Plan Highlights & Enrollment 2026
Plan Types (Quick Guide)
- HMO: Care managed by a Primary Care Physician (PCP) who coordinates referrals.
- PPO: See any doctor without a referral; strongest coverage in-network.
- HDHP PPO: Higher deductible; still a PPO (no referrals). May be HSA-eligible.
Personalized Benefit Statement
What it is
Your personalized statement shows your current benefits, your 2026 options specific to your situation, and what your elections will be if you don’t take action.
Where to find it
Log into your Benefits Central Portal and click the “Open Enrollment 2026” tile in the middle of the home page. From this tile, you can access your personalized communications and start your enrollment.
- Go to KeepingLAwell.com and open the Benefits Central Portal.
- Click the Open Enrollment 2026 tile to download your statement.
Open Enrollment 2026 tile
Tip: After you review your statement, return to the tile to start or update your enrollment.
Kaiser HMO (No Changes)
Kaiser benefits remain the same in 2026. No PCP selection required; services are within Kaiser facilities and pharmacies.
Common Medical Group Availability
Snapshot for convenience only—always confirm your specific PCP in each plan directory at KeepingLAwell.com/ProviderLookup.
| Medical Group | Blue Shield Trio | UHC Harmony | UHC SV |
|---|---|---|---|
| Allied Pacific IPA | ✅ | ✅ | |
| AXMINSTER | ✅ | ✅ | |
| Cedars-Sinai | ✅ | ||
| Facey Medical Foundation | ✅ | ||
| Lakeside | ✅ | ||
| MemorialCare | ✅ | ✅ | |
| Optum | ✅ | ✅ | ✅ |
| PIH Health | ✅ | ✅ | |
| Providence | ✅ | ✅ | ✅ |
| Regal Medical Group | ✅ | ||
| Torrance Memorial | ✅ | ✅ | ✅ |
| UCLA Medical | ✅ |
HMO Plan Highlights: In-Network Only
| Type of Care | Blue Shield Trio HMO | Kaiser Permanente HMO | UnitedHealthcare SignatureValue (SV) HMO |
|---|---|---|---|
| Calendar Year Deductible | $0/person; $0/family | $0/person; $0/family | $0/person; $0/family |
| Calendar Year Out-of-Pocket Limit | $500/person; $1,500/family | $1,500/person; $3,000/family | $500/person; $1,500/family |
| Routine Office Visits | Plan pays 100% after $15 Copay | Plan pays 100% after $15 Copay | Plan pays 100% after $15 Copay |
| Preventive Care | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) |
| Urgent Care | Plan pays 100% after $15 Copay | Plan pays 100% after $15 Copay | Plan pays 100% after $15 Copay |
| Telehealth/Virtual Visits | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) |
| Maternity Care (Preventive Care Visit) | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) |
| Pregnancy | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) |
| Inpatient Hospitalization | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) |
| Outpatient Surgery | Plan pays 100% ($0 Copay) | Plan pays 100% after $15 Copay | Plan pays 100% ($0 Copay) |
| Diagnostics & Advanced Imaging | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) |
| Emergency Room Care | Plan pays 100% after $100 Copay | Plan pays 100% after $100 Copay | Plan pays 100% after $100 Copay |
| Emergency Medical Transportation | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) | Plan pays 100% ($0 Copay) |
| Hearing Aid Benefit | Plan pays 100%; hearing aids per 24 months | $2,000 allowance each ear every 36 months | Plan pays 100% pair each 24 months; $5,000 annual max |
PPO Plan Highlights: In-Network & Out-of-Network
| Type of Care | Blue Shield PPO In-Network |
Blue Shield PPO Out-of-Network |
Blue Shield HDHP PPO In-Network |
Blue Shield HDHP PPO Out-of-Network |
|---|---|---|---|---|
| Calendar Year Deductible | $750/person; $1,500/family | $1,250/person; $2,500/family | $2,200/person; $4,400/family | $4,000/person; $8,000/family |
| Calendar Year Out-of-Pocket Limit | $2,000/person; $4,000/family (in & out combined) | $4,600/person; $9,200/family | $10,000/person; $20,000/family | — |
| Routine Office Visits | 100% after $30 Copay | 70% | 90% | 70% |
| Preventive Care | 100% ($0 Copay) | — | 100% ($0 Copay) | — |
| Urgent Care | 100% after $30 Copay | 90% | — | — |
| Telehealth/Virtual Visits | Not Covered | Not Covered | Not Covered | Not Covered |
| Maternity Care | 90% | 70% | 90% | 70% |
| Pregnancy | 100% ($0 Copay) | 100% ($0 Copay) | — | — |
| Inpatient Hospitalization | 90% | 70% up to $1,500/day | 90% | 70% up to $1,500/day |
| Outpatient Hospitalization | — | 70% up to $350/day | — | 70% up to $350/day |
| Diagnostics & Imaging | 70% | 70% | — | 70% |
| Emergency Room Care | 90% after $100 Copay | — | 90% after $100 Copay | — |
| Emergency Medical Transportation | 90% | — | 90% | — |
| Hearing Aid Benefit | 80% (2 aids / 24 months) | — | — | — |
PCP Requirements & How to Get Help
Blue Shield Trio, UHC Harmony, and UHC SignatureValue (SV) HMO plans require you to designate a Primary Care Physician (PCP).
Find Your PCP
- Use each plan’s directory: KeepingLAwell.com/ProviderLookup.
- A mapping letter will show your current PCP and any mapped plan changes.
- Each family member may have a different PCP; dependents must share the same medical plan.
- Download your Benefit Statement and Mapping Letter from the Benefits Central Portal.
Specialist care is accessed through a referral from your PCP. If you’re in ongoing treatment, ask your new plan about continuing care via your medical group’s referral pathways.
Plan Contacts & Support
| Plan | Phone | In-Person Help | Website |
|---|---|---|---|
| Blue Shield | (855) 201-2086 | Open Enrollment Events | KeepingLAwell.com/BlueShield |
| UnitedHealthcare | (800) 980-5216 | Open Enrollment Events | KeepingLAwell.com/UHC |
Designating Your PCP & Medical Group
To keep seeing your current doctor in Blue Shield Trio HMO, UHC Harmony, or UHC SV HMO, designate your Primary Care Physician (PCP) and, if required, your medical group. Refer to your Mapping Letter and Benefit Statement for guidance.
Complete This During Enrollment
You’ll need the following for each doctor you select:
- NPI (National Provider Identifier)
- Doctor’s Name
- Provider/PCP ID of the new plan