Medical
GYM DISCOUNT INFO
24 Hour Fitness:
Planet Fitness:
MEDICAL FORMS AND INFORMATION
Medical Enrollment or Changes - CalPERS HBD-12 Form
Pre-Tax Election & Waiver Form for Medical Insurance Premium Payroll Deduction
2023 Cash-In-Lieu of Medical Benefits
2023 CalPERS Health Benefit Summary Booklet
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
2023 CalPERS Health Benefit Summary Booklet
Summary of Benefits and Coverage Notice
Glossary of Health Coverage and Medical Terms
2023 Summary of Benefits and Coverage
- Anthem Select HMO
- Anthem Traditional HMO
- Blue Shield HMO
- Health Net Smart Care HMO
- Kaiser HMO
- United Healthcare HMO
- Western Health HMO - (Not available in Contra Costa County)
- Anthem Blue Cross PERS Platinum PPO
- Anthem Blue Cross PERS Gold PPO
2022-23 MEDICAL PLAN RATE SHEET
- MDEA DMA 12 MONTHS RATES
- MDEA DMA 11 MONTHS RATES
- MDEA DMA 10 MONTHS RATES
- CLASSIFIED/MDSPA 12 MONTHS RATES
- CLASSIFIED/MDSPA 11 MONTHS RATES
- CLASSIFIED/MDSPA 10 MONTHS RATES
2023 NEW MEDICAL ENROLLMENT
SELF PAY (Unpaid Leave)
Self Pay Medical, Dental and Vision Rate Sheet (If on Unpaid Leave)
OTHER
John Muir Behavioral Health Center, Outpatient Services