Medical
MEDICAL FORMS AND INFORMATION
Medical Enrollment or Changes - CalPERS HBD-12 Form
Pre-Tax Election & Waiver Form for Medical Insurance Premium Payroll Deduction
2024 Cash-In-Lieu of Medical Benefits
2024 CalPERS Health Benefit Summary Booklet
2024 Summary of Benefits and Coverage Notice
Glossary of Health Coverage and Medical Terms
MEDICAL BENEFITS
Medical Enrollment or Changes - CalPERS HBD-12 Form
Pre-Tax Election & Waiver Form for Medical Insurance Premium Payroll Deduction
2024 Summary of Benefits and Coverage Notice
Glossary of Health Coverage and Medical Terms
2024 Summary of Benefits and Coverage
- Anthem Select HMO
- Anthem Traditional HMO
- Blue Shield Access HMO
- Kaiser HMO
- United Healthcare SignatureValue Alliance HMO
- Western Health HMO - (Not available in Contra Costa County)
- Anthem Blue Cross PERS Platinum PPO
- Anthem Blue Cross PERS Gold PPO
2023-24 MEDICAL PLAN RATE SHEET
- MDEA DMA CSEA 12 MONTHS RATES
- MDEA DMA CSEA 11 MONTHS RATES
- MDEA DMA CSEA 10 MONTHS RATES
- CLASSIFIED/MDSPA 12 MONTHS RATES
- CLASSIFIED/MDSPA 11 MONTHS RATES
- CLASSIFIED/MDSPA 10 MONTHS RATES
SELF PAY (Unpaid Leave)
Self Pay Medical, Dental and Vision Rate Sheet (If on Unpaid Leave)
OTHER
John Muir Behavioral Health Center, Outpatient Services