The Health Plans offered through the CalPERS Health Benefits Program in our region are as follows:

• United Healthcare (HMO) - Benchmark Plan 
• Anthem Blue Cross Select (HMO) – Limited availability*
• Anthem Blue Cross Traditional (HMO)
• Blue Shield Access+ (HMO)
• Kaiser (HMO)
• PERS Gold (PPO)
• PERS Platinum (PPO)
• PORAC (PPO) - Only available to members of PORAC

Review the 2026 CalPERS Health Benefit Summary ->
Visit the CalPERS Website ->

Employees may enroll in a health plan based on their residence or work zip code.
Search Health Plans by ZIP Code ->

The County offers two (2) Dental Plans, one PPO plan and one Dental HMO plan. Participation in the dental/vision program is voluntary. You may choose to take medical coverage only, but there is no option to enroll in dental/vision only.

Ameritas Dental (PPO)

You may select a dentist of your choice. The plan pays 80% of preventive and basic and 50% of major procedures authorized costs. If you use a preferred provider, the plan pays 100% of preventive and basic and 70% of major procedures’ costs once you meet the $50 deductible.

 Review the Ameritas Summary ->
 Visit the Ameritas Website ->

DeltaCare (DHMO)

Like a medical HMO, you are required to select a primary care dentist from the DeltaCare list of providers and receive all your general care from that dentist. There are no deductibles, and there is either a copayment or no payment due depending on the dental procedures.

We strongly recommend you contact the dentist’s office to ensure they are taking new patients.

Review the DeltaCare Summary ->
Visit the DeltaCare Website -> 

If you elect to participate in the Dental Program, membership in the VSP Vision Plan is included. You may use any provider who accepts the VSP Vision Plan, including many discount retailers.

Review the VSP Benefits Summary ->
Visit the VSP Website ->

You may choose to waive County health insurance. If you maintain alternative medical coverage, you may be eligible to receive a $100 monthly incentive contributed to your Deferred Compensation account. To qualify for this benefit, you must provide Human Resources with proof of outside coverage dated within the last 60 days. Please note that a signed Deferred Compensation enrollment form is required to process these funds.

Please contact the hr@maderacounty.com for more information.

Vested employees may be eligible to continue their CalPERS health benefits into retirement. For those who qualify, the County will continue to pay the employer portion of the medical premium.

While medical coverage can continue, the County only provides 18 months of COBRA continuation for dental and vision benefits upon retirement. After this period, you will need to secure independent coverage for these services.

Please note that once you or a covered dependent reaches age 65, CalPERS requires enrollment in Medicare Part A and Part B to maintain health coverage. At that time, CalPERS will transition you into a Medicare Supplemental or Managed Medicare plan, which typically offers lower premiums than active employee plans.

1. What is the difference between a HMO and PPO?
   • Health Maintenance Organization (HMO): An HMO plan provides health care from specific doctors and hospitals under contract with the plan. You pay co-payments for some services, but you have no deductible, no claim forms, and a geographically restricted service area.
   • Preferred Provider Organization (PPO): A PPO is similar to a traditional fee-for-service plan, but you must use doctors in the PPO provider network or pay higher co-insurance (percentage of charges). You must usually meet an annual deductible before some benefits apply. You are responsible for a certain coinsurance amount and the plan pays the balance up to the allowable amount.
   
   
2. What is the difference between a Deductible, Copay, and Coinsurance?
   • Deductible: The amount you must pay for covered medical services before your insurance plan starts to pay. For example, if your deductible is $1,000, you pay the first $1,000 of your medical bills.
   • Copay (Copayment): A fixed amount you pay for a covered service after you have met your deductible. For instance, you might have a $25 copay for a doctor's visit.
   • Coinsurance: Your share of the costs of a covered service, calculated as a percentage. For example, after you have met your deductible, your plan might pay 80% of the cost, and you would be responsible for the remaining 20% (the coinsurance).


3. When can I make changes to my health plan?
   •  After initial hire, there are two ways to change your health coverage:
     • Open Enrollment: This is your once-a-year window to make any changes to your health, dental, or vision plans without needing a specific reason. It is usually held in the fall. Changes made during this time take effect on January 1 of the following year. If you are happy with your current health coverage, you typically do not need to do anything during Open Enrollment; your health plan will automatically roll over.
     • Qualifying Life Events (QLE): A QLE allows you to make specific changes to your coverage outside of the Open Enrollment period. Common events include marriage, divorce, birth or adoption of a child, or loss of other health coverage (e.g., a spouse losing their job). You must submit your request and documentation (like a birth or marriage certificate) within 60 days of the event. Changes usually become effective the first of the month following the event or the date the request is received.

     Learn more about CalPERS Life Events ->