Note: Effective 2023 Aetna replaced Blue Shield
The County of San Mateo offers employees choices in Health coverage under two primary carriers. We offer plans with Kaiser and Aetna.
All of your medical plan options provide access to quality care and cover a similar list of procedures. It’s the details of how you share the cost of care – your bi-weekly contribution amount, and your co-payments and coinsurance – that differ.
Open Enrollment Information
Once a year in October, employees may change from one plan to another or add dependents. During the year new dependents may be added within 31 days of marriage, birth, adoption or formation of domestic partnership, and children of domestic partners. After 31 days, the dependent cannot be added until the next open enrollment.
The different plans that we currently offer for both Kaiser and Aetna are defined below:
HMO Plans |
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Aetna HMO |
All medical services are coordinated through a Primary Care Physician (PCP) in the Aetna HMO network. Any specialty care you need must be coordinated through your PCP and will require pre-authorization from Aetna. Most services and medicines are covered with a small co-payment. |
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Aetna AVN HMO |
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Kaiser HMO |
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PPO Plans |
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Aetna PPO ($200 deductible) |
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HDHP Plans |
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Aetna HDHP PPO |
Works in conjunction with a Health Savings Plan (HSA). You use the same PPO Network that you would under the standard PPO plan. All your preventative services are covered in full. You pay for the entire cost of non-preventative services until you satisfy your annual deductible after which, you pay 10% of the cost for non- preventative services until you reach your Calendar Year Maximum. |
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KAISER HDHP HMO |
Works in conjunction with an HSA. You use the same Kaiser facilities that you would under the standard Kaiser plan. All your preventative services are covered in full. You pay for the entire cost of non-preventative services until you satisfy your annual deductible after which, you pay 10% of the cost for non-preventative services until you reach your Calendar Year Maximum. |
Transparency in Coverage - Machine Readable Files
The information available through the below link is provided in good faith to comply with the Machine-Readable Files (MRF) provision of the Transparency in Coverage Final Rule (TCFR). These files are extensive collections of data to be ingested and read by machines and are not intended for consumer/member use. When the Access files link below is selected the company EIN/tax ID number with no hyphen will be required.
To learn more about the TCFR and the MRF provision, refer to this Centers for Medicare & Medicaid Services page.