Plans & Rates
Active members: Visit your health plan's website to learn how benefits, claims, and payment of claims are covered, as well as the service limitations and exclusions that may apply. Here are some tips to help you choose a health plan:
- Log in to my|CalPERS to use the Find a Medical Plan tool to research the health plan coverage and benefits most important to you and your family.
- Review each plan's Evidence of Coverage, and Summary of Benefits and Coverage with Glossary, in the sections below.
- Use our Health Plan Search by ZIP Code tool to see which plans are available in your area.
- View the 2018 Health Benefit Summary (PDF) to compare features of the different health plans.
- Current subscribers of the Basic PERSCare, PERS Choice, and PERS Select PPO health plans can visit CalPERS | Compare to shop for doctors, hospitals, medical services, and prescriptions.
- View the Non-Discrimination Notice (PDF) in accordance with Section 1557 of the Affordable Care Act.
Are you retired? View Retiree Plans & Rates customized just for you.
Rates & Employer Contributions
2018
View the 2018 health premium rates approved by the CalPERS Board of Administration:
Employer Contribution Amounts
Active State Members
Your cost is any amount above the employer contribution. The following are the official CalHR-approved 2018 employer health contribution amounts and CoBen allowances:
State Employer Health Benefit Contributions
| Bargaining Units | One-Party | Two-Party | Family |
|---|---|---|---|
| 5 and 9 | $615 | $1,194 | $1,540 |
| 1, 3, 4, 6, 10, 11, 12, 13, 14, 15, 20, and 21 | $579 | $1,158 | $1,504 |
State CoBen Allowances
| Bargaining Units | One-Party | Two-Party | Family |
|---|---|---|---|
| 2, 7, 16, 17, 18, and 19 | $626 | $1,233 | $1,609 |
| 8 | $662 | $1,269 | $1,645 |
| Excluded Employees | $663 | $1,281 | $1,658 |
Check with your employer to determine your contribution amount.
Active CSU Members
- All Employees (Except Unit 6) - One-Party: $725; Two-Party: $1,377; Family: $1,766
- Unit 6 - One-Party: $730; Two-Party: $1,387; Family: $1,786
COBRA Rates
If you have continued health coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA), contact your employer for your monthly premium rate. Refer to COBRA for information on continuing health coverage for yourself and your dependents if you involuntarily lose your health benefits.
Since health care costs vary throughout California, regional pricing adjusts premiums to reflect the actual cost of health care in your specific region. This ensures that your CalPERS premiums are appropriate and competitive for where you live.
To find your specific health plan premium rates, choose your region from the options below:
- Bay Area Rates (PDF) - View rates for Alameda, Amador, Contra Costa, Marin, Napa, Nevada, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma, Sutter, and Yuba.
- Los Angeles Area Rates (PDF) - View rates for Los Angeles, San Bernardino, and Ventura.
- Other Northern California Rates (PDF) - View rates for Alpine, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Plumas, San Benito, Shasta, Sierra, Siskiyou, Stanislaus, Tehama, Trinity, and Tuolumne.
- Other Southern California Rates (PDF) - View rates for Fresno, Imperial, Inyo, Kern, Kings, Madera, Orange, Riverside, San Diego, San Luis Obispo, Santa Barbara, and Tulare.
- Out-of-State Rates (PDF) - View rates for health plans available outside of California.
- Sacramento Area Rates (PDF) - View rates for El Dorado, Placer, Sacramento, and Yolo.
Employer Contribution Amounts
Contributions vary by employer. Contact your employer to find out how much they contribute toward your monthly premium rate.
COBRA Rates
If you have continued health coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA), contact your employer for your monthly premium rate. Refer to COBRA for information on continuing health coverage for yourself and your dependents if you involuntarily lose your health benefits.
2019
View the 2019 health premium rates approved by the CalPERS Board of Administration:
Employer Contribution Amounts
Active State Members
Below are the contribution rates. Your cost is any amount above the employer contribution.
CalPERS Health Program
| State Active Contribution Rates for 2019 | |||
|---|---|---|---|
| 80-80 Formula | Single (1) | 2-Party (2) | Family (3+) |
| $583 | $1,170 | $1,518 | |
| 85-80 Formula | Single (1) | 2-Party (2) | Family (3+) |
| $620 | $1,206 | $1,555 | |
State Employer Health Benefit Contributions
Active CSU Members
- All Employees (Except Unit 6) - One-Party: $734; Two-Party: $1,398; Family: $1,788
- Unit 6 - One-Party: $739; Two-Party: $1,408; Family: $1,808
CSU Health Vesting Requirements
Employees hired by the CSU who become members of CalPERS on or after July 1, 2017 for employees represented by CSU BU 3 or on or after July 1, 2018 for employees hired in non-represented classifications, must have 10 or more years of service credit with CalPERS to be eligible to receive any portion of the employer contribution for retiree health and dental benefits at the time of his or her service retirement.
State CoBen Allowances
Consolidated Benefits (CoBen) is the employer-provided benefit allowance to offset the cost of health, dental, and vision benefits. For more information, visit CalHR. Check with your employer to determine your contribution amount.
COBRA Rates
If you have continued health coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA), contact your employer for your monthly premium rate. Refer to COBRA for information on continuing health coverage for yourself and your dependents if you involuntarily lose your health benefits.
Since health care costs vary throughout California, regional pricing adjusts premiums to reflect the actual cost of health care in your specific region. This ensures that your CalPERS premiums are appropriate and competitive for where you live.
To find your specific health plan premium rates, choose your region from the options below:
- Bay Area Rates (PDF) - View rates for Alameda, Amador, Contra Costa, Marin, Napa, Nevada, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma, Sutter, and Yuba.
- Los Angeles Area Rates (PDF) - View rates for Los Angeles, San Bernardino, and Ventura.
- Other Northern California Rates (PDF) - View rates for Alpine, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Plumas, San Benito, Shasta, Sierra, Siskiyou, Stanislaus, Tehama, Trinity, and Tuolumne.
- Other Southern California Rates (PDF) - View rates for Fresno, Imperial, Inyo, Kern, Kings, Madera, Orange, Riverside, San Diego, San Luis Obispo, Santa Barbara, and Tulare.
- Out-of-State Rates (PDF) - View rates for health plans available outside of California.
- Sacramento Area Rates (PDF) - View rates for El Dorado, Placer, Sacramento, and Yolo.
Employer Contribution Amounts
Contributions vary by employer. Contact your employer to find out how much they contribute toward your monthly premium rate.
COBRA Rates
If you have continued health coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA), contact your employer for your monthly premium rate. Refer to COBRA for information on continuing health coverage for yourself and your dependents if you involuntarily lose your health benefits.
Health Plans
2018
Administrator: Anthem Blue Cross
Offers Medicare? No
Prescription Drug Services: OptumRx
Directory: Find A Doctor, Pharmacy, Hospital or Urgent Care Center
Basic Publications
- 2018 Anthem Blue Cross Select HMO Basic Evidence of Coverage (PDF)
- 2018 Anthem Blue Cross Select HMO Basic Summary of Benefits and Coverage with Uniform Glossary (PDF)
- 2018 Anthem Blue Cross Traditional HMO Basic Evidence of Coverage (PDF)
- 2018 Anthem Blue Cross Traditional HMO Basic Summary of Benefits and Coverage with Uniform Glossary (PDF)
- 2018 OptumRx Outpatient Prescription Drug Benefit Plan for Selected HMO Basic Plans Evidence of Coverage (PDF)
Anthem Blue Cross EPO is available only in Del Norte county.
Administrator: Anthem Blue Cross
Offers Medicare? No
Prescription Drug Services: OptumRx
Directory: Find A Doctor, Pharmacy, Hospital or Urgent Care Center
Basic Publications
Administrator: Anthem Blue Cross
Offers Medicare? Yes
Prescription Drug Services: OptumRx
Basic Publications
Administrator: Blue Shield of California
Offers Medicare? No
Directory: Find a Doctor
Basic Publications
Blue Shield EPO is available only in Colusa, Mendocino, and Sierra counties.
Administrator: Blue Shield of California
Offers Medicare? No
Directory: Find a Doctor
Basic Publications
You must belong to the specific employee association and pay applicable dues to enroll in the California Association of Highway Patrolmen (CAHP).
Administrator: Anthem Blue Cross
Offers Medicare? Yes
Directory: Find a Doctor
Basic Publications
Medicare Publications
You must belong to the specific employee association and pay applicable dues to enroll in the California Correctional Peace Officers Association (CCPOA). The CCPOA plan is available only to dues-paying members of that organization and their families.
Administrator: Blue Shield of California
Offers Medicare? Yes
Directory: Find a Doctor
Basic Publications
Medicare Publications
Administrator: Health Net of California
Offers Medicare? No
Prescription Drug Services: OptumRx
Directory: ProviderSearch
Basic Publications
- 2018 Health Net of California: Salud y Más HMO Evidence of Coverage (PDF)
- 2018 Health Net of California: Salud y Más HMO Summary of Benefits and Coverage with Uniform Glossary (PDF)
- 2018 Health Net of California: SmartCare HMO Evidence of Coverage (PDF)
- 2018 Health Net of California: SmartCare HMO Summary of Benefits and Coverage with Uniform Glossary (PDF)
- 2018 OptumRx Outpatient Prescription Drug Benefit Plan for Selected HMO Basic Plans Evidence of Coverage (PDF)
This plan is available in some states. Refer to the Evidence of Coverage for service area information.
Administrator: Kaiser Permanente
Offers Medicare? Yes
Directory: Doctors & Locations
Basic Publications
Medicare Publications
You must belong to the specific employee association and pay applicable dues to enroll in the Peace Officers Research Association of California (PORAC). This plan is available outside of California. Refer to the plan's Evidence of Coverage for service area information.
Administrator: Anthem Blue Cross
Offers Medicare? Yes
Directory: Find a Doctor
Basic Publications
- 2018 PORAC Prudent Buyer Plan Evidence of Coverage
- 2018 PORAC Prudent Buyer Plan Summary of Benefits and Coverage with Uniform Glossary
- 2018 PORAC Out-of-State Resident Basic Health Plan Evidence of Coverage
- 2018 PORAC Out-of-State Resident Summary of Benefits and Coverage with Uniform Glossary
Medicare Publications
Medicare publications will be available soon.
This plan has no geographical restrictions. It provides coverage anywhere in the world.
Administrator: Anthem Blue Cross
Offers Medicare? Yes
Prescription Drug Services: OptumRx
Directory: Find A Doctor, Pharmacy, Hospital or Urgent Care Center
Basic Publications
- 2018 PERSCare Basic Plan Evidence of Coverage (PDF)
- 2018 PERSCare Basic Plan Summary of Benefits and Coverage with Uniform Glossary (PDF)
Medicare Publications
This plan has no geographical restrictions. It provides coverage anywhere in the world.
Administrator: Anthem Blue Cross
Offers Medicare? Yes
Prescription Drug Services: OptumRx
Directory: Find A Doctor, Pharmacy, Hospital or Urgent Care Center
Basic Publications
- 2018 PERS Choice Basic Plan Evidence of Coverage (PDF)
- 2018 PERS Choice Basic Plan Summary of Benefits and Coverage with Uniform Glossary (PDF)
Medicare Publications
Administrator: Anthem Blue Cross
Offers Medicare? Yes
Prescription Drug Services: OptumRx
Directory: Find A Doctor, Pharmacy, Hospital or Urgent Care Center
Basic Publications
- 2018 PERS Select Basic Plan Evidence of Coverage (PDF)
- 2018 PERS Select Basic Plan Summary of Benefits and Coverage with Uniform Glossary (PDF)
Medicare Publications
Administrator: Sharp Health Plan
Offers Medicare? No
Prescription Drug Services: OptumRx
Directory: Find a Doctor
Basic Publications
Administrator: UnitedHealthcare
Offers Medicare? No
Prescription Drug Services: OptumRx
Directory: Find a Doctor
Basic Publications
Administrator: UnitedHealthcare
Offers Medicare? Yes
Directory: Find a Doctor
Publications
Administrator: Western Health Advantage
Offers Medicare? No
Basic Publications
2019
The CalPERS Board reviews health plan contracts annually to determine health plans, covered benefits, and co-payments.
Check back in late August for 2019 Evidence of Coverage and Summary of Benefits and Coverage publications.
About Our Plans
- HMO - A Health Maintenance Organization (HMO) plan provides health care from specific doctors and hospitals under contract with the plan. You pay co-payments for some services, but you have no deductible, no claim forms, and a geographically restricted service area.
- PPO - A Preferred Provider Organization (PPO) is similar to a traditional "fee-for-service" plan, but you must use doctors in the PPO provider network or pay higher co-insurance (percentage of charges). You must usually meet an annual deductible before some benefits apply. You're responsible for a certain co-insurance amount and the plan pays the balance up to the allowable amount.
- EPO - The Exclusive Provider Organization (EPO) plan offers the same covered services as an HMO plan, but you must seek services from the plans' PPO network of preferred providers. You're not required to select a primary care physician.
- Combination Plans - A combination plan means at least one family member is enrolled in a Medicare health plan and at least one family member is enrolled in a Basic health plan through the same health carrier. CalPERS requires all family members to have the same health carrier.
