1. Open Enrollment runs from September 10 – October 5, 2018.

Any elections you make during Open Enrollment become effective January 1, 2019.

Next Steps: To compare available health plans based on your eligibility ZIP code, log in to your my|CalPERS account and use the Find a Medical Plan Tool, or visit mobile.my.calpers.ca.gov from your smartphone or tablet. To change your plan:

Active Employees

Contact your employer's personnel specialist or health benefits officer for required forms and documentation to make health plan changes.

Retirees

You may change your health plan online during Open Enrollment through my|CalPERS or on your mobile device at mobile.my.calpers.ca.gov. You may also mail your request to CalPERS' Health Account Management Division at P.O. Box 942715, Sacramento, CA 94229-2715, or call us toll free at 888 CalPERS (or 888-225-7377).

2. CalPERS negotiated its lowest overall health premium increase in 21 years, at an average 1.16 percent.

Several health plans will see an average premium decrease in 2019, representing out-of-pocket savings for many CalPERS members. Overall rates for seven HMO plans will be less than the 2018 rates. About 800,000 CalPERS HMO Basic members (excluding those in association plans) are expected to see their premiums decline in 2019, if they remain with their current plans.

Next steps: To view premium rates based on your eligibility ZIP code, log in to your my|CalPERS account and use the Find a Medical Plan Tool, or visit mobile.my.calpers.ca.gov on your mobile device.

3. Blue Shield Access+ will no longer be available in eight Bay Area counties in 2019.

The counties are: Alameda, Contra Costa, Marin, San Francisco, San Mateo, Santa Clara, Solano, and Sonoma.

Next steps: Members who are affected will be automatically enrolled in Health Net SmartCare, unless they choose a different plan during Open Enrollment. Most doctors and medical groups are available through other CalPERS health plans in the area, but as with any new plan, prescription benefit providers are subject to change. Check with your provider to learn which plans are in their network.

4. Health Net SmartCare will no longer be available in the Sacramento region.

This change includes the following counties: El Dorado, Placer, Sacramento, and Yolo.

Next steps: Members who are affected will be automatically enrolled in UnitedHealthcare, unless they choose a different plan during Open Enrollment. Most doctors and medical groups are available through other CalPERS health plans in the area. Check with your provider to learn which plans are in their network.

5. UnitedHealthcare SignatureValue Alliance HMO Basic plan will no longer be available in the Bay Area and Other Northern regions, for contracting agencies only.

This change only impacts public agency and school Basic plan members. State, CSU, and Medicare members are unaffected.

Next steps: Members who are affected will be automatically enrolled in Anthem Blue Cross Traditional HMO, unless they choose a different plan during Open Enrollment. Most doctors and medical groups are available through other CalPERS health plans in the area. Check with your provider to see which plans are in their network.

6. UnitedHealthcare SignatureValue Alliance HMO Basic plan will close access to UC Davis providers for new members.

Any new members joining UnitedHealthcare SignatureValue Alliance during Open Enrollment will not be able to enroll with UC Davis Medical group. However, all current UnitedHealthcare members currently enrolled with UC Davis Medical group may remain enrolled. No action is required on their part.

Next steps: UnitedHealthcare will automatically assign a primary care physician that is accepting new patients. Contact UnitedHealthcare Member Service with questions or concerns.

7. UC Davis Medical group will no longer be available for Anthem Blue Cross Select HMO plan subscribers.

Members may remain with their current health plan, but they will need to select a new doctor from another available medical group in their health plan. Otherwise, Anthem Blue Cross Select HMO will automatically assign a new medical group.

Next steps: Most doctors and medical groups are available through other CalPERS health plans in the area. Check with your provider to see which plans are in their network.

8. PERS Choice and PERSCare Basic plans will increase some copayments.

Copayments for urgent care and specialist office visits will increase from $20 to $35 to align with higher cost of care provided by specialists and urgent care facilities. Copayments for primary care doctor visits will remain the same.

Next steps: Review your Open Enrollment materials, specifically the Health Benefits Summary, for a detailed comparison of plans and benefits.

9. PERS Select Basic will adopt a value-based insurance design (VBID).

VBID aims to improve the quality — while lowering the cost — of health care by empowering member choice. That means enhanced care, better wellness education programs, fewer unwarranted medical procedures, and accessible cost incentives.

  • Copayments for urgent care and specialist office visits will increase from $20 to $35, but copayments for primary care doctor visits will reduce to $10.
  • The PERS Select deductible will increase to $1,000 for individual or $2,000 for family.
  • Members may earn credits to reduce their annual deductible (up to $500 for individuals or up to $1,000 for families) by completing acts of preventive care, such as annual biometric screenings and nonsmoking certifications.

Next steps: Compare the PERS Select Basic changes between 2018 and 2019, and review your Open Enrollment materials, specifically the Health Benefits Summary, for a detailed comparison of costs and benefits.

10. SpineZone, an online back and neck pain program, and Wisdom, a study to optimize breast cancer screening, will be available to PERS Select, PERS Choice, and PERSCare members.

Next steps: Wisdom will be open to members starting November 2018. The SpineZone program begins January 2019.