Access+ HMO plan Overview Access+ HMO

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1 You don’t have to sacrifice choice for lower costs

Nothing matters more than your health. Except protecting it.

Get access to one of the largest networks of doctors, specialists and hospitals in California with Access+ HMO®. It offers you many care options, so you can choose what’s right for you and your family.

For 2018, we've worked to lower our rates for Access+ HMO to offer you a plan that delivers choice and affordability.

Here are some of the valuable Access+ HMO programs and services that offer you more choice, convenience and control over your own care:

Self-refer to a Select a different Contact a Stay covered across the specialist within primary care physician through country for extended your medical physician (PCP) Teladoc 24/7/365 periods with the Away group, without for each member when your doctor From Home Care® going to your of your family and isn’t available, program when you doctor first.1 change that doctor even while have students, long-term anytime you want. traveling, for only travelers and families a $5 copay.10 living apart.7

2 Access+ HMO plan Overview

About the Access+ HMO plan Blue Shield’s Access+ HMO plan is designed to provide both comprehensive coverage and access to one of the largest, quality networks of doctors, specialists and hospitals throughout the state.

With our Access+ HMO plan, you can expect zero or low copayments for most covered services, plus no deductible and virtually no claim forms.

Choosing a doctor When you enroll in the Access+ HMO plan, you will be asked to select a primary care physician (PCP) for you and each of your dependents. You and your covered dependents have the option to select different PCPs and medical groups within the Access+ HMO Network of providers.

To find out if your current doctor is in our network, or to locate a new doctor, go to blueshieldca.com/ Self-refernetworkcalpershmo to a specialist and selectSelect Primary a different Care PhysicianContact to search a physician for a network PCP.Stay Enter covered your across city the withinand state your ormedical ZIP code, then clickprimary Continue care. Click on thethrough PCP’s Teladoc name to24/7/365 find the PCP’scountry provider for numberextended group,and medicalwithout going group/Independent to physician Practice (PCP) Association when number. your doctor You will isn’t need these numbersperiods with when the youyour enroll doctor in first.the 1plan for thefor first each time. member available, even while Away From Home of your family traveling for only a $5 Care® program when If you don’t have access to the Internet or would like personal assistance, call Shield Concierge, and change that copay. you have students, our dedicated customer service team for CalPERS members, at (800) 334-5847, 7 a.m. to 8 p.m., doctor anytime long-term travelers and seven days a week. you want. families living apart.7

Access emergency and Receive up to Get up to a 90-day Call Shield urgent care services 20 combined supply for the cost of Concierge, our almost anywhere in chiropractic and a 60-day supply of team of experts, the United States and in acupuncture prescriptions by mail for help with more than 200 countries treatments per or from select retail healthcare through the BlueCard® year for a $15 pharmacies when you questions, concerns Program and Blue Shield copay per visit. take medication for a or decisions Global Core. chronic condition.

3 Comprehensive benefit summary

for the Access+ HMO plan

Calendar-year deductible Member None Family None Physician services Preventive health exam No charge Gynecological/well-woman exam No charge Pregnancy and maternity care; prenatal/postnatal office visits No charge Well-baby care No charge Immunization/inoculation No charge Allergy testing/treatment No charge Office/home visits $15/visit Teladoc video or phone consultation $5/call Urgent care $15/visit Infertility testing and treatment 50% of allowable amount Physician inpatient hospital visits No charge Surgery/anesthesia No charge Chiropractic and acupuncture services $15/visit (Combined maximum of 20 visits per year) Access+ SpecialistSM,1 – self-referral to specialists $30/visit Hospital services Inpatient No charge Outpatient No charge Ambulatory surgery centers No charge Transgender surgical services No charge Ambulance services No charge Emergency care – no copayment if hospitalized or kept $50/visit for observation

Diagnostic X-ray/lab No charge Skilled nursing facility – up to 100 days per calendar year No charge Hospice No charge Mental health/substance use disorder Inpatient No charge Outpatient $15/visit

4 Access+ HMO plan Overview

Prescriptions2 Prescriptions for non-maintenance drugs and for the first three fills of $5 generic maintenance drugs from a retail pharmacy (up to a 30-day supply) $20 formulary brand $50 non-formulary brand Prescriptions for maintenance drugs after the first three fills from a retail $10 generic pharmacy (up to a 30-day supply)3 $40 formulary brand $100 non-formulary brand Prescriptions for maintenance drugs from a select* retail pharmacy $10 generic (up to a 90-day supply) $40 formulary brand $100 non-formulary brand Prescriptions for maintenance drugs by mail order (up to a 90-day supply) $10 generic $40 formulary brand $100 non-formulary brand Prescriptions for specialty drugs (up to a 30-day supply) $30 Prescription drugs to treat sexual dysfunction 50% of the cost of the drug Maximum annual out-of-pocket payments for mail service formulary $1,000 prescription drugs4 Flu vaccine from participating retail pharmacies5 No charge Vision care Eye refraction to determine need for corrective lenses No charge (This service is limited to one visit per calendar year for members 18 and older; no limit on number of visits for members under 18.) Eyeglasses – not covered, except for those that are necessary after 20% discount available8 cataract surgery (See page 11.) Hearing-aid services Evaluation No charge Hearing aid – up to a maximum of $1,000 per member, every 36 months for Charges in excess of $1,000 both ears for the hearing-aid instrument and ancillary equipment Durable medical equipment, including orthoses and prostheses No charge

Physical/occupational/speech therapy Inpatient visits at a hospital or skilled nursing facility No charge Outpatient and home visits $15/visit Member calendar-year out-of-pocket maximum Member: $7, 3 5 0 Family: $14,700 – Medical: $1,500 maximum – Medical: $3,000 maximum – Pharmacy: $5,850 maximum† – Pharmacy: $11,700 maximum†

* CalPERS network select pharmacies are Costco, CVS and Safeway/Vons. † Includes the $1,000 maximum annual out-of-pocket payments for mail service formulary prescription drugs per member.

This chart is a summary of the Access+ HMO plan benefit coverage. It is not a contract. For complete details, please visit our website, blueshieldca.com/calpers, where you can find in-depth information about the plan, as well as download the Access+ HMO Evidence of Coverage. Or you can contact Shield Concierge at (800) 334-5847 if you prefer a printed copy. 5 Pharmacy benefits

Blue Shield’s pharmacy benefits are fully integrated with the medical benefits, offering you the convenience of one Blue Shield member ID card and one Member Services phone number for both pharmacy and medical benefit questions.

Filling your prescription at a local pharmacy You can locate a network pharmacy by calling Shield Concierge at (800) 334-5847 or by visiting blueshieldca.com/wellness/drugs.

Copayments for prescription drugs filled at a retail pharmacy:

Non- Formulary Retail prescription drugs Generic formulary brand brand

Up to a 30-day supply of non-maintenance drugs and $5 $20 $50 the first three fills of maintenance drugs*

Up to a 30-day supply of maintenance drugs after the $10 $40 $100 first three fills3

Up to a 90-day supply of maintenance drugs from a select retail pharmacy (Costco, CVS and Safeway/ $10 $40 $100 Vons)

You may also receive your flu immunization from participating pharmacies as well as your primary care physician’s office at no charge.

Mail service prescriptions Blue Shield provides the convenience of mail service6 delivery of prescription drugs through CVS Caremark®. You may receive up to a 90-day supply of covered maintenance drugs delivered to your home or office, with no charge for shipping.

Mail service prescription drugs (90-day supply)

$10 generic $40 formulary brand $100 non-formulary brand

* Maintenance drugs are prescribed to treat chronic health conditions such as asthma, diabetes, high blood pressure or high cholesterol and are taken on an ongoing, regular basis to maintain health. You can view the list of covered maintenance drugs by visiting blueshieldca.com/ wellness/drugs/formulary and scrolling down to the formularies under Large Groups (100+ employees).

6 Access+ HMO plan Overview

To receive medications from CVS Caremark, go to blueshieldca.com/wellness/drugs and then click on Mail Service Prescriptions. For new prescriptions, please allow 10 to 14 days to receive your covered maintenance medications. Once your prescription is on file with CVS Caremark, please allow five to eight days to receive refills of your covered medications.

About our drug formulary The Blue Shield Plus Drug Formulary is a list of preferred generic and brand drugs that are eligible for coverage under the outpatient prescription drug benefit. You can help lower your out-of-pocket prescription drug costs by requesting generic and formulary brand medications when you see your doctor because these medications are usually covered at a lower copayment than non-formulary drugs. To see our drug formulary, visit blueshieldca.com/wellness/drugs/ formulary and select the link Plus Drug Formulary under Large Groups (100+ employees).

Specialty drugs Specialty drugs are drugs that may require coordination of care, close monitoring or extensive patient training for self-administration. Most specialty drugs must be filled through CVS Caremark, our network specialty pharmacy. Prescriptions for specialty drugs are available for up to a 30-day supply per fill, with a copayment of $30. A complete list of specialty drugs is available at blueshieldca.com/wellness/drugs/ formulary; scroll down to the specialty drug list under Large Groups (100+ employees).

Out-of-pocket expenses The annual out-of-pocket maximum for pharmacy expenses is $5,850 for an individual and $11,700 for a family. Additionally, once you have paid $1,000 for formulary mail service prescriptions, you will pay $0 for formulary prescriptions filled at CVS Caremark for the remainder of the year. (Non-formulary brand drugs and drugs to treat sexual dysfunction do not accumulate toward this mail service out-of-pocket maximum.)

7 Plus lots more

Additional care options

Self-refer to a specialist With Access+ Specialist, you can self-refer to a participating specialist in the same medical group for a fixed office copayment of $30 per visit.1

Teladoc Teladoc gives you remote access to the same type of board-certified physicians you would visit in person. They are available by phone or video, even while you are traveling10. Physicians can provide you with a prescription if medically necessary and consults are always a $5 copay.

Coverage while traveling You have access to care for emergency and urgent care services across the United States and around the world through the BlueCard® Program and Blue Cross Blue Shield Global Core. If you use providers in the BlueCard Program, you will pay only your regular copay at the time of service and will not have any claim forms to fill out when you return.

Coverage for students or families living apart The Away From Home Care program7 offers students, long-term travelers, workers on long- distance assignments and families living apart access to health coverage from Blue Shield and Blue Cross plans across the country. The program is available in 31 states and the District of Columbia, but availability varies by county within each state. HMO benefits vary by state.

Chiropractic and acupuncture services You can visit any participating chiropractor or acupuncturist from the American Specialty Health Networks, Inc. (ASH Networks) without a referral from your primary care physician. There is a $15 copay per visit and a combined maximum of 20 visits per year.

NurseHelp 24/7 With NurseHelp 24/7SM, registered nurses are available to answer your health questions at any time, every day.

LifeReferrals 24/7 With LifeReferrals 24/7SM, experienced professionals are ready to help you with personal, family and work issues at any time.

8 Access+ HMO plan Overview

Health and wellness programs

Wellvolution An online wellness program that makes getting serious about your health some serious fun. Wellvolution® includes:

Well-Being Assessment Take a quick and confidential assessment to receive a personalized report with suggestions for ways to improve your health.

Diabetes Prevention Program This program can help qualifying members lose weight, adopt healthier habits and reduce the risk of developing type 2 diabetes.

Daily Challenge With Daily Challenge®, each day receive an email message for one simple wellness- related activity to help you live healthier and improve your overall well-being.

Walkadoo Simply wear a wireless device that tracks your steps throughout the day, and the Walkadoo® walking program will keep track of your activity and goals. When you join the program, you are eligible to get a Fitbit® activity tracker at no extra cost.

QuitNet Get online and mobile peer support from QuitNet®, the largest quit-smoking community in the world for those who want to quit smoking.

Condition Management Program Get guidance and information on conditions such as asthma, chronic obstructive pulmonary disease (COPD), coronary artery disease (CAD), diabetes, heart failure and musculoskeletal conditions.

Prenatal Program Expectant parents get 24/7 phone access to maternity nurses and other support and guidance during pregnancy.

9 Other services and resources

Shield Concierge As a CalPERS member, you have access to one-on-one support from our Shield Concierge team of healthcare experts who can support your various needs with:

Customer service representatives who can answer your questions about plan coverage, doctor selection, claims, ID cards, pre-authorization and referrals

Registered nurses who can follow your condition, case or illness, answer health-related questions and consult on medical issues and symptoms

 Social workers who can provide support and assistance with your physical and emotional well-being and provide information about community resources

Health coaches who can help you with disease prevention, nutrition, weight management, stress reduction and general lifestyle health

Pharmacy technicians who can answer your questions about benefits, formulary alternatives and prior authorization of prescriptions

Pharmacists who can answer your questions relating to medications, side effects, drug safety, costs and treatment options

Shield Connect in a Flash When you register on blueshieldca.com, you’ll automatically receive our Shield Connect in a Flash e-newsletter every other month. This online newsletter will keep you current on benefits and services available to you throughout the year.

Blueshieldca.com When you become a member, you can register at blueshieldca.com where you will be able to manage your health plan online, from changing your primary care physician to accessing your plan benefits and downloading temporary Blue Shield member ID cards.

Take us with you anywhere Download the Blue Shield of California mobile app and keep your health plan information at your fingertips. Our mobile app is available on the App StoreSM and Google PlayTM. Or connect with us using our mobile-friendly website at blueshieldca.com. Find a doctor and access important plan and benefits information such as claims, copays and your member ID card.

ID protection and credit monitoring Get covered right down to your identity with credit monitoring, identity repair assistance and identity theft insurance.

10 Access+ HMO plan Overview

Discount programs

Your wellness is important to us. To make it easier for you to take better care of yourself, we offer a wide range of member discounts8 on popular programs that can help you save money and get healthier. Learn more at blueshieldca.com/wellnessdiscounts.

Discount Vision Program Members have access to participating providers in the Discount Vision Program network and can get a 20% discount for the following: • Routine eye examinations • Frames and lenses (including photochromic) • Tints and coatings • Extra pair of glasses • Non-prescription sunglasses • Hard contact lenses

LASIK discount program LASIK and PRK correction surgery, an alternative to contacts or glasses, is one of the fastest- growing vision treatments. The discount program gives covered members access to: • A 15% discount through the NVISION, Inc. provider network in California, or • Savings on LASIK surgery at more than 45 QualSight surgery centers in California.

MESVisionOptics.com Members receive competitive prices on many contact lens brands as well as a selection of sunglasses, reading glasses and eye care accessories.9 Free shipping is available for all orders over $50.

24 Hour Fitness Now it is easier to get in shape and stay fit with: • Waived enrollment and processing fees • Discounted initiation fees and monthly dues – as low as $24.99 a month

ClubSport or Renaissance ClubSport Get fit and save a bundle: • 60% discount on enrollments when joining on a month-to-month agreement. • $0 enrollment fee when joining with a 12-month agreement. A one-time $25 processing fee applies at the time of enrollment.

11 Alternative Care Discount Program

Relax and save on alternative healthcare services from participating practitioners participating with American Specialty Health Group, Inc. (ASH Group):

Acupuncture services Members receive 25% off the usual and customary fees for: • Examinations • Acupuncture or electro-acupuncture • Adjunctive therapeutic procedures

Chiropractic services Members receive 25% off the usual and customary fees for: • Examinations • X-rays • Manipulative treatment • Supports and appliances • Adjunctive therapeutic procedures

Massage therapy Members receive 25% off the usual and customary fees for massage therapy visits. Techniques may include: • Swedish massage • Deep-muscle massage • Deep-tissue massage

Health and wellness products Members may browse and purchase a broad selection of health improvement and wellness products, fulfilled by an e-retail site. These include: • Vitamins and minerals • Pilates, yoga and tai chi • Food supplements • Fitness and activity • Sports nutrition • Health books and videos • Herbs and botanicals • Beauty and personal • Relaxation resources

12 Access+ HMO plan Overview

Del Norte Siskiyou Modoc Access+ HMO service area

Shasta Lassen The Access+ HMO plan is offered in 35 counties Humboldt Trinity and includes about 300 medical groups.

Tehama Plumas County coverage*

Butte Mendocino Glenn Sierra No coverage

Nevada Colusa Sutter Yuba Lake Placer

El Dorado Yolo Sonoma Alpine Napa Sacra- mento Amador Solano Calaveras Marin Tuolumne San Mono Contra Joaquin Costa San Francisco Alameda Mariposa Stanislaus San Mateo Santa Clara Merced Madera Santa Cruz

San Benito Fresno Inyo

Monterey Tulare

Kings

San Luis Obispo Kern

San Bernadino Santa Barbara

Ventura Los Angeles

Orange Riverside

* Partial coverage in El Dorado, Nevada, Placer, San Bernardino and San Diego counties. San Diego Imperial Full county coverage elsewhere. To find out if the Access+ service area includes the ZIP code where you reside or work, please contact Shield Concierge at (80 0) 334 -5847. You may also use CalPERS’ online service, the Health Plan Search by ZIP Code, available at www.calpers.ca.gov.

13 Endnotes 1 The Access+ Specialist option allows HMO members direct access to participating specialists in the same medical group or IPA as their Personal Physician. Not all medical groups or IPAs participate in this program. 2 If a brand drug is chosen when there are FDA-approved generic equivalents available, then the cost difference between the brand drug and the generic equivalent drug, plus a generic copay, will apply. Exceptions for medical necessity are available via prior authorization; if approved, the applicable brand copay applies. 3 Does not apply if filled at a select retail pharmacy. CalPERS network select pharmacies are Costco, CVS and Safeway/Vons. 4 Non-formulary brand drugs and drugs to treat sexual dysfunction do not accumulate toward the $1,000 mail service out-of-pocket maximum. 5 Flu shots are available at participating retail pharmacies. To find participating pharmacies, visit blueshieldca.com/wellness/drugs, scroll down to Locate Pharmacies then click on Find a Pharmacy. You also have the option to continue receiving the flu vaccine at your doctor’s office. 6 Your mail service benefit does not provide coverage for prescriptions used to treat short-term conditions, such as antibiotics or drugs used on an as-needed basis, including drugs for pain. In addition, home self-injectable drugs are not covered under the mail service benefit. This program applies to outpatient prescription drug benefits available through plans underwritten by Blue Shield of California. 7 Availability varies from area to area. The coverage through the Away From Home Care program is that of the host plan, not the coverage offered by Blue Shield of California. For more information, please call (800) 622-9402. 8 These discount program services are not a covered benefit of Blue Shield health plans and none of the terms or conditions of Blue Shield health plans apply. Discount program services are available to all members with a Blue Shield medical, dental, vision, or life insurance plan. The networks of practitioners and facilities in the discount programs are managed by the external program administrators identified below, including any screening and credentialing of providers. Blue Shield does not review the services provided by discount program providers for medical necessity or efficacy. Nor does Blue Shield make any recommendations, representations, claims, or guarantees regarding the practitioners, their availability, fees, services, or products. Some services offered through the discount program may already be included as part of the Blue Shield plan covered benefits. Members should access those covered services prior to using the discount program. Blue Shield reserves the right to terminate this program at any time without notice. Discount programs are administered by or arranged through the following independent companies: • Alternative Care Discount Program – American Specialty Health Systems, Inc. and American Specialty Health Group, Inc. • Discount Vision Program and MESVisionOptics.com – MESVision • Fitness facilities – 24 Hour Fitness, ClubSport and Renaissance ClubSport • LASIK – QualSight, Inc. and NVISION, Inc. The Discount Vision Program network is currently available in Arizona, California, Colorado, Idaho, Nevada, Oregon, Texas, Utah and Washington. 9 Requires a prescription from your doctor or licensed optical professional. 10 Teladoc visits are unavailable outside of the United States.

© 2017-2018 Teladoc, Inc. All rights reserved.

Daily Challenge, Walkadoo and QuitNet are registered trademarks of MYH, Inc.

The Diabetes Prevention Program is provided by Solera Health, an independent company.

App Store is a service mark of Apple Inc.

Google Play is a trademark of Google Inc.

Access+ HMO, Access+ Specialist, NurseHelp 24/7, LifeReferrals 24/7 and Wellvolution are service marks or registered trademarks of Blue Shield of California. Blue Shield and the Shield symbol are registered trademarks of the BlueCross BlueShield Association, an association of independent Blue Cross and Blue Shield plans.

14 Access+ HMO plan Overview

Still have questions? Call or visit us online.

Go online: blueshieldca.com/calpers A custom website for CalPERS members with full-time access to plan benefits, services, Find a Doctor and more.

Call us: (800) 334-5847 Our Shield Concierge team is ready to help from 7 a.m. to 8 p.m., seven days a week.

15 Access+ HMO Network* This Access+ HMO Network listing is a general guide only and is subject to change. For the most up-to-date listing and to verify a provider is in the network, please visit blueshieldca.com/networkcalpershmo.

Participating physician groups Hospitals Alameda County Affinity Bay Valley Region Alta Bates Medical Center Herrick Campus Affinity Medical Group Alta Bates Medical Center Alta Bates Campus Alta Bates Medical Group Alta Bates Medical Center Summit Campus Brown & Toland Medical Group Children's Hospital Oakland Research Institute Hill Physicians Medical Group Inc Kindred Hospital San Francisco Bay Area John Muir Physician Network ValleyCare Medical Center Palo Alto Medical Foundation Valley Memorial Hospital Physicians Medical Group San Jose Washington Hospital Sutter East Bay Medical Foundation Sutter East Bay Medical Foundation Diablo Division Butte County Butte County Blue Shield of California Administered Enloe Medical Center Cohasset Glenn County Blue Shield of California Administered Enloe Medical Center Esplanade Enloe Rehabilitation Center Feather River Hospital Orchard Hospital Oroville Hospital Contra Costa County Affinity Medical Group John Muir Medical Center Concord Campus Alta Bates Medical Group John Muir Medical Center Walnut Creek Campus Brown & Toland Medical Group San Ramon Regional Medical Center Hill Physicians Medical Group Inc Sutter Delta Medical Center John Muir Physician Network Palo Alto Medical Foundation Sutter East Bay Medical Foundation Sutter East Bay Medical Foundation Diablo Division El Dorado County Hill Physicians Sacramento No listings Mercy Medical Group Fresno County Saint Agnes Medical Group Adventist Medical Center Reedley Sante Community Physicians Inc Sante Health System Clovis Community Hospital Coalinga Regional Medical Center Fresno Community Hospital Fresno Surgical Hospital San Joaquin Valley Rehabilitation Hospital Selma Community Hospital Saint Agnes Medical Center Glenn County Butte County Blue Shield of California Administered Glenn Medical Center Glenn County Blue Shield of California Administered

16 Access+ HMO plan Overview

Participating physician groups Hospitals Humboldt County Humboldt Del Norte IPA Mad River Community Hospital Redwood Memorial Hospital St. Joseph Hospital Eureka Imperial County Imperial County Physicians Medical Group El Centro Regional Medical Center Pioneers Memorial Hospital Kern County Bakersfield Family Medical Group Adventist Health Medical Center Tehachapi Gemcare Medical Group Delano Bakersfield Memorial Hospital Gemcare Medical Group MCS of Kern County Delano Regional Medical Center Health Now IPA Good Samaritan Hospital Bakersfield Independence Medical Group HealthSouth Bakersfield Rehabilitation Hospital Kern Medical Center Kern Valley Hospital Mercy Hospital Bakersfield Ridgecrest Regional Hospital San Joaquin Community Hospital Kings County Key Medical Group Adventist Medical Center Sante Community Physicians Inc Sante Health System Los Angeles County Access Medical Group Inc Alhambra Hospital Medical Center Access Medical Group Santa Monica Antelope Valley Hospital Medical Center Affiliated Doctors of Orange County Barlow Respiratory Hospital Alamitos IPA Beverly Hospital All Care Medical Group A Division Of DCHSMF California Hospital Medical Center Los Angeles Allied Healthcare Providers Catalina Island Medical Center Allied Pacific of California Children’s Hospital Los Angeles Alpha Care Medical Group Citrus Valley Medical Center IC Campus Altamed Health Services Citrus Valley Medical Center QV Campus Angeles IPA City of Hope National Medical Center Applecare Medical Group Coast Plaza Hospital Applecare Medical Group Select Community Hospital of Huntington Park Applecare Medical Group St Francis Region Community Hospital of Long Beach Applecare Medical Group Whittier Earl and Lorraine Miller Children’s Hospital Associated Hispanic Physicians IPA East Los Angeles Doctors Hospital Foothill Presbyterian Hospital Axminster Medical Group Inc Garfield Medical Center Axminster Medical Group Little Company of Mary – Glendale Adventist Medical Center IPA Torrance Good Samaritan Hospital Los Angeles Axminster Medical Group Little Company of Mary – Greater El Monte Community Hospital San Pedro Henry Mayo Newhall Hospital Axminster Medical Group Olympia Hollywood Presbyterian Medical Center Axminster Providence Care Network Huntington Memorial Hospital Bella Vista Medical Group IPA Keck Hospital of USC Brookshire IPA Kindred Hospital Baldwin Park Centinela Valley IPA Kindred Hospital La Mirada Chaffey Medical Group EHP Kindred Hospital Los Angeles Citrus Valley Physicians Group Kindred Hospital San Gabriel Valley Daehan Prospect Medical Group Kindred Hospital South Bay ECMG Avalon Medical Group LAC+USC Medical Center ECMG Greater LA Healthcare Lakewood Regional Medical Center ECMG Greater San Gabriel Valley Physicians Long Beach Memorial Medical Center ECMG Mabuhay Medical Group Los Angeles Community Hospital ECMG Mid Cities IPA Marina Del Rey Hospital ECMG Pasadena Primecare Physicians Martin Luther King Jr. Community Hospital

17 Participating physician groups Hospitals ECMG PCP IPA Memorial Hospital of Gardena ECMG Serendib Healthways Methodist Hospital of Southern California Facey Medical Foundation Burbank Miracle Mile Medical Center Facey Medical Foundation San Fernando Valley Monterey Park Hospital Facey Medical Foundation Santa Clarita Motion Picture & Television Hospital Family Care Specialists IPA Northridge Hospital Medical Center Roscoe Campus Family Care Specialists Montebello Olympia Medical Center Family Health Alliance Pacifica Hospital of the Valley Global Care Medical Group Inc Pacific Alliance Medical Center GNP Long Beach Memorial Palmdale Regional Medical Center Good Samaritan Medical Practice Association PIH Health Hospital – Downey Greater Covina Medical Group Inc Pomona Valley Hospital Medical Center Harriman Jones Medical Group A Division of Presbyterian Intercommunity Hospital Healthcare Partners Promise Hospital of East LA HCP IPA Arta Health Network Promise Hospital of East LA Suburban Campus HCP IPA South Coast Providence Holy Cross Medical Center HCP Northridge Medical Group Providence Little Company of Mary Medical Center – HCP PA Beverly Montebello San Pedro HCP PA Citrus Providence Little Company of Mary Medical Center – HCP PA Glendale Greater San Gabriel Torrance HCP PA Pasadena Arcadia Providence Saint John’s Health Center HCP PA San Gabriel Providence Saint Joseph Medical Center HCP Talbert Medical Group Providence Tarzana Medical Center Healthcare LA Inc Ronald Reagan UCLA Medical Center Healthcare Partners San Dimas Community Hospital Healthcare Partners IPA Arcadia San Gabriel Valley Medical Center Healthcare Partners IPA East Los Angeles Santa Monica UCLA Medical Center Southern California Hospital at Culver City Healthcare Partners IPA East West St. Francis Medical Center Healthcare Partners IPA Glendale St. Vincent Medical Center Healthcare Partners IPA Hillcrest Torrance Memorial Medical Center Healthcare Partners IPA Little Company of Mary USC Kenneth Norris Jr. Cancer Hospital Healthcare Partners IPA Long Beach Valley Presbyterian Hospital Healthcare Partners IPA Los Angeles County White Memorial Medical Center Healthcare Partners IPA Montebello Whittier Hospital Medical Center Healthcare Partners IPA Pasadena Healthcare Partners IPA San Fernando Valley Healthcare Partners IPA South Bay Healthcare Partners Medical Group Arcadia Healthcare Partners Medical Group Bay Shores MG Healthcare Partners Medical Group East Los Angeles Healthcare Partners Medical Group Glen Oaks Healthcare Partners Medical Group Glendale Healthcare Partners Medical Group Glendora Healthcare Partners Medical Group Long Beach Healthcare Partners Medical Group Los Angeles Healthcare Partners Medical Group Monrovia Healthcare Partners Medical Group Montebello Healthcare Partners Medical Group Pasadena Healthcare Partners Medical Group San Fernando Healthcare Partners Medical Group Temple City Healthcare Partners Network Magan Covina Healthcare Partners Santa Anita High Desert Medical Group Hispanic Physicians IPA Inland Valleys IPA Korean American Medical Group Lakeside Medical Organization Agoura Hills Lakeside Medical Organization Burbank North Hollywood Lakeside Medical Organization Central Valley Lakeside Medical Organization Glendale Lakeside Medical Organization North Valley

18 Access+ HMO plan Overview

Participating physician groups Hospitals Lakeside Medical Organization Santa Clarita Lakeside Medical Organization Tarzana A Medical Group Inc Lakeside Medical Organization Verdugo Lakeside Medical Organization West Covina Lakeside Medical Organization West Valley A Medical Group Inc Lakewood IPA Maverick Medical Group Inc MemorialCare Medical Group MemorialCare Medical Group Long Beach Nuestra Familia Prospect Medical Group Omnicare Medical Group PIH Health Physicians Affiliated Physicians PIH Health Physicians Medical Group Pioneer Provider Network A Medical Group Inc Pomona Valley Medical Group Inc DBA PROMED Health Network Premier Physician Network Valley Division Premier Physicians Network Primecare Medical Group of Chino Valley Inc Prospect Gateway Medical Group Prospect Genesis Healthcare Prospect Health Source Medical Group Prospect Medical Group Orange Prospect Medical Group Van Nuys Prospect Northwest Orange County Medical Group Prospect Professional Medical Group IPA Prudent Medical Group Regal Burbank Group Regal Glendale Physicians Alliance HPN Regal Los Angeles Regal Medical Group NW Orange County Regal Pomona Valley Regal San Fernando Valley Regal San Gabriel Valley Regal Ventura County Seaside Health Plan Seoul Medical Group Integrated Physician Services Serra Community Medical Clinic Sierra Medical Group HPN St Jude Affiliated Physicians St Jude Heritage Medical Group St Mary IPA St Vincent IPA Medical Corporation Superior Choice Medical Group Torrance Health IPA UCLA Medical Group UCLA Medical Group Northwest UCLA Medical Group SMBP Upland Medical Group Madera County Saint Agnes Medical Group Madera Madera Community Hospital Sante Community Physicians Inc Sante Health System Valley Children's Hospital Marin County Brown & Toland Medical Group Kentfield Hospital Meritage Medical Network Marin General Hospital Novato Community Hospital Mariposa County Mariposa County Blue Shield of California Administered John C. Fremont Hospital

19 Participating physician groups Hospitals Merced County Allcare IPA Merced Mercy Medical Center Merced Community Campus Mercy Medical Center Merced Dominican Campus Nevada County Sierra Sacramento Blue Shield of California Sierra Nevada Memorial Hospital Administered Tahoe Forest Hospital Orange County Affiliated Doctors of Orange County Anaheim Global Medical Center Alamitos IPA Anaheim Regional Medical Center Allied Pacific of California IPA Chapman Global Medical Center Altamed Health Services Children's Hospital at Mission AMVI Medical Group Children's Hospital of Orange County Angeles IPA College Hospital Costa Mesa Applecare Medical Group Fountain Valley Regional Hospital & Medical Center Applecare Medical Group Select HealthBridge Children’s Hospital Orange Applecare Medical Group Whittier HealthSouth Tustin Rehabilitation Hospital Brookshire IPA Hoag Hospital Irvine Daehan Prospect Medical Group Hoag Memorial Hospital Presbyterian ECMG United Care Hoag Orthopedic Institute Edinger Medical Group Kindred Hospital Brea Family Choice Medical Group Kindred Hospital Santa Ana GNP Hoag Hospital Kindred Hospital Westminster GNP Long Beach Memorial Los Alamitos Medical Center GNP Orange Coast Memorial Mission Hospital Laguna Beach GNP Saddleback Memorial Mission Hospital Regional Medical Center Harriman Jones Medical Group A Division of Orange Coast Memorial Medical Center Healthcare Partners Orange County Global Medical Center HCP IPA Arta Health Network Placentia-Linda Hospital HCP IPA South Coast Saddleback Memorial Medical Center HCP Talbert Medical Group South Coast Global Medical Center Hispanic Physicians IPA St. Joseph Hospital Orange Hoag Affliated Physicians St. Jude Medical Center Hoag Medical Group University of California Irvine Medical Center Lakewood IPA MemorialCare Medical Group MemorialCare Medical Group Saddleback Mission Heritage Medical Group Mission Hospital Affliated Physicians Noble AMA IPA Orange County Blue Shield of California Administered PIH Health Physicians Affiliated Physicians Prospect Gateway Medical Group Prospect Genesis Healthcare Prospect Medical Group Orange Prospect Northwest Orange County Medical Group Prospect Professional Medical Group IPA Regal Los Angeles Regal Medical Group NW Orange County Seaside Health Plan Seoul Medical Group Integrated Physicians Services St Joseph Heritage Medical Group St Joseph Hospital Affiliated Physicians St Jude Affiliated Physicians St Jude Heritage Medical Group St Mary IPA UC Irvine Health Affiliated Physicians UC Irvine Health Medical Group Placer County Hill Physicians Sacramento No listings Mercy Medical Group Sierra Sacramento Blue Shield of California Administered 20 Access+ HMO plan Overview

Participating physician groups Hospitals UC Davis Health System UC Davis Health System Auburn Riverside County Alpha Care Medical Group Corona Regional Medical Center Alpha Care Medical Group Region 3 Hemet Valley Desert Regional Medical Center Alpha Care Medical Group Region 4 Low Desert Eisenhower Medical Center Beaver Medical Group EHP Hemet Valley Medical Center Blythe Blue Shield of California Administered John F. Kennedy Memorial Hospital Coachella Valley Physicians Inc Kindred Hospital Riverside Desert Oasis Healthcare Loma Linda University Medical Center Murrieta Empire Physicians Medical Group Menifee Valley Medical Center Hemet Community Medical Group Global Medical Palo Verde Hospital Services Parkview Community Hospital Medical Center Hemet Community Medical Group Menifee Riverside Community Hospital Hemet Community Medical Group Temecula San Gorgonio Memorial Hospital Inland Valleys IPA Southwest Healthcare System Murrieta Inland Valleys IPA Coachella Valley Southwest Healthcare System Wildomar Inland Valleys IPA Temecula Valley Temecula Valley Hospital Lakeside Medical Group San Bernardino Primecare of Citrus Valley Primecare of Corona Inc Primecare of Hemet Valley Inc Primecare of Moreno Valley Inc Primecare of Riverside Inc Primecare of Sun City Inc Primecare of Temecula Inc Prospect Health Corona Rady Children’s Health Network Regal Medical Group Temecula Valley Regal Riverside Regal San Bernardino Riverside Medical Clinic Riverside Physician Network Sharp Community Medical Group Graybill Temecula St Joseph Hospital Affliated Physicians Upland Medical Group Valley Physicians Network Inc Vantage IPA Riverside Sacramento County Hill Physicians Sacramento Mercy General Hospital Mercy Medical Group Mercy Hospital of Folsom Sierra Sacramento Blue Shield of California Mercy San Juan Hospital Administered UC Davis Health System Methodist Hospital of Sacramento UC Davis Health System Auburn Shriners Hospitals for Children Northern California Woodland Medical Group UC Davis Medical Center Vibra Hospital of Sacramento San Bernardino County Alliance Desert Physicians EHP Arrowhead Regional Medical Center Allied Pacific of California IPA Barstow Community Hospital Alpha Care Medical Group Bear Valley Community Hospital Beaver Medical Group EHP Colorado River Medical Center Chaffey Medical Group EHP Desert Valley Hospital Choice Med Group Apple Valley Hi-Desert Medical Center Choice Medical Group Barstow Kindred Hospital Ontario Citrus Valley Physicians Group Kindred Hospital Rancho Desert Oasis Healthcare Loma Linda University Medical Center Desert Valley Medical Group Mountains Community Hospital Dignity Health Medical Group Inland Empire Redlands Community Hospital Heritage Victor Valley Medical Group San Antonio Community Hospital Hispanic Physicians IPA St. Bernardine Medical Center Inland Valleys IPA St. Mary Regional Medical Center Lakeside Medical Organization San Bernardino Victor Valley Global Medical Center Lakeside Medical Organization West Covina 21 Participating physician groups Hospitals My Family Medical Group Pinnacle Medical Group EHP Pomona Valley Medical Group Inc DBA ProMed Health Network Premier Healthcare IPA Primecare Med Group of Chino Valley Inc Primecare of Inland Valley Inc Primecare of Redlands Inc Primecare of San Bernardino Inc Redlands Yucaipa Medical Group Regal Medical Group NW Orange County Regal Pomona Valley Regal Riverside Regal San Bernardino San Bernardino Medical Group St Mary High Desert Medical Group Upland Medical Group Vantage IPA Riverside Vantage IPA San Bernardino San Diego County Encompass Medical Group Alvarado Hospital Medical Center Greater Tri Cities IPA Grossmont Hospital Mercy Physicians Medical Group Kindred Hospital San Diego Mid County Physicians Medical Group Palomar Health Downtown Campus Multicultural Primary Care Medical Group Palomar Medical Center Primary Care Associates Medical Group Inc Paradise Valley Hospital Rady Children’s Health Network Pomerado Hospital Regal Medical Group Temecula Valley Rady Children's Hospital San Diego Scripps Clinic Medical Group Scripps Green Hospital Scripps Physicians Medical Group Scripps Memorial Hospital Sharp Community Inland North Scripps Memorial Hospital Encinitas Sharp Community Medical Group Chula Vista Scripps Mercy Hospital Sharp Community Medical Group Graybill Escondido Scripps Mercy Hospital Chula Vista Fallbrook Sharp Chula Vista Medical Center Sharp Community Medical Group Grossmont Sharp Coronado Hospital and Healthcare Center Sharp Community Medical Group San Diego Sharp Mary Birch Hospital for Women & Newborns Sharp Rees Stealy Sharp McDonald Center SHPS Scripps Coastal Medical Center Sharp Memorial Hospital Tri-City Medical Center UCSD La Jolla John Sally Thornton UCSD Medical Center Vibra Hospital of San Diego San Francisco County Brown & Toland Medical Group Chinese Hospital Chinese Community Healthcare Associates Medical Center at UCSF Hill Physicians San Francisco Inc St. Francis Memorial Hospital St. Mary's Medical Center San Francisco UCSF Medical Center at Mission Bay UCSF Medical Center at Mount Zion San Joaquin County Allcare IPA Dameron Hospital Association Hill Physicians San Joaquin Doctors Hospital of Manteca Lodi Memorial Hospital St. Joseph's Medical Center of Stockton San Luis Obispo County Coastal Communities Provider Network French Hospital Medical Center Physician Choice Medical Group of San Luis Obispo Marian Regional Medical Center Arroyo Grande Sierra Vista Regional Medical Center Twin Cities Community Hospital San Mateo County Affinity Medical Group South Bay Menlo Park Surgical Hospital Brown & Toland Medical Group Mills Health Center Hill Physicians San Francisco Inc Mills-Peninsula Medical Center

22 Access+ HMO plan Overview

Participating physician groups Hospitals Palo Alto Medical Foundation Sequoia Hospital PAMF Mills Peninsula Division Seton Coastside San Mateo Blue Shield of California Administered Seton Medical Center Sequoia Physicians Network Santa Barbara County North Santa Barbara Blue Shield of California Administered Goleta Valley Cottage Hospital Sansum Clinic Central Lompoc Valley Medical Center Sansum Clinic South Marian Regional Medical Center Santa Barbara Select IPA Medical Group Inc Santa Barbara Cottage Hospital Santa Ynez Valley Cottage Hospital Santa Clara County Affinity Medical Group South Bay El Camino Hospital DCHS Medical Foundation El Camino Hospital Los Gatos Palo Alto Medical Foundation Good Samaritan Hospital Palo Alto Medical Foundation Camino Lucile Packard Children's Hospital Physicians Medical Group San Jose Mission Oaks Hospital Santa Clara County IPA O'Connor Hospital Regional Medical Center of San Jose Saint Louise Regional Hospital Stanford Health Care Santa Cruz County Palo Alto Medical Foundation Santa Cruz Dominican Hospital Santa Cruz Physicians Medical Group of Santa Cruz Sutter Maternity & Surgery Center of Santa Cruz Watsonville Community Hospital Solano County Hill Physicians Medical Group Solano Sutter Solano Medical Center John Muir Physician Network Northbay Healthcare Group Sonoma County Meritage Medical Network Healdsburg District Hospital Sonoma County Blue Shield of California Administered Petaluma Valley Hospital Santa Rosa Memorial Hospital Sonoma Valley Hospital Stanislaus County Allcare IPA Central Valley Specialty Hospital Doctors Medical Center Emanuel Medical Center Oak Valley District Hospital Stanislaus Surgical Hospital Tulare County Key Medical Group Kaweah Delta District Hospital Sante Community Physicians Inc Sante Health System Sierra View District Hospital Tulare Regional Medical Center Ventura County Lakeside Medical Organization Simi Valley Community Memorial Hospital of San Buenaventura Lakeside Medical Organization Thousand Oaks Ojai Valley Community Hospital Regal Ventura County Santa Paula Hospital Seaview IPA Simi Valley Hospital and Health Care Services UCLA Medical Group Northwest St. John's Pleasant Valley Hospital Valley Care IPA St. John's Regional Medical Center – Mercy Healthcare Valley Care Select IPA Ventura Ventura County Medical Center Yolo County Hill Physicians Sacramento Woodland Memorial Hospital UC Davis Health System Woodland Clinic

23 To locate adoctor, visit aweek.days 334-5847, Concierge to 7a.m. at Shield (800) call or 8p.m., seven moreFor Access+ on information HMO, visit version of you Discover the healthiest member info and support. It’s info support. way and member easy an to stay for media Follow healthy social on inspiration, us tips, daily blueshieldca.com/networkcalpershmo blueshieldca.com/calpers

. connected.

Blue Shield of California is an independent member of the Blue Shield Association A50230-CALPERS (8/17)