Employee Benefits- Medical Benefits
Welcome to the Medical Benefits Page. Employees have a choice between an EPO plan and a High Deductible Health Plan that includes a Health Savings Account (HSA).* The County will contribute a portion of the cost of the EPO or HDHP Medical plan. Physician Provider lists can be found on the carrier's websites by clicking on the provider links below.
Summary of Benefits and Coverage Notices and additional Mandatory Annual Notices are listed at the bottom of this page including information on Health Care Reform and the Health Insurance Exchange/Marketplace.
- For information on how you can qualify for Domestic Partner Coverage click on the Secretary of State's website.
- Operating Engineers health insurance may be offered based on position.
Medical Plan Carrier is based on where you live. For those members who live in the local service area, the County offers Stanislaus County Partners in Health (SCPH). For those members who live outside of the local service area, the County offers Anthem Blue Cross. Review the Local Service Area Zip Code List below to confirm which Medical Plan Carrier you are eligible for.
Stanislaus County Partners in Health (SCPH):
- SCPH HDHP w/HSA Benefit Summary
- SCPH EPO Benefit Summary
- SCPH FAQ's
- SCPH HDHP Summary of Benefits and Coverage Notice (SBC)
- SCPH EPO Summary of Benefits and Coverage Notice (SBC)
For claim status, eligibility and benefits, contact POMCO at:
Out of area providers will no longer be available under MultiPlan. The new out of area provider network will be First Health Complimentary. Click on the blue First Health link to view information on how to access the online out of area provider directory.
For questions regarding providers or to access the list of providers and pharmacies, contact SCPH at:
Prescription Pharmacy Network:
- CVS Caremark's Website
- SCPH/CVS Caremark Pharmacy Mail Order Form
- SCPH/CVS Caremark Prescription Reimbursement Claim Form
Flu Shot Information:
Children under the age of 9 will need to see their pediatrician/physician to obtain their flu vaccination. You may or may not have to pay for an office visit. Contact your physician to confirm their office procedure.
Anthem Blue Cross
- Anthem Blue Cross EPO Benefit Summary
- Anthem EPO Summary of Benefits and Coverage Notice (SBC)
- Anthem Blue Cross HDHP Benefit Summary
- Anthem HDHP Summary of Benefits and Coverage Notice (SBC)
- How to Estimate your Out of Pocket Cost on the HDHP
Anthem Contact Info:
EPO Plan Customer Service: 800-888-8288
EPO Pharmacy Benefit: 800-700-2541
Anthem Contact Info:
HDHP Customer Service: 866-207-9878
HDHP Pharmacy Benefit: 800-281-4880
For a list of providers, refer to the Anthem BlueCross website below:
- How to Find a Doctor
- Anthem Website
- Express Scripts Pharmacy website
- Anthem / Express Scripts Pharmacy Mail Order Form
- American Specialty Health Website - Phone: 800-972-4226
Operating Engineers Fund:
(This option is only offered to the Attorney bargaining unit.)
- Health Insurance Exchange Notice
- What does Health Care Reform and the Health Insurance Exchange mean to you?
- COBRA Initial Notice
- Children's Health Insurance Program Reauthorization Act Notice
- Women's Health and Cancer Rights Act Notice
- Newborns and Mothers Health Protection Act Notice
- Medicare Part D Creditable Coverage Notice
- Notice of Special Enrollment Rights
- HIPAA Notice of Privacy Practices
- Summary of Benefits and Coverage (SBC) Uniform Glossary
All benefit forms are located on the FORMS web page!