Compare Retiree Medical Plans

The County of San Luis Obispo offers 4 non-Medicare early retiree medical plans, as well as two Medicare supplemental plans for different needs and budgets. Every plan includes free preventive care from network providers to check that you’re staying healthy. Each plan provides its own network of doctors, hospitals and labs. The differences are in cost, flexibility and access to care.

For the most current plan information, please review the Retiree Benefits Brochure. 

Retiree Medical Plans

A PPO gives you flexibility and choice, but you might pay more. You can go to any doctor without a referral, but you will pay more of the cost if they are not in the plan's network. You’ll need to meet an annual deductible before the plan starts to pay. 

The County offers four PPO plan options for retirees:

  • Early Retiree Blue Shield Tandem PPO
  • Early Retiree Blue Shield Choice PPO
  • Early Retiree Blue Shield Care PPO
  • Blue Shield Medicare PPO

Blue Shield PPOs coordinate with Express Scripts for your pharmacy benefits.

2024 Blue Shield PPO Plan Documents
2024 PPO Summary of Benefits (SOB), Summary of Benefits and Coverage (SBC), and Evidence of Coverage (EOC)
PPO Medicare Summary of Benefits Tandem PPO Summary of Benefits Choice PPO Summary of Benefits Care PPO Summary of Benefits
PPO Medicare Summary of Benefits and Coverage Tandem PPO Summary of Benefits and Coverage Choice PPO Summary of Benefits and Coverage Care PPO Summary of Benefits and Coverage
PPO Medicare Evidence of Coverage Tandem PPO Evidence of Coverage Choice PPO Evidence of Coverage Care PPO Evidence of Coverage
 
2025 Blue Shield PPO Plan Documents
2025 PPO Summary of Benefits (SOB), Summary of Benefits and Coverage (SBC), and Evidence of Coverage (EOC)
PPO Medicare Summary of Benefits Tandem PPO Summary of Benefits Choice PPO Summary of Benefits Care PPO Summary of Benefits
PPO Medicare Summary of Benefits and Coverage Tandem PPO Summary of Benefits and Coverage Choice PPO Summary of Benefits and Coverage Care PPO Summary of Benefits and Coverage
PPO Medicare Evidence of Coverage Tandem PPO Evidence of Coverage Choice PPO Evidence of Coverage Care PPO Evidence of Coverage

The three early retiree PPO plans have differing premium costs, provider networks, and out of pocket maximums. Please see below for a comparison of the three plans to help you find a plan that's right for you and your family:

County PPO Plan Comparison
  Blue Shield Tandem Blue Shield Choice Blue Shield Care
Network Narrow Network of Providers Larger Network of Providers Larger Network of Providers
Out of Pocket Maximum Higher Out of Pocket Maximum Higher Out of Pocket Maximum Lowest Out of Pocket Maximum
Premium Costs Lowest Premiums Higher Premiums Highest Premiums

Unsure what some of these terms mean for you and your dependents? Visit the Choosing a Medical Plan page to learn more about these key terms and other considerations.

An EPO gives you more predictable costs but less flexibility. Out-of-network care is not covered except in an emergency. You pay a fixed copay for most services. 

The County offers two EPO plan options for retirees:

  • Blue Shield EPO 
  • Blue Shield EPO Medicare

The Blue Shield EPO plan coordinates with Express Scripts for your pharmacy benefit. 

2024 Blue Shield EPO Plan Documents

2024 EPO Summary of Benefits (SOB), Summary of Benefits and Coverage (SBC), and Evidence of Coverage (EOC)
Early Retiree Blue Shield EPO Summary of Benefits Early Retiree BlueShield EPO Summary of Benefits and Coverage Early Retiree Blue Shield EPO Evidence of Coverage
Blue Shield Medicare EPO Summary of Benefits Blue Shield Medicare EPO Summary of Benefits and Coverage Blue Shield Medicare EPO Evidence of Coverage

2025 Blue Shield EPO Plan Documents

2025 EPO Summary of Benefits (SOB), Summary of Benefits and Coverage (SBC), and Evidence of Coverage (EOC)
Early Retiree Blue Shield EPO Summary of Benefits Early Retiree BlueShield EPO Summary of Benefits and Coverage Early Retiree Blue Shield EPO Evidence of Coverage
Blue Shield Medicare EPO Summary of Benefits Blue Shield Medicare EPO Summary of Benefits and Coverage Blue Shield Medicare EPO Evidence of Coverage

FAQs

No, the County Blue Shield plans do not include OTC.
No, the County Blue Shield plans do not include Wellvolution.
If you are enrolled in a County retiree medical plan, you will receive a Blue Shield Medical ID card upon your initial enrollment. You will receive a separate Express Scripts ID card for pharmacy.
  • Medical ID cards will only be in the name of the primary subscriber (retiree)
  • Medicare retirees will have a card that says PRISM/County of SLO - MCP in the bottom right.
If you do not make any plan changes during Open Enrollment, you will not receive a new ID card for the new year. You will continue to use your current card. 

If you lose your medical ID card or need to request a new one be mailed, contact Accolade at (866) 406-1275.