Pharmacy Benefits Manager (PBM) Employer Toolkit
Effective January 1, 2026, CVS Caremark will replace OptumRx as the new Pharmacy Benefits Manager (PBM) for certain CalPERS health plans.
This toolkit provides resources to help you communicate this transition with your employees during Open Enrollment and beyond.
Key Messages
- CVS Caremark will replace OptumRx as the new Pharmacy Benefits Manager (PBM) beginning January 1, 2026.
- Medical plans and benefits are not changing.
- Most members can continue using their same pharmacy.
- Employees should use the CVS Caremark Pharmacy Benefits page for Frequently Asked Questions (FAQs), drug coverage details, and all tools.
Sample Internal Post
Use for your agency’s internal webpage.
Headline: Pharmacy Benefits Update for 2026
Beginning January 1, 2026, CVS Caremark will administer pharmacy benefits for certain CalPERS health plans.
For details, including a list of impacted plans, Frequently Asked Questions (FAQs) including what this change means for you, drug coverage, resources, and updates on the change, visit the CVS Caremark Pharmacy Benefits page.
Sample Email for Employer
You can use the following template to notify employees about the PBM transition. It highlights the upcoming change, reminds them of Open Enrollment, and promotes the PBM webinar.
Subject: CalPERS 2026 Pharmacy Benefits Update
Dear Employees,
Beginning January 1, 2026, CVS Caremark will replace OptumRx as the pharmacy benefits manager (PBM) for certain CalPERS health plans.
What this means if you are enrolled in an affected plan:
- Most employees will continue filling prescriptions at their current pharmacy.
- Some employees may see changes in copays or be asked to switch to an equally safe and effective alternative.
- There are plans in place to ensure a smooth transition for filling prescriptions including automatic transfer of approved prior authorizations.
- Affected employees will receive communication from CVS Caremark and new ID card(s) from their health plan.
Pharmacy Benefits Manager Webinar
CalPERS and CVS Caremark hosted a live webinar on Thursday, September 18, at 10:00 a.m. (PT) about the PBM transition.
If you were unable to attend live, a recording is available for you to view on the CalPERS YouTube channel and the CVS Caremark Pharmacy Benefits webpage.
Note: This page is designed for employers. For more information on the PBM change use these tools to communicate the transition and direct employees to the CVS Caremark Pharmacy Benefits page.