advantage HMO Vivity HMO Advantage HMO (Yes =Vivity (Low Low Copay (Yes =Vivity (Low = Low Copay No=Non-Vivity) High High Copay) No=Non-Vivity) High = High Copay) Los Angeles YMW MAVERICK MEDICAL GROUP INC Los Angeles Yes No No No High 0BJ MEDICO HISPANO/CLINICA MEDICA GENERAL Los Angeles Yes Yes Yes No Low 69U PHYS ASSOC OF THE GREATER SAN GABRIEL VALLEY Los Angeles Yes Yes No No Low 0LK PIONEER PROVIDER NETWORK-LONG BEACH Los Angeles Yes Yes Yes No Low 0SE POMONA VALLEY MEDICAL GROUP Los Angeles Yes No No No High 0NF PREMIER PHYSICIAN NETWORK/VALLEY DIVISION Los Angeles Yes Yes Yes No Low 0MP PROSPECT HEALTH SOURCE MEDICAL GROUP Los Angeles Yes No No No High 0JS PROSPECT PROFESSIONAL CARE MEDICAL GROUP, INC Los Angeles Yes Yes No No Low 1AB PRUDENT MEDICAL GROUP, INC Los Angeles Yes Yes Yes No Low 0YP REGAL-GLENDALE PHYSICIANS ALLIANCE INC Los Angeles Yes Yes No No Low 0YC REGAL MEDICAL GROUP Los Angeles Yes Yes No No Low 0U1 SEASIDE HEALTH PLAN Los Angeles Yes Yes Yes No Low 7AF SELECT NETWORK/LOS ANGELES Los Angeles No Yes No No N/A 0YA SEOUL MEDICAL GROUP Los Angeles Yes Yes Yes No Low ACG SIERRA MEDICAL GROUP Los Angeles Yes Yes No No Low 0YK ST. MARY IPA Los Angeles Yes No No No High 0JI ST. VINCENT IPA MEDICAL CORPORATION Los Angeles Yes Yes No No Low 0EG TORRANCE HOSPITAL IPA MEDICAL GROUP Los Angeles Yes Yes No Yes Low 0FQ UCLA MEDICAL GROUP Los Angeles Yes No No Yes High 7BK UCLA MED GRP-SANTA MONICA BAY PHYSICIANS Los Angeles Yes No No Yes High 0T4 WEST COVINA MEDICAL CLINIC Los Angeles Yes Yes No No Low Nevada 0JR SIERRA NEVADA MEDICAL ASSOCIATES Nevada Yes Yes No No Low Orange 0ZH AFFILIATED DOCTORS OF ORANGE COUNTY MEDICAL Orange Yes Yes No No Low 0YY AMVI MEDICAL GROUP INC Orange Yes Yes Yes No Low 0WL ARTA HEALTH NETWORK Orange Yes Yes Yes No Low 6V7 DAEHAN PROSPECT MEDICAL GROUP INC Orange Yes Yes No No Low 0DJ EDINGER MEDICAL GROUP, IPA Orange Yes No No Yes High 0YR FAMILY CHOICE MEDICAL GROUP Orange Yes Yes Yes No Low X08 FOUNTAIN VALLEY IPA Orange Yes No No No High 0ZR GREATER NEWPORT PHYSICIANS Orange Yes No No No High 5KW GREATER NEWPORT PHYSICIANS/ORANGE COAST Orange Yes Yes No Yes Low 5KY GREATER NEWPORT PHYSICIANS/SADDLEBACK Orange Yes Yes No Yes Low YNL HOAG AFFILIATED PHYSICIANS Orange Yes No No No High 0V5 MEMORIALCARE BPMG/COSTA MESA Orange Yes Yes No Yes Low AFN MISSION HERITAGE MEDICAL GROUP Orange Yes No No No High n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage 5

6 Prime PMG Name County Select Plus HMO (Yes = Select Plus) No = Non-Select Plus) Orange 0XL MISSION HOSPITAL AFFILIATED PHYSICIANS Orange Yes No No No High 0UW MONARCH HEALTHCARE MEDICAL GROUP Orange Yes Yes No No Low 0RK NOBLE AMA IPA MEDICAL GROUP Orange Yes Yes Yes No Low 0V3 PROSPECT GATEWAY MEDICAL GROUP Orange Yes Yes Yes No Low 0WY PROSPECT GENESIS HEALTHCARE Orange Yes Yes Yes No Low 0PY PROSPECT MEDICAL GROUP Orange Yes Yes No No Low 0DN PROSPECT NWOC MEDICAL GROUP INC Orange Yes Yes Yes No Low 1BG ST. JOSEPH HERITAGE MEDICAL GROUP/ORANGE-CHA Orange Yes No No No High 0WX ST. JOSEPH HOSPITAL AFFILIATED PHYSICIANS Orange Yes No No No High 0DL ST.JUDE AFFILIATED PHYSICIANS Orange Yes No No No High 0RD ST.JUDE HERITAGE MEDICAL GROUP Orange Yes No No No High 0UL TALBERT MEDICAL GROUP/FOUNTAIN VALLEY Orange Yes Yes No No Low YVS UC IRVINE HEALTH AFFILIATED PHYSICIANS Orange Yes No No Yes High YV0 UC IRVINE - ORANGE Orange Yes No No Yes High YVT UC IRVINE - TUSTIN Orange Yes No No Yes High Riverside 8OO BMG-TRI VALLEY MEDICAL GROUP IPA Riverside Yes No Yes No High ABL COACHELLA VALLEY PHYSICIANS OF PRIMECARE Riverside Yes Yes No No Low 0GH DESERT OASIS HEALTHCARE Riverside Yes Yes No No Low 0MY EMPIRE PHYSICIANS MEDICAL GROUP Riverside Yes No No No High 0NL HEMET COMMUNITY MEDICAL GROUP, INC Riverside Yes No No No High ABK PRIMECARE MEDICAL GROUP OF CITRUS VALLEY Riverside Yes Yes No No Low 0LJ PRIMECARE MEDICAL GROUP OF CORONA, INC Riverside Yes Yes No No Low 0TY PRIMECARE MEDICAL GROUP OF HEMET VALLEY, INC Riverside Yes Yes Yes No Low 0NN PRIMECARE MEDICAL GROUP OF MORENO VALLEY Riverside Yes Yes Yes No Low 0LH PRIMECARE MEDICAL GROUP OF RIVERSIDE, INC Riverside Yes Yes No No Low 0UG PRIMECARE MEDICAL GROUP OF SUN CITY Riverside Yes Yes No No Low 0HY PRIMECARE MEDICAL GROUP OF TEMECULA, INC Riverside Yes Yes Yes No Low 0V9 RIVERSIDE MEDICAL CLINIC Riverside Yes No No No High 0NY RIVERSIDE PHYSICIAN NETWORK Riverside Yes Yes No No Low 5N8 VALLEY PHYSICIANS NETWORK Riverside Yes Yes No No Low Sacramento Select HMO (Yes=Select No = Non-Select) Vivity HMO (Yes =Vivity No=Non-Vivity) Advantage HMO (Low = Low Copay High = High Copay) 0JN HILL PHYSICIANS MEDICAL GROUP/SACRAMENTO Sacramento Yes Yes No No Low 0KY MERCY MEDICAL GROUP Sacramento Yes Yes No No Low 7AD SELECT NETWORK/SACRAMENTO Sacramento No Yes No No N/A 0XA SUTTER INDEPENDENT PHYSICIANS Sacramento Yes No No No N/A n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage 6

7 Prime Sacramento 0WW SUTTER MEDICAL GROUP Sacramento Yes No No No N/A 0MW UC DAVIS MEDICAL GROUP Sacramento Yes No No No High San Benito 0TM SAN BENITO MEDICAL ASSOCIATES San Benito Yes No No No High San Bernardino 0K3 BEAVER MEDICAL GROUP San Bernardino Yes Yes No No Low AFF BMG-ALLIANCE DESERT PHYS San Bernardino Yes No No No High Z1I CHAFFEY MEDICAL GROUP-BMG San Bernardino Yes Yes No No Low 0DS CHOICE MEDICAL GROUP San Bernardino Yes Yes No No Low 0GP INLAND HEALTHCARE GROUP, INC San Bernardino Yes No No No High 0RN LAKE ARROWHEAD NETWORK San Bernardino Yes No No No High 0RS LA SALLE MEDICAL ASSOCIATES San Bernardino Yes Yes Yes No Low 0X6 LOMA LINDA UNIVERSITY HEALTH CARE ADMINISTRA San Bernardino Yes No No No High 0SK MY FAMILY MEDICAL GROUP San Bernardino Yes Yes Yes No Low 0FB PINNACLE MEDICAL GROUP San Bernardino Yes Yes Yes No Low 0GK PRIMECARE MEDICAL GROUP OF CHINO VALLEY, INC San Bernardino Yes Yes Yes No Low 0TX PRIMECARE MEDICAL GROUP OF INLAND VALLEY,INC San Bernardino Yes Yes No No Low 0UA PRIMECARE MEDICAL GROUP OF REDLANDS, INC San Bernardino Yes Yes Yes No Low ABJ PRIMECARE MEDICAL GROUP OF SAN BERNARDINO San Bernardino Yes Yes Yes No Low 0YN REDLANDS YUCAIPA MEDICAL GROUP San Bernardino Yes Yes No No Low 1BX SAN BERNARDINO MEDICAL GROUP INC San Bernardino Yes No No No High 0ZP ST MARY HIGH DESERT MEDICAL GROUP San Bernardino Yes No No No High 0YH UPLAND MEDICAL GROUP San Bernardino Yes Yes No No Low San Diego ABC ENCOMPASS MEDICAL GROUP San Diego Yes Yes Yes No Low 99R GRAYBILL MEDICAL GROUP San Diego Yes Yes No No Low 0TI GREATER TRI CITIES IPA San Diego Yes Yes Yes No Low ECP MERCY PHYSICIANS MEDICAL GROUP, INC San Diego Yes No No No High 0DQ MULTICULTURAL PRIMARY CARE MEDICAL GROUP San Diego Yes Yes Yes No Low 0WD PRIMARY CARE ASSOCIATES MEDICAL GROUP San Diego Yes Yes Yes No Low ZM5 RADY CHILDRENS HEALTH NETWORK San Diego Yes Yes Yes No Low 0ZN PMG Name County Select Plus HMO (Yes = Select Plus) No = Non-Select Plus) SCRIPPS PHYSICIANS MEDICAL GROUP (formerly San Diego Physicians Medical Group) San Diego Yes Yes No No Low 7AE SELECT NETWORK/SAN DIEGO San Diego No Yes No No N/A AAB SCRIPPS CLINIC TORREY PINES San Diego No No No No High ABA SCRIPPS COASTAL MEDICAL CENTER San Diego No No No No High 0HP SHARP COMMUNITY MEDICAL GROUP San Diego Yes Yes No No Low n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage Select HMO (Yes=Select No = Non-Select) Vivity HMO (Yes =Vivity No=Non-Vivity) Advantage HMO (Low = Low Copay High = High Copay) n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage 7

8 Prime PMG Name County Select Plus HMO Select HMO Prime PMG Name County Select Plus HMO Select HMO (Yes Select Plus) (Yes=Select (Yes = Select Plus) (Yes=Select No Non-Select Plus) No Non-Select) No = Non-Select Plus) No = Non-Select) (Yes Priority Select No Non Priority Select) Vivity HMO Advantage HMO Vivity HMO Advantage HMO (Yes =Vivity (Low Low Copay (Yes =Vivity (Low = Low Copay No=Non-Vivity) High High Copay) No=Non-Vivity) High = High Copay) San Diego Z42 SHARP COMMUNITY MEDICAL GROUP - ARCH San Diego Yes Yes No No Low 24F SHARP COMMUNITY MEDICAL GROUP - INLAND NORTH San Diego Yes Yes No No Low 0AW SHARP REES-STEALY MEDICAL GROUP, SAN DIEGO San Diego Yes Yes Yes No Low 1CR UCSD MED GRP-FAM MED/LEWIS San Diego Yes Yes No No Low X8V UCSD PHYSICIAN NETWORK-PRIMARY CARE San Diego Yes Yes No No Low San Francisco 0KC BROWN AND TOLAND MEDICAL GROUP San Francisco Yes No No No High 0LE CHINESE COMMUNITY HEALTH CARE ASSOCIATION San Francisco Yes Yes No No Low 0UC HILL PHYSICIANS MEDICAL GROUP/SAN FRANCISCO San Francisco Yes No No No High 0XR SAN FRANCISCO NETWORK San Francisco Yes No No No High 7AL SELECT NETWORK/SAN FRANCISCO San Francisco No Yes No No N/A San Joaquin 0YZ HILL PHYSICIANS MEDICAL GROUP San Joaquin Yes No No No High 0ZV MEDCORE MEDICAL GROUP San Joaquin Yes Yes No No Low San Luis Obispo 1BS COASTAL COMMUNITIES PHYSICIAN NETWORK San Luis Obispo Yes No No No High San Mateo Z06 PALO ALTO MEDICAL FOUNDATION/MILLS PENINSULA DIVISION San Mateo Yes No No No N/A 5PN PENINSULA MEDICAL CLINIC San Mateo Yes No No No N/A ACF SEQUOIA PHYSICIANS NETWORK San Mateo Yes No No No High Santa Barbara 0L5 PHYSICIANS CHOICE Santa Barbara Yes No No No Low 0X0 SANSUM CLINIC Santa Barbara Yes No No No High 0DG SANTA BARBARA SELECT IPA MED GROUP Santa Barbara Yes No No No High Santa Clara 2K9 AFFINITY MEDICAL GROUP - SOUTH BAY Santa Clara Yes No No No High 0KM DCHS MEDICAL FOUNDATION Santa Clara Yes No No No High 0KN PALO ALTO MEDICAL FOUNDATION Santa Clara Yes No No No N/A 0JF PALO ALTO MEDICAL FOUNDATION/CAMINO SITE Santa Clara Yes No No No N/A 0UK PHYSICIANS MEDICAL GROUP OF SAN JOSE Santa Clara Yes Yes No No Low 13Q PREMIER CARE OF NORTHERN CALIFORNIA INC Santa Clara Yes No No No High 0MM SANTA CLARA IPA Santa Clara Yes Yes No No Low 7AB SELECT NETWORK/SANTA CLARA Santa Clara No Yes No No N/A 0YS SILICON VALLEY NETWORK Santa Clara Yes No No No High Santa Cruz ADK PALO ALTO FOUNDATION/SANTA CRUZ SITE Santa Cruz Yes No No No N/A 0ER PHYSICIANS MEDICAL GROUP OF SANTA CRUZ COUNTY Santa Cruz Yes Yes No No Low n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage 8

9 Prime PMG Name County Select Plus HMO Select HMO Prime PMG Name County Select Plus HMO Select HMO (Yes Select Plus) (Yes=Select (Yes = Select Plus) (Yes=Select No Non-Select Plus) No Non-Select) No = Non-Select Plus) No = Non-Select) Shasta (Yes Priority Select No Non Priority Select) Vivity HMO Advantage HMO Vivity HMO Advantage HMO (Yes =Vivity (Low Low Copay (Yes =Vivity (Low = Low Copay No=Non-Vivity) High High Copay) No=Non-Vivity) High = High Copay) 0RE SHASTA/TEHEMA COUNTY NETWORK Shasta Yes No No No High Solano 0KS HILL PHYSICIANS MEDICAL GROUP/SOLANO Solano Yes No No No High 1CF SUTTER REGIONAL MEDICAL FOUNDATION Solano Yes No No No N/A Sonoma 0JZ MERITAGE MEDICAL NETWORK Sonoma Yes No No No Low 0RG SONOMA COUNTY NETWORK Sonoma Yes No No No High 0XK SUTTER MEDICAL GROUP OF THE REDWOODS Sonoma Yes No No No N/A Stanislaus 0KJ ALLCARE IPA Stanislaus Yes Yes No No Low 7AJ SELECT NETWORK/STANISLAUS Stanislaus No Yes No No N/A 0WF SUTTER GOULD MEDICAL FOUNDATION Stanislaus Yes No No No N/A Tulare 1CL COASTAL COMMUNITIES PHYSICIAN NETWORK Tulare Yes Yes No No Low AED KEY MEDICAL GROUP Tulare Yes Yes No No Low 7AG SELECT NETWORK/TULARE Tulare No Yes No No N/A Tuolumne 0RW TUOLUMNE COUNTY NETWORK Tuolumne Yes No No No High Ventura 0LY COMMUNITY MED GRP OF VENTURA CTY - IPA Ventura Yes Yes No No Low 0LZ COMMUNITY MED GRP OF VENTURA CTY- SIMI VALLE Ventura Yes Yes No No Low 0GN SEAVIEW IPA Ventura Yes Yes No No Low 1CB VALLEY CARE IPA Ventura Yes Yes No No Low 8DK VALLEY CARE SELECT IPA Ventura Yes Yes No No Low Yolo 0KK SUTTER WEST MEDICAL GROUP Yolo Yes No No No N/A 0KW WOODLAND CLINIC MEDICAL GROUP Yolo Yes Yes No No Low Mexico Y84 SIMNSA N/A Yes Yes Yes No Low n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage 9

10 Notes 10

12 BCABR1430C Rev. 01/16 Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

2019 CALPERS MONTHLY PREMIUMS BAY AREA REGION EMPLOYEES REPRESENTED BY UNITED CHIEF OFFICERS' ASSOCIATION BARGAINING UNIT HA

2019 CALPERS MONTHLY PREMIUMS BAY AREA REGION EMPLOYEES REPRESENTED BY UNITED CHIEF OFFICERS' ASSOCIATION BARGAINING UNIT HA BAY AREA REGION $831.44 $652.01 $179.43 $1,662.88 $1,304.00 $358.88 $2,161.74 $1,695.21 $466.53 $1,111.13 $725.04 $386.09 $2,222.26 $1,450.06 $772.20 $2,888.94 $1,885.09 $1,003.85 * BLUE SHIELD ACCESS+