Plan Details
Plan Materials
HMO Members: Find simple answers to your frequently asked questions
Important: Prior to enrollment, refer to the Summary of Benefits and/or Summary of Benefits and Coverage documents for specific plan benefits.
2023 – Schedule of Benefits
- 2023 – Active employee and Flex Retiree HMO Schedule (PDF)
- 2023 – PrimeCare CA PPO and Out of State PPO Schedule (PDF)
- 2023 – PrimeCare HMO Schedule (PDF)
- 2023 – Flex Retiree Seniority Plus Schedule (PDF)
- 2023 – PrimeCare Seniority Plus Schedule (PDF)
2023 – Summary of Benefits and Coverage (SBC) documents
- 2023 – Summary of Benefits Active employee and Flex Retiree HMO (PDF)
- 2023 – Summary of Benefits PrimeCare CA PPO and Out of State PPO (PDF)
- 2023 – Summary of Benefits PrimeCare HMO (PDF)
- 2023 – Active employee and Flex Retiree HMO Disclosure Form (PDF)
- 2023 – PrimeCare CA PPO and Out of State PPO Disclosure Form (PDF)
- 2023 – PrimeCare HMO Disclosure Form (PDF)