Anthem Blue Cross EPO (Yosemite, Sierra, Pismo)

EPOs, or Exclusive Provider Organizations, are copay based and only cover services performed solely by providers within their network (with the exception of emergency services). On this plan, you may self-refer to in-network specialists.

• Medical and mental health coverage is through Anthem Blue Cross.
• Prescription coverage is through EmpiRx.
• Vision coverage is through the Vision Service Plan (VSP).

Anthem Blue Cross PPO 250

PPOs, or Preferred Provider Organizations, allow you to use out-of-network providers, but at a higher rate. The deductible period for this PPO plan is for the plan year, starting the first day of the payroll plan year in December.

• Medical and mental health coverage is through Anthem Blue Cross.
• Prescription coverage is through EmpiRx.
• Vision coverage is through the Vision Service Plan (VSP).

Anthem Blue Cross HDPPO 3000

HDPPOs, or High Deductible Preferred Provider Organizations, have high deductibles and low premiums. As with other PPO plans, they allow you to use out-of-network providers, but at a higher rate. The deductible period for this HDPPO plans is based on the calendar year, starting January 1.

• Medical and mental health coverage is through Anthem Blue Cross.
• Prescription coverage is through EmpiRx.
• Vision coverage is through Vision Service Plan (VSP).

Is Your Doctor In the Anthem Network?

Visit Anthem’s Website today and follow this pathway:

1. Providers > Provider Resources > Find a Doctor
2. From here, you can search as member or search as guest.
   • How do you get insurance? Through my employer
   • What state do you want to search in? Choose the State
   • What type of care are you searching for? Medical
   • Select a plan/network: EPO (it should be about 6 down on the list)
3. Finally, use the search engine to look for your doctor!

Kaiser Permanente HMO

HMOs, or Health Maintenance Organizations, are copay based and cover services performed solely by providers within their network (with the exception of emergency services).

• Medical, mental health, prescription, and vision coverage are all through Kaiser Permanente.

Kaiser Permanente HDHP

NEW this year! The County of Fresno is pleased to offer an additional health plan option, Kaiser Permanente High Deductible Health Plan, for employees and their families. With this plan you will pay the full cost of non-preventive health care services until you meet the annual deductible. Once the out-of-pocket maximum is reached, the plan will pay the full cost of all qualified health care services for the remainder of the calendar year. With this plan you must use Kaiser facilities and providers for your medical, vision, and pharmacy needs. Services received outside of the Kaiser network are not covered, except in the case of emergency medical care. 

• Medical, mental health, prescription, and vision coverage are all through Kaiser Permanente.

Delta Dental DPPO

PPOs, or Preferred Provider Organizations, allow you to use out-of-network providers, but at a higher rate. The deductible period for this PPO plan is based on the calendar year.

DeltaCare USA DHMO

HMOs, or Health Maintenance Organizations, are copay based and cover services performed solely by providers within their network (with the exception of emergency services).

Dental Plan Option Comparison Chart

Visit deltadentalins.com to search for an in-network provider.

Employees experiencing a qualifying life event outside of the Open Enrollment period have thirty (30) days from the event date to turn in the required forms and supplemental documentation to Employee Benefits. Applicable changes may include enrollment or opting out of County health insurance coverage, enrolling or removing dependents, and changing your plan options during those instances. Please contact Employee Benefits for more information or to obtain necessary forms for any applicable qualifying life event.

Please note, Employee Benefits is not responsible for lost/delayed forms sent through the mail and therefore not received by the deadline. To confirm receipt of forms and/or supporting documentation, please contact Employee Benefits.

Opt Outs - Gaining Other Coverage Mid Plan Year

If you newly gain group medical health insurance coverage throughout the plan year, you will be eligible to opt out (waive) the County health insurance benefits. To opt out, please complete the current plan year Opt Out Request form and submit proof of qualifying gained health insurance coverage as detailed below. Please contact Employee Benefits to obtain the Opt Out Request form. 

Opt Out Submission Deadline: 30 days from the date your other qualifying coverage becomes effective. Because the County of Fresno health benefit eligibility is on a bi-weekly basis, your opt out status will become effective the following pay period after the qualifying coverage becomes effective or following receipt of the completed Opt Out Request; whichever is later.

Proof submitted must be:

1. Current - You must submit recent proof that shows your enrollment will become active under the other plan.
2. Group-Sponsored Plan - Acceptable coverage includes, but is not limited to, other or former employer provided coverage or coverage obtained through a spouse’s employer. Medi-cal/Medicaid and individual policies are not eligible health plans to opt out of the County health insurance. However, employees under the age of 26 may opt out under a parent’s insurance policy, regardless of the type of policy.
3. Written - Acceptable documentation of proof of coverage must include your name (employee name) and the date your other coverage becomes effective, and are provided as one of the following:
   • A copy of your insurance card with your name reflected. If your insurance card does not have your name shown, you must provide additional documentation showing you listed as a dependent of the individual listed on the card
   • A letter, HIPAA certificate, or screenshot from the health insurance company
   • A letter, HIPAA certificate, or screenshot from the health plan administrator
   • A letter or screenshot from the employer providing the coverage
   Contact Employee Benefits for more information or to confirm if your other health insurance is qualifying to opt out of County health insurance.

Human Resources - Employee Benefits
2220 Tulare St., 14th Floor
Fresno, CA 93721

(559) 600 - 1810
(559) 455 - 4787 - Fax
HRBenefits@fresnocountyca.gov

Office Hours
Monday - Friday
8am - 5pm

• Medicare Prescription Creditable Coverage Disclosure Notice(PDF, 133KB)
• CHIPRA/CHIP Notice(PDF, 158KB)