Medical
The County of Sonoma recognizes that every employee and their family's needs are unique. As an Extra Help Employe you have a choice between three different HMO providers, each with three HMO plan options, to ensure your family has access to the services that best suit their needs.
HMO Plans - The County offers HMO plans with Kaiser Permanente, Sutter Health Plan and Western Health Advantage. You must live or work in the provider's service area to be eligible for an HMO plan. HMO plans require a Primary Care Physician's referral for specialist and medical laboratory services.
2025-2026 Extra Help Semi-Monthly Medical Premiums
HMO plans
Traditional HMO
The Traditional HMO plans have a higher monthly premium with no deductible, low copays, and a lower out of pocket annual maximum, making your total annual expenses more predictable. Hospitalization, radiology, lab tests and most preventive services are also covered at no cost. Generally, specialist services require a referral from your primary care physician (PCP) and you must use the provider’s network unless you have an out-of-area urgent or emergency situation or an approved referral.
Hospital Services DHMO
The Hospital Services DHMO plans offer a lower monthly premium with deductibles only on hospital related services, including emergency room visits, inpatient stays, and outpatient surgery. You pay the full cost of these services up to the deductible then a 20% coinsurance until you reach your out-of-pocket maximum. The out-of-pocket maximum includes the calendar year deductible, copays, and coinsurance. Physician and specialist visits, radiology, lab tests, and prescriptions have a flat copay, without having to meet the deductible. Preventative services are covered at no cost.
Deductible First HDHP
The Deductible First HDHP plans offer the lowest monthly premium and requires a member to meet the calendar year deductible FIRST before ANY plan benefits will be paid, except covered preventive services. Members will pay 100% of the doctor office visits, radiology services, lab tests, prescriptions, hospitalizations, etc., until the calendar year deductible is met. Once the deductible is met, covered medical, hospital, and prescription benefits will be provided for a copay or coinsurance amount. The calendar year out-of-pocket maximum includes calendar year deductibles, copays, and coinsurance.
Providers
Kaiser Permanente
Kaiser Permanente is an HMO Provider. HMO plans require a referral from your primary care provider when seeking services and specialists. You must live or work within the Kaiser network to enroll in a Kaiser plan.
Sutter Health Plan
Sutter Health Plan is a HMO Provider. HMO plans require a referral from your primary care provider when seeking services and speciailists. You must live or work within Sutter's network to enroll in a Sutter Health Plan plan.
Video Presenation (12:04 minutes)
Western Health Advantage
Western Health Advantage is a HMO Provider. HMO plans require a referral from your primary care provider when seeking services and speciailists. You must live or work within Western Health Advantage's network to enroll in a Western Health Advantage plan.
Western Health Advantage Microsite
Video Presentation (8:31 minutes)
No Surprises: Understand your rights against surprise medical bills
The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.
For more information, review Your Rights and Protections Against Surprise Medical Bills.
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