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Blue Cross In-network Summary Matrix - April 2012

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Medical Rating Area Definitions
The following indicate rating area by county and ZIP code except for the Power Select HMO Plan. The employee's home address determines the rating area. If there is a question regarding area availability, please call your local agent or Blue Cross at (800) 627-8797.
Alameda   Modoc Area 1 San Mateo Area 2
95304, 95377, 95391 Area 2 Mono Area 2 Santa Barbara  
all other Alameda ZIPs Area 3 Monterey   93252 Area 7
Alpine Area 2 93451 Area 8 all other Santa Barbara ZIPs Area 8
Amador Area 2 95076 Area 3 Santa Clara  
Butte Area 3 all other Monterey ZIPs Area 1 94303, 95023 Area 2
Calaveras Area 2 Napa Area 3 all other Santa Clara ZIPs Area 3
Colusa Area 3 Nevada   Santa Cruz Area 3
Contra Costa Area 3 95977 Area 3 Shasta Area 1
Del Norte Area 1 all other Nevada ZIPs Area 2 Sierra  
El Dorado Area 2 Orange   95922 Area 3
Fresno   90638 Area 9 95960 Area 2
93245, 93618 Area 7 all other Orange ZIPs Area 4 all other Sierra ZIPs Area 1
all other Fresno ZIPs Area 2 Placer   Siskiyou Area 1
Glenn Area 3 95668, 95692 Area 3 Solano  
Humboldt Area 3 all other Placer ZIPs Area 2 95690 Area 2
Imperial Area 6 Plumas   all other Solano ZIPs Area 3
Inyo   95981 Area 3 Sonoma Area 3
93527 Area 7 all other Plumas ZIPs Area 1 Stanislaus Area 2
all other Inyo ZIPs Area 2 Riverside   Sutter  
Kern   92883 Area 4 95626, 95648, 95837 Area 2
93536 Area 9 all other Riverside ZIPs Area 6 all other Sutter ZIPs Area 3
93558 Area 6 Sacramento   Tehama  
all other Kern ZIPs Area 7 94571 Area 3 95963, 95973 Area 3
Kings   all other Sacramento ZIPs Area 2 all other Tehama ZIPs Area 1
93242, 93631, 93656 Area 2 San Benito   Trinity  
all other Kings ZIPs Area 7 93930, 95004 Area 1 95526 Area 3
Lake Area 3 all other San Benito ZIPs Area 2 all otherTrinity ZIPs Area 1
Lassen Area 1 San Bernardino   Tulare  
Los Angeles   91766, 91792 Area 9 93631, 93641, 93646, 93654 Area 2
ZIP codes beginning with 906-912, 915, 917, 918 & 935  Area 9 93516, 93555 Area 7 all other Tulare ZIPs Area 7
(except 90623, 90630, 90631, 91709, 93560)   all other San Bernardino ZIPs Area 6 Tuolumne Area 2
90623, 90630, 90631 Area 4 San Diego Area 6 Ventura  
91709 Area 6 San Francisco Area 3 90265 and ZIP codes beginning with 913 Area 5
93243, 93560 Area 7 San Joaquin   93252 Area 7
all other Los Angeles ZIPs Area 5 94514 Area 3 all other Ventura ZIPs Area 8
Madera Area 2 all other San Joaquin ZIPs Area 2 Yolo Area 3
Marin Area 2 San Luis Obispo   Yuba  
Mariposa Area 2 93252 Area 7    
Mendocino Area 3 93426 Area 1 95960 Area 2
Merced Area 2 all other San Luis Obispo ZIPs Area 8 all other Yuba ZIPs Area 3
Power Select HMO Medical Rating Area Definitions
The following indicate rating area by county and ZIP code for the Power Select HMO Plan only. The employee's home address determines the rating area. If there is a question regarding area availability, please call your local agent or Blue Cross at (800) 627-8797.
Alameda   Riverside  
95304, 95377, 95391 Area 2 92883 Area 4
all other Alameda ZIPs Area 3 all other Riverside ZIPs Area 6
Contra Costa Area 3 (except 92225, 92226, 92239)  
Fresno   Sacramento  
93245, 93618 Area 7 94571 Area 3
all other Fresno ZIPs Area 2 all other Sacramento ZIPs Area 2
Imperial Area 6 San Bernardino  
Kern   91766, 91792 Area 9
93536 Area 9 93516, 93555 Area 7
93558 Area 6 all other San Bernardino ZIPs   Area 6
all other Kern ZIPs Area 7 (except 92363, 92364, 92365)  
Los Angeles   San Diego  
ZIP codes beginning with 906-912, 915, 917, 918 & 935    San Diego (except 91901, 91905, 91906, 91916,  Area 6
(except 90623, 90630, 90631, 91709, 93560) Area 9 91917, 91934, 91935, 91948, 91962, 91963, 91980,   
90623, 90630, 90631 Area 4 92004, 92036, 92059, 92061, 92066, 92086)  
91709 Area 6 San Francisco Area 3
93243, 93560 Area 7 San Joaquin  
all other Los Angeles ZIPs Area 5 94514 Area 3
Merced Area 2 all other San Joaquin ZIPs Area 2
Nevada   San Mateo Area 2
95977 Area 3 Santa Clara  
all other Nevada ZIPs Area 2 94303, 95023 Area 2
(except 95728, 96111, 96160, 96161, 96162)   all other Santa Clara ZIPs Area 3
Orange   Santa Cruz Area 3
90638 Area 9 Stanislaus Area 2
all other Orange ZIPs Area 4 Tulare  
Placer   93631, 93641, 93646, 93654 Area 2
95668, 95692 Area 3 all other Tulare ZIPs Area 7
all other Placer ZIPs (except 95715, 95724, 96140,  Area 2    
96141, 96142, 96143, 96145, 96146, 96148, 96161)   Yolo Area 3