Health
HMO
- 2022 Blue Shield Access Plus HMO Plan (PDF)
- 2023 Anthem Blue Cross Select HMO Evidence and Coverage (PDF)
- 2023 Anthem Blue Cross Select HMO Plan (PDF)
- 2023 Anthem Blue Cross Traditional HMO Evidence and Coverage (PDF)
- 2023 Anthem Blue Cross Traditional HMO Plan (PDF)
- 2023 Health Net Smartcare Evidence of Coverage (PDF)
- 2023 Health Net Smartcare Plan (PDF)
- 2023 Kaiser Permanente Evidence of Coverage (PDF)
- 2023 Kaiser Permanente Plan (PDF)
PPO
- 2023 PERS Gold Basic Plan (PDF)
- 2023 PERS Gold Basic Evidence of Coverage (PDF)
- 2023 PERS Platinum Basic Plan (PDF)
- 2023 PERS Platinum Basic Evidence of Coverage (PDF)
- PORAC Plan
- 2023 PORAC Evidence of Coverage and Disclosure Form (PDF)
Medical Rates
Cash in Lieu
Allows you to waive City of Milpitas medical insurance coverage in exchange for cash, provided you have other health insurance coverage. Employees waiving medical receive $125 per month on their paycheck.
Dental
- Delta Dental PPO
- Miscellaneous Employees and Fire Delta Dental Benefits Summary (Group 02998) (PDF)
- Miscellaneous Employees and Fire Delta Dental Evidence of Coverage (PDF)
- Police Delta Dental Benefits Summary (Group 00103) (PDF)
- Police Delta Dental Evidence of Coverage (PDF)
Vision
- Medical Eye Services (MES)
- Vision Benefits Summary (PDF) (Group W0051125)