Alameda

AlpineAmador

Butte

Calaveras

Colusa

ContraCosta

Del Norte

El Dorado

Fresno

Glenn

Humboldt

Imperial

Inyo

Kern

Kings

Lake

Lassen

Los Angeles

Madera

Marin

Mariposa

Mendocino

Merced

Modoc

Mono

Monterey

Napa

Nevada

Orange

Placer

Plumas

Riverside

Sacramento

SanBenito

San Bernardino

San Diego

San Francisco»SanJoaquin

SanLuisObispo

SanMateo

SantaBarbara

Santa Clara

SantaCruz

Shasta

Sierra

Siskiyou

Solano

Sonoma

Stanislaus

Sutter

Tehama

Trinity

Tulare

Tuolumne

Ventura

Yolo

Yuba

HMO Network Comparison Guide

The HMO Network Comparison Guide allows you to view the participating medical groups/independent practice associations (PMGs/IPAs) that are part of the Anthem Blue Cross HMO (CaliforniaCare), Select Plus HMO, Select HMO, Priority Select HMO, and Vivity HMO networks. The guide, which is organized by county, also indicates if a PMG/IPA participates in the Advantage HMO plan and whether a high or low copay is assigned to it.

BCABR1430C Rev. 01/16

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem

Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

2

HMO Network Comparison Guide

Definition of terms

PMG/IPA Participating Medical Group (PMG) or Independent Practice Association (IPA): A group of physicians organized as a legal entity that provides services to HMO members.

Prime Code Anthem Blue Cross’ identifying number for its contracted PMGs/IPAs.

County The county where the PMG/IPA offers services.

HMO The Anthem Blue Cross HMO (CaliforniaCare) network.

Select Plus HMO This network offers more access than the Select network, while still offering a lower cost than CaliforniaCare.

Select HMO This network is built around those PMGs/IPAs demonstrating the most efficient practice patterns and hospital referrals.

Priority Select HMO This network is built around those PMGs/IPAs demonstrating the most efficient practice patterns and hospital referrals in selected Southern California counties: Los Angeles, Orange, Riverside, San Bernardino and San Diego.

Vivity HMO Anthem Blue Cross has partnered with seven of the top hospitals in Los Angeles and Orange counties in a joint venture to create the Vivity plan offering. The Vivity network features a virtual, integrated health delivery system that provides convenient access to some of the best primary care doctors, specialists and hospitals in the region at an affordable price.

Advantage HMO Empowers members to consider cost and quality before selecting their PMG/IPA. The benefit plan allows the members to select from two comprehensive medical benefit designs:

£ Low = Low Copay – Members who select a low-copay provider will have lower out-of-pocket medical expenses.

£ High = High Copay – Members who select a high-copay provider will have higher out-of-pocket medical expenses.

Information is current as of January 2016 and will be updated periodically. The names of some provider groups may have changed. For the latest information, use the online provider finder at anthem.com/ca by selecting the “Find a Doctor” link.

HMO Network Comparison GuideHMO Network Comparison Guide

3

n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage

Information is current as of January 2016 and will be updated periodically. The names of some provider groups may have changed. For the latest information, use Provider Finder at anthem.com/ca by clicking on the Finding a Doctor or Hospital link.

Alameda

0XX AFFINITY MED GRP-EDEN/SAN LEANDRO REGION Alameda Yes No No No High

0XW AFFINITY MEDICAL GROUP-ALAMEDA REGION Alameda Yes NO No No High

0XQ AFFINITY MEDICAL GROUP-BAY VALLEY REGION Alameda Yes Yes No No Low

0PG ALTA BATES MEDICAL GROUP Alameda Yes Yes No No Low

0PB HILL PHYSICIANS MEDICAL GROUP Alameda Yes Yes No No Low

0VA SUTTER EAST BAY MEDICAL FOUNDATION Alameda Yes No No No N/A

7AC SELECT NETWORK/ALAMEDA Alameda No Yes No No N/A

Butte

0XU BUTTE COUNTY NETWORK Butte Yes No No No Low

Contra Costa

0XS AFFINITY MEDICAL GROUP-ROSSMOOR REGION Contra Costa Yes Yes No No Low

0XY AFFINITY MEDICAL GROUP-WEST COUNTY REGION Contra Costa Yes No No No High

0JM JOHN MUIR PHYSICIAN NETWORK Contra Costa Yes No No No High

7AH SELECT NETWORK/CONTRA COSTA Contra Costa No Yes No No N/A

1CG SEBMF-DIABLO DIVISION Contra Costa Yes No No No N/A

Fresno

0KQ SANTE COMMUNITY PHYSICIANS Fresno Yes No No No Low

7AA SELECT NETWORK/FRESNO Fresno No Yes No No N/A

Humboldt

0KR HUMBOLDT IPA Humboldt Yes No No No Low

Imperial

Z5R IMPERIAL COUNTY PHYSICIANS MEDICAL GROUP INC Imperial Yes Yes No No Low

Kern

0EY BAKERSFIELD FAMILY MEDICAL CENTER Kern Yes Yes No No Low

XJD DELANO MEDICAL GROUP Kern Yes No No No High

5MB DIGNITY HEALTH MEDICAL GROUP - MERCED Kern Yes Yes No No Low

XJE GEMCARE MEDICAL GROUP Kern Yes No No No High

Z0Z HISPANIC PHYSICIANS IPA KERN Kern Yes No No No High

0JH INDEPENDENCE MEDICAL GROUP Kern Yes Yes No No Low

Kings

7AK SELECT NETWORK/KINGS Kings No Yes No No N/A

Los Angeles

0MH ACCOUNTABLE HEALTH CARE IPA Los Angeles Yes Yes Yes No Low

0MT ALAMITOS IPA Los Angeles Yes Yes No No Low

0CK ALL CARE MEDICAL GROUP Los Angeles Yes Yes Yes No Low

0HZ ALLIED HEALTHCARE PROVIDERS INC Los Angeles Yes Yes Yes No Low

0HL ALLIED PHYSICIANS OF CALIFORNIA Los Angeles Yes Yes Yes No Low

HMO Network Comparison GuidePrime Code

PMG Name County Select Plus HMO(Yes = Select Plus)

No = Non-Select Plus)

Select HMO (Yes=Select

No = Non-Select)

Priority Select HMO(Yes = Priority Select

No = Non Priority Select)

Vivity HMO (Yes =Vivity

No=Non-Vivity)

Advantage HMO (Low = Low CopayHigh = High Copay)

HMO Network Comparison Guide

Los Angeles

0BG ALTAMED MEDICAL GROUP- PICO RIVERA Los Angeles Yes Yes Yes No Low

0XG ANGELES IPA Los Angeles Yes Yes Yes No Low

0RH APPLECARE MEDICAL GROUP-DOWNEY REGION Los Angeles Yes Yes Yes No Low

0SI APPLECARE MEDICAL GROUP-ST.FRANCIS REGION Los Angeles Yes Yes Yes No Low

0Q1 AXMINSTER MEDICAL GROUP - SLAUSON Los Angeles Yes Yes No No Low

0AF BRIGHT HEALTH PHYSICIANS OF PIH GROUP DIVISION Los Angeles Yes No No Yes High

0XM BRIGHT HEALTH PHYSICIANS OF PIH-IPA DIVISION Los Angeles Yes No No Yes High

7SI BROOKSHIRE IPA Los Angeles Yes Yes Yes No Low

0PN CEDARS-SINAI HEALTH ASSOCIATES Los Angeles Yes No No Yes High

0UR CEDARS-SINAI MEDICAL GROUP Los Angeles Yes No No Yes High

0TS CENTINELA VALLEY IPA Los Angeles Yes Yes Yes No Low

0RB CITRUS VALLEY PHYSICIANS GROUP Los Angeles Yes Yes Yes No Low

0T7 COMMUNITY MEDICAL GROUP OF THE WEST VALLEY/CANOGA PARK/WEST HILLS Los Angeles Yes Yes No No Low

0ZM COMMUNITY MEDICAL GROUP-IPA Los Angeles Yes Yes No No Low

7MD CROWN CITY MEDICAL GROUP IPA Los Angeles Yes Yes Yes No Low

0AH DIAMOND BAR MEDICAL GROUP Los Angeles Yes Yes Yes No Low

0HA EASTLAND MEDICAL GROUP INC Los Angeles Yes Yes No No Low

0UM EMPLOYEE HEALTH SYSTEM MEDICAL GROUP Los Angeles Yes Yes Yes No Low

0N0 FACEY MEDICAL FOUNDATION, AT MISSION HILLS Los Angeles Yes Yes No No Low

0GE FAMILY CARE SPECIALISTS Los Angeles Yes Yes Yes No Low

0CS GOOD SAMARITAN MEDICAL PRACTICE ASSOCIATION Los Angeles Yes Yes No Yes Low

2RQ GREATER NEWPORT PHYSICIAN/LONG BEACH MEMORIAL Los Angeles Yes Yes No Yes Low

0P0 HARRIMAN JONES-WILLOW/HCP Los Angeles Yes Yes No No Low

0DF HEALTHCARE PARTNERS IPA-NORTHRIDGE MED GRP Los Angeles Yes Yes No No Low

7KJ HEALTHCARE PARTNERS MEDICAL GROUP-EAST Los Angeles Yes Yes No No Low

0T2 HEALTHCARE PARTNERS MEDICAL GROUP-MEMBER SER Los Angeles Yes Yes No No Low

0EZ HIGH DESERT MEDICAL GROUP Los Angeles Yes Yes No No Low

YS8 HUNTINGTON MEMORIAL/HCP NETWORK (IN VIVITY NETWORK ONLY) Los Angeles No No No Yes N/A

0GM KOREAN AMERICAN MEDICAL GROUP Los Angeles Yes Yes Yes Yes Low

0DR LAKESIDE CENTRAL VALLEY Los Angeles Yes Yes No No Low

0SY LAKESIDE GLENDALE Los Angeles Yes Yes No No Low

0CJ LAKESIDE MEDICAL-BURBANK/NORTHHOLLYWOOD Los Angeles Yes Yes No No Low

1CP LAKESIDE NORTH VALLEY Los Angeles Yes Yes No No Low

0HQ LAKESIDE SANTA CLARITA VALLEY Los Angeles Yes Yes No No Low

0YW LAKESIDE VERDUGO HILLS Los Angeles Yes Yes No No Low

0MR LAKEWOOD IPA INC Los Angeles Yes Yes Yes No Low

HMO Network Comparison GuideHMO Network Comparison Guide

4

n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage

Information is current as of January 2016 and will be updated periodically. The names of some provider groups may have changed. For the latest information, use Provider Finder at anthem.com/ca by clicking on the Finding a Doctor or Hospital link.

HMO Network Comparison GuidePrime Code

PMG Name County Select Plus HMO(Yes = Select Plus)

No = Non-Select Plus)

Select HMO (Yes=Select

No = Non-Select)

Priority Select HMO(Yes = Priority Select

No = Non Priority Select)

Vivity HMO (Yes =Vivity

No=Non-Vivity)

Advantage HMO (Low = Low CopayHigh = High Copay)

Los Angeles

YMW MAVERICK MEDICAL GROUP INC Los Angeles Yes No No No High

0BJ MEDICO HISPANO/CLINICA MEDICA GENERAL Los Angeles Yes Yes Yes No Low

69U PHYS ASSOC OF THE GREATER SAN GABRIEL VALLEY Los Angeles Yes Yes No No Low

0LK PIONEER PROVIDER NETWORK-LONG BEACH Los Angeles Yes Yes Yes No Low

0SE POMONA VALLEY MEDICAL GROUP Los Angeles Yes No No No High

0NF PREMIER PHYSICIAN NETWORK/VALLEY DIVISION Los Angeles Yes Yes Yes No Low

0MP PROSPECT HEALTH SOURCE MEDICAL GROUP Los Angeles Yes No No No High

0JS PROSPECT PROFESSIONAL CARE MEDICAL GROUP, INC Los Angeles Yes Yes No No Low

1AB PRUDENT MEDICAL GROUP, INC Los Angeles Yes Yes Yes No Low

0YP REGAL-GLENDALE PHYSICIANS ALLIANCE INC Los Angeles Yes Yes No No Low

0YC REGAL MEDICAL GROUP Los Angeles Yes Yes No No Low

0U1 SEASIDE HEALTH PLAN Los Angeles Yes Yes Yes No Low

7AF SELECT NETWORK/LOS ANGELES Los Angeles No Yes No No N/A

0YA SEOUL MEDICAL GROUP Los Angeles Yes Yes Yes No Low

ACG SIERRA MEDICAL GROUP Los Angeles Yes Yes No No Low

0YK ST. MARY IPA Los Angeles Yes No No No High

0JI ST. VINCENT IPA MEDICAL CORPORATION Los Angeles Yes Yes No No Low

0EG TORRANCE HOSPITAL IPA MEDICAL GROUP Los Angeles Yes Yes No Yes Low

0FQ UCLA MEDICAL GROUP Los Angeles Yes No No Yes High

7BK UCLA MED GRP-SANTA MONICA BAY PHYSICIANS Los Angeles Yes No No Yes High

0T4 WEST COVINA MEDICAL CLINIC Los Angeles Yes Yes No No Low

Nevada

0JR SIERRA NEVADA MEDICAL ASSOCIATES Nevada Yes Yes No No Low

Orange

0ZH AFFILIATED DOCTORS OF ORANGE COUNTY MEDICAL Orange Yes Yes No No Low

0YY AMVI MEDICAL GROUP INC Orange Yes Yes Yes No Low

0WL ARTA HEALTH NETWORK Orange Yes Yes Yes No Low

6V7 DAEHAN PROSPECT MEDICAL GROUP INC Orange Yes Yes No No Low

0DJ EDINGER MEDICAL GROUP, IPA Orange Yes No No Yes High

0YR FAMILY CHOICE MEDICAL GROUP Orange Yes Yes Yes No Low

X08 FOUNTAIN VALLEY IPA Orange Yes No No No High

0ZR GREATER NEWPORT PHYSICIANS Orange Yes No No No High

5KW GREATER NEWPORT PHYSICIANS/ORANGE COAST Orange Yes Yes No Yes Low

5KY GREATER NEWPORT PHYSICIANS/SADDLEBACK Orange Yes Yes No Yes Low

YNL HOAG AFFILIATED PHYSICIANS Orange Yes No No No High

0V5 MEMORIALCARE BPMG/COSTA MESA Orange Yes Yes No Yes Low

AFN MISSION HERITAGE MEDICAL GROUP Orange Yes No No No High

Prime Code

PMG Name County Select Plus HMO(Yes = Select Plus)

No = Non-Select Plus)

Select HMO (Yes=Select

No = Non-Select)

Priority Select HMO(Yes = Priority Select

No = Non Priority Select)

Vivity HMO (Yes =Vivity

No=Non-Vivity)

Advantage HMO (Low = Low CopayHigh = High Copay)

HMO Network Comparison GuideHMO Network Comparison Guide

5

n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage

Information is current as of January 2016 and will be updated periodically. The names of some provider groups may have changed. For the latest information, use Provider Finder at anthem.com/ca by clicking on the Finding a Doctor or Hospital link.

HMO Network Comparison GuidePrime Code

PMG Name County Select Plus HMO(Yes = Select Plus)

No = Non-Select Plus)

Select HMO (Yes=Select

No = Non-Select)

Priority Select HMO(Yes = Priority Select

No = Non Priority Select)

Vivity HMO (Yes =Vivity

No=Non-Vivity)

Advantage HMO (Low = Low CopayHigh = High Copay)

Orange

0XL MISSION HOSPITAL AFFILIATED PHYSICIANS Orange Yes No No No High

0UW MONARCH HEALTHCARE MEDICAL GROUP Orange Yes Yes No No Low

0RK NOBLE AMA IPA MEDICAL GROUP Orange Yes Yes Yes No Low

0V3 PROSPECT GATEWAY MEDICAL GROUP Orange Yes Yes Yes No Low

0WY PROSPECT GENESIS HEALTHCARE Orange Yes Yes Yes No Low

0PY PROSPECT MEDICAL GROUP Orange Yes Yes No No Low

0DN PROSPECT NWOC MEDICAL GROUP INC Orange Yes Yes Yes No Low

1BG ST. JOSEPH HERITAGE MEDICAL GROUP/ORANGE-CHA Orange Yes No No No High

0WX ST. JOSEPH HOSPITAL AFFILIATED PHYSICIANS Orange Yes No No No High

0DL ST.JUDE AFFILIATED PHYSICIANS Orange Yes No No No High

0RD ST.JUDE HERITAGE MEDICAL GROUP Orange Yes No No No High

0UL TALBERT MEDICAL GROUP/FOUNTAIN VALLEY Orange Yes Yes No No Low

YVS UC IRVINE HEALTH AFFILIATED PHYSICIANS Orange Yes No No Yes High

YV0 UC IRVINE - ORANGE Orange Yes No No Yes High

YVT UC IRVINE - TUSTIN Orange Yes No No Yes High

Riverside

8OO BMG-TRI VALLEY MEDICAL GROUP IPA Riverside Yes No Yes No High

ABL COACHELLA VALLEY PHYSICIANS OF PRIMECARE Riverside Yes Yes No No Low

0GH DESERT OASIS HEALTHCARE Riverside Yes Yes No No Low

0MY EMPIRE PHYSICIANS MEDICAL GROUP Riverside Yes No No No High

0NL HEMET COMMUNITY MEDICAL GROUP, INC Riverside Yes No No No High

ABK PRIMECARE MEDICAL GROUP OF CITRUS VALLEY Riverside Yes Yes No No Low

0LJ PRIMECARE MEDICAL GROUP OF CORONA, INC Riverside Yes Yes No No Low

0TY PRIMECARE MEDICAL GROUP OF HEMET VALLEY, INC Riverside Yes Yes Yes No Low

0NN PRIMECARE MEDICAL GROUP OF MORENO VALLEY Riverside Yes Yes Yes No Low

0LH PRIMECARE MEDICAL GROUP OF RIVERSIDE, INC Riverside Yes Yes No No Low

0UG PRIMECARE MEDICAL GROUP OF SUN CITY Riverside Yes Yes No No Low

0HY PRIMECARE MEDICAL GROUP OF TEMECULA, INC Riverside Yes Yes Yes No Low

0V9 RIVERSIDE MEDICAL CLINIC Riverside Yes No No No High

0NY RIVERSIDE PHYSICIAN NETWORK Riverside Yes Yes No No Low

5N8 VALLEY PHYSICIANS NETWORK Riverside Yes Yes No No Low

Sacramento

0JN HILL PHYSICIANS MEDICAL GROUP/SACRAMENTO Sacramento Yes Yes No No Low

0KY MERCY MEDICAL GROUP Sacramento Yes Yes No No Low

7AD SELECT NETWORK/SACRAMENTO Sacramento No Yes No No N/A

0XA SUTTER INDEPENDENT PHYSICIANS Sacramento Yes No No No N/A

HMO Network Comparison GuideHMO Network Comparison Guide

6

n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage

Information is current as of January 2016 and will be updated periodically. The names of some provider groups may have changed. For the latest information, use Provider Finder at anthem.com/ca by clicking on the Finding a Doctor or Hospital link.

HMO Network Comparison GuidePrime Code

PMG Name County Select Plus HMO(Yes = Select Plus)

No = Non-Select Plus)

Select HMO (Yes=Select

No = Non-Select)

Priority Select HMO(Yes = Priority Select

No = Non Priority Select)

Vivity HMO (Yes =Vivity

No=Non-Vivity)

Advantage HMO (Low = Low CopayHigh = High Copay)

Sacramento

0WW SUTTER MEDICAL GROUP Sacramento Yes No No No N/A

0MW UC DAVIS MEDICAL GROUP Sacramento Yes No No No High

San Benito

0TM SAN BENITO MEDICAL ASSOCIATES San Benito Yes No No No High

San Bernardino

0K3 BEAVER MEDICAL GROUP San Bernardino Yes Yes No No Low

AFF BMG-ALLIANCE DESERT PHYS San Bernardino Yes No No No High

Z1I CHAFFEY MEDICAL GROUP-BMG San Bernardino Yes Yes No No Low

0DS CHOICE MEDICAL GROUP San Bernardino Yes Yes No No Low

0GP INLAND HEALTHCARE GROUP, INC San Bernardino Yes No No No High

0RN LAKE ARROWHEAD NETWORK San Bernardino Yes No No No High

0RS LA SALLE MEDICAL ASSOCIATES San Bernardino Yes Yes Yes No Low

0X6 LOMA LINDA UNIVERSITY HEALTH CARE ADMINISTRA San Bernardino Yes No No No High

0SK MY FAMILY MEDICAL GROUP San Bernardino Yes Yes Yes No Low

0FB PINNACLE MEDICAL GROUP San Bernardino Yes Yes Yes No Low

0GK PRIMECARE MEDICAL GROUP OF CHINO VALLEY, INC San Bernardino Yes Yes Yes No Low

0TX PRIMECARE MEDICAL GROUP OF INLAND VALLEY,INC San Bernardino Yes Yes No No Low

0UA PRIMECARE MEDICAL GROUP OF REDLANDS, INC San Bernardino Yes Yes Yes No Low

ABJ PRIMECARE MEDICAL GROUP OF SAN BERNARDINO San Bernardino Yes Yes Yes No Low

0YN REDLANDS YUCAIPA MEDICAL GROUP San Bernardino Yes Yes No No Low

1BX SAN BERNARDINO MEDICAL GROUP INC San Bernardino Yes No No No High

0ZP ST MARY HIGH DESERT MEDICAL GROUP San Bernardino Yes No No No High

0YH UPLAND MEDICAL GROUP San Bernardino Yes Yes No No Low

San Diego

ABC ENCOMPASS MEDICAL GROUP San Diego Yes Yes Yes No Low

99R GRAYBILL MEDICAL GROUP San Diego Yes Yes No No Low

0TI GREATER TRI CITIES IPA San Diego Yes Yes Yes No Low

ECP MERCY PHYSICIANS MEDICAL GROUP, INC San Diego Yes No No No High

0DQ MULTICULTURAL PRIMARY CARE MEDICAL GROUP San Diego Yes Yes Yes No Low

0WD PRIMARY CARE ASSOCIATES MEDICAL GROUP San Diego Yes Yes Yes No Low

ZM5 RADY CHILDRENS HEALTH NETWORK San Diego Yes Yes Yes No Low

0ZN SCRIPPS PHYSICIANS MEDICAL GROUP (formerly San Diego Physicians Medical Group) San Diego Yes Yes No No Low

7AE SELECT NETWORK/SAN DIEGO San Diego No Yes No No N/A

AAB SCRIPPS CLINIC TORREY PINES San Diego No No No No High

ABA SCRIPPS COASTAL MEDICAL CENTER San Diego No No No No High

0HP SHARP COMMUNITY MEDICAL GROUP San Diego Yes Yes No No Low

HMO Network Comparison GuideHMO Network Comparison Guide

7

n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage

Information is current as of January 2016 and will be updated periodically. The names of some provider groups may have changed. For the latest information, use Provider Finder at anthem.com/ca by clicking on the Finding a Doctor or Hospital link.

HMO Network Comparison GuidePrime Code

PMG Name County Select Plus HMO(Yes = Select Plus)

No = Non-Select Plus)

Select HMO (Yes=Select

No = Non-Select)

Priority Select HMO(Yes = Priority Select

No = Non Priority Select)

Vivity HMO (Yes =Vivity

No=Non-Vivity)

Advantage HMO (Low = Low CopayHigh = High Copay)

HMO Network Comparison GuideHMO Network Comparison Guide

San Diego

Z42 SHARP COMMUNITY MEDICAL GROUP - ARCH San Diego Yes Yes No No Low

24F SHARP COMMUNITY MEDICAL GROUP - INLAND NORTH San Diego Yes Yes No No Low

0AW SHARP REES-STEALY MEDICAL GROUP, SAN DIEGO San Diego Yes Yes Yes No Low

1CR UCSD MED GRP-FAM MED/LEWIS San Diego Yes Yes No No Low

X8V UCSD PHYSICIAN NETWORK-PRIMARY CARE San Diego Yes Yes No No Low

San Francisco

0KC BROWN AND TOLAND MEDICAL GROUP San Francisco Yes No No No High

0LE CHINESE COMMUNITY HEALTH CARE ASSOCIATION San Francisco Yes Yes No No Low

0UC HILL PHYSICIANS MEDICAL GROUP/SAN FRANCISCO San Francisco Yes No No No High

0XR SAN FRANCISCO NETWORK San Francisco Yes No No No High

7AL SELECT NETWORK/SAN FRANCISCO San Francisco No Yes No No N/A

San Joaquin

0YZ HILL PHYSICIANS MEDICAL GROUP San Joaquin Yes No No No High

0ZV MEDCORE MEDICAL GROUP San Joaquin Yes Yes No No Low

San Luis Obispo

1BS COASTAL COMMUNITIES PHYSICIAN NETWORK San Luis Obispo Yes No No No High

San Mateo

Z06 PALO ALTO MEDICAL FOUNDATION/MILLS PENINSULA DIVISION San Mateo Yes No No No N/A

5PN PENINSULA MEDICAL CLINIC San Mateo Yes No No No N/A

ACF SEQUOIA PHYSICIANS NETWORK San Mateo Yes No No No High

Santa Barbara

0L5 PHYSICIANS CHOICE Santa Barbara Yes No No No Low

0X0 SANSUM CLINIC Santa Barbara Yes No No No High

0DG SANTA BARBARA SELECT IPA MED GROUP Santa Barbara Yes No No No High

Santa Clara

2K9 AFFINITY MEDICAL GROUP - SOUTH BAY Santa Clara Yes No No No High

0KM DCHS MEDICAL FOUNDATION Santa Clara Yes No No No High

0KN PALO ALTO MEDICAL FOUNDATION Santa Clara Yes No No No N/A

0JF PALO ALTO MEDICAL FOUNDATION/CAMINO SITE Santa Clara Yes No No No N/A

0UK PHYSICIANS MEDICAL GROUP OF SAN JOSE Santa Clara Yes Yes No No Low

13Q PREMIER CARE OF NORTHERN CALIFORNIA INC Santa Clara Yes No No No High

0MM SANTA CLARA IPA Santa Clara Yes Yes No No Low

7AB SELECT NETWORK/SANTA CLARA Santa Clara No Yes No No N/A

0YS SILICON VALLEY NETWORK Santa Clara Yes No No No High

Santa Cruz

ADK PALO ALTO FOUNDATION/SANTA CRUZ SITE Santa Cruz Yes No No No N/A

0ER PHYSICIANS MEDICAL GROUP OF SANTA CRUZ COUNTY Santa Cruz Yes Yes No No Low

Prime Code

PMG Name County Select Plus HMO(Yes = Select Plus)

No = Non-Select Plus)

Select HMO (Yes=Select

No = Non-Select)

Priority Select HMO(Yes = Priority Select

No = Non Priority Select)

Vivity HMO (Yes =Vivity

No=Non-Vivity)

Advantage HMO (Low = Low CopayHigh = High Copay)

HMO Network Comparison GuideHMO Network Comparison Guide

8

n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage

Information is current as of January 2016 and will be updated periodically. The names of some provider groups may have changed. For the latest information, use Provider Finder at anthem.com/ca by clicking on the Finding a Doctor or Hospital link.

HMO Network Comparison GuidePrime Code

PMG Name County Select Plus HMO(Yes = Select Plus)

No = Non-Select Plus)

Select HMO (Yes=Select

No = Non-Select)

Priority Select HMO(Yes = Priority Select

No = Non Priority Select)

Vivity HMO (Yes =Vivity

No=Non-Vivity)

Advantage HMO (Low = Low CopayHigh = High Copay)

HMO Network Comparison GuideHMO Network Comparison Guide

Prime Code

PMG Name County Select Plus HMO(Yes = Select Plus)

No = Non-Select Plus)

Select HMO (Yes=Select

No = Non-Select)

Priority Select HMO(Yes = Priority Select

No = Non Priority Select)

Vivity HMO (Yes =Vivity

No=Non-Vivity)

Advantage HMO (Low = Low CopayHigh = High Copay)

Shasta

0RE SHASTA/TEHEMA COUNTY NETWORK Shasta Yes No No No High

Solano

0KS HILL PHYSICIANS MEDICAL GROUP/SOLANO Solano Yes No No No High

1CF SUTTER REGIONAL MEDICAL FOUNDATION Solano Yes No No No N/A

Sonoma

0JZ MERITAGE MEDICAL NETWORK Sonoma Yes No No No Low

0RG SONOMA COUNTY NETWORK Sonoma Yes No No No High

0XK SUTTER MEDICAL GROUP OF THE REDWOODS Sonoma Yes No No No N/A

Stanislaus

0KJ ALLCARE IPA Stanislaus Yes Yes No No Low

7AJ SELECT NETWORK/STANISLAUS Stanislaus No Yes No No N/A

0WF SUTTER GOULD MEDICAL FOUNDATION Stanislaus Yes No No No N/A

Tulare

1CL COASTAL COMMUNITIES PHYSICIAN NETWORK Tulare Yes Yes No No Low

AED KEY MEDICAL GROUP Tulare Yes Yes No No Low

7AG SELECT NETWORK/TULARE Tulare No Yes No No N/A

Tuolumne

0RW TUOLUMNE COUNTY NETWORK Tuolumne Yes No No No High

Ventura

0LY COMMUNITY MED GRP OF VENTURA CTY - IPA Ventura Yes Yes No No Low

0LZ COMMUNITY MED GRP OF VENTURA CTY- SIMI VALLE Ventura Yes Yes No No Low

0GN SEAVIEW IPA Ventura Yes Yes No No Low

1CB VALLEY CARE IPA Ventura Yes Yes No No Low

8DK VALLEY CARE SELECT IPA Ventura Yes Yes No No Low

Yolo

0KK SUTTER WEST MEDICAL GROUP Yolo Yes No No No N/A

0KW WOODLAND CLINIC MEDICAL GROUP Yolo Yes Yes No No Low

Mexico

Y84 SIMNSA N/A Yes Yes Yes No Low

HMO Network Comparison GuideHMO Network Comparison Guide

9

n In Select Plus HMO and CalCare Network, but not in Select HMO or Advantage n In Select HMO Network, but not in Select Plus HMO, CalCare or Advantage

Information is current as of January 2016 and will be updated periodically. The names of some provider groups may have changed. For the latest information, use Provider Finder at anthem.com/ca by clicking on the Finding a Doctor or Hospital link.

HMO Network Comparison GuidePrime Code

PMG Name County Select Plus HMO(Yes = Select Plus)

No = Non-Select Plus)

Select HMO (Yes=Select

No = Non-Select)

Priority Select HMO(Yes = Priority Select

No = Non Priority Select)

Vivity HMO (Yes =Vivity

No=Non-Vivity)

Advantage HMO (Low = Low CopayHigh = High Copay)

HMO Network Comparison GuideHMO Network Comparison GuideHMO Network Comparison GuideHMO Network Comparison Guide

10

Notes

BCABR1430C Rev. 01/16

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem

Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.