Health Benefits Overview
CalPERS is the third largest purchaser of health care in the nation, providing benefits to more than 1.3 million public employees, retirees, and their families. The program covers State employees by law and local public agencies and school employers can contract to have CalPERS provide these benefits to their employees (whether or not they contract for our retirement program).
CalPERS offers three types of health plans:
- Preferred Provider Organizations (PPOs)
- Health Maintenance Organizations (HMOs)
- Exclusive Provider Organizations (EPOs) (limited to members in certain California counties).
More than two-thirds of our members are enrolled in HMO plans, which offer a standard benefit design. All HMO, PPO, and EPO plans offer separate Medicare supplemental plans for those members eligible for Medicare.
Health plans offered, covered benefits, monthly rates, and co-payments are determined by the CalPERS Board, which reviews health plan contracts annually.
Employers make a contribution towards the member's monthly premiums, with members covering the difference between the employer's contribution and the actual premium amount. The employer contribution rate is normally established through collective bargaining agreements.