Plans & Rates
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. You can also log in to myCalPERS to use the Search Health Plans tool to research the health plan coverage and benefits most important to you and your family.
Some health plans are available only in certain counties and/or ZIP Codes. Contact the health plan before enrolling to make sure they cover your ZIP Codes and that their provider network is accepting new patients in your area. You may also use our online service, the Health Plan Search by ZIP Code.
Open Enrollment is an annual process that occurs in the fall. During this time, you can enroll, change health plans, add eligible dependents, delete dependents, or cancel coverage. View Annual Health Plan Changes for details on health plans, service areas, and benefit design changes for 2023.
Are you a retiree? View Retiree Plans & Rates customized just for you.
Rates & Employer Contributions
View How CalPERS Sets Health Premiums to get details on the rates and plans process.
2023
View the 2023 health premiums 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. Active subscribers are subject to the 80-80 or 85-80 formula. Active subscribers should contact their employer to inquire which formula applies to their bargaining unit.
CalPERS Health Program
| Formula | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| 80-80 Formula | $689 | $1,386 | $1,784 |
| 85-80 Formula | $732 | $1,429 | $1,827 |
| Formula | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| 80/80 CoBen | $735 | $1,461 | $1,888 |
| 85/80 CoBen | $798 | $1,504 | $1,931 |
| 85/80 CoBen (Excluded) | $780 | $1,515 | $1,945 |
*CoBen is the employer-provided benefit allowance for employees in bargaining units 2, 7, 8, 16, 17, 18, and 19, and excluded employees, to offset the cost of health, dental, and vision benefits. For more information, visit CalHR. Check with your employer to determine your contribution amount.
Active CSU Members
| Group | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| All Employees (Except Unit 6) | $883 | $1,699 | $2,124 |
| Unit 6 | $888 | $1,709 | $2,144 |
CalPERS 2023 Statewide COBRA Health Premiums
Effective Date: January 1, 2023
COBRA premiums are calculated at 102% of the Basic premiums, but some carriers may charge less than these maximum amounts.
| Plan Name | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| Anthem Blue Cross Del Norte EPO | $1,105.57 | $2,211.14 | $2,874.47 |
| Anthem Blue Cross Select HMO | $921.93 | $1,843.85 | $2,397.01 |
| Anthem Blue Cross Traditional HMO | $1,138.98 | $2,277.97 | $2,961.36 |
| Blue Shield Access+ EPO | $859.46 | $1,718.92 | $2,234.61 |
| Blue Shield Access+ HMO | $859.46 | $1,718.92 | $2,234.61 |
| Blue Shield Trio HMO | $775.92 | $1,551.85 | $2,017.41 |
| CAHP | $784.04 | $1,522.10 | $1,990.76 |
| CCPOA - North | $946.83 | $1,898.41 | $2,563.25 |
| CCPOA - South | $780.63 | $1,565.94 | $2,116.21 |
| Health Net Salud y Más | $644.53 | $1,289.06 | $1,675.77 |
| Health Net SmartCare | $1,013.26 | $2,026.52 | $2,634.47 |
| Kaiser Permanente (CA) | $869.73 | $1,739.47 | $2,261.31 |
| Kaiser Permanente (Out-of-State)1 | $1,178.54 | $2,357.08 | $3,064.20 |
| PERS Gold | $781.43 | $1,562.86 | $2,031.73 |
| PERS Platinum | $1,105.57 | $2,211.14 | $2,874.47 |
| PORAC | $790.50 | $1,555.50 | $2,040.00 |
| Sharp Performance Plus | $780.26 | $1,560.52 | $2,028.68 |
| UnitedHealthcare SignatureValue Alliance | $858.55 | $1,717.11 | $2,232.24 |
| UnitedHealthcare SignatureValue Harmony | $736.73 | $1,473.45 | $1,915.49 |
| Western Health Advantage HMO | $775.37 | $1,550.75 | $2,015.97 |
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:
- Region 1 Premiums (PDF) - View rates for Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, Del Norte, El Dorado, Glenn, Humboldt, Lake, Lassen, Marin, Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Napa, Nevada, Placer, Plumas, Sacramento, San Benito, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Shasta, Sierra, Siskiyou, Solano, Sonoma, Stanislaus, Sutter, Tehama, Trinity, Tuolumne, Yolo, and Yuba.
- Region 2 Premiums (PDF) - View rates for Fresno, Imperial, Inyo, Kern, Kings, Madera, Orange, San Diego, San Luis Obispo, Santa Barbara, Tulare, and Ventura.
- Region 3 Premiums (PDF) - View rates for Los Angeles, Riverside, and San Bernardino.
- Out-of-State Premiums (PDF) - View rates for health plans available outside of California.
CalPERS 2023 Public Agencies and Schools COBRA Health Premiums
Effective Date: January 1, 2023
COBRA premiums are calculated at 102% of the Basic premiums, but some carriers may charge less than these maximum amounts.
View the 2023 COBRA premiums by region (PDF).
2022
View the 2022 health premiums 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. Active subscribers are subject to the 80-80 or 85-80 formula. Active subscribers should contact their employer to inquire which formula applies to their bargaining unit.
CalPERS Health Program
| Formula | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| 80-80 Formula | $651 | $1,302 | $1,686 |
| 85-80 Formula | $691 | $1,342 | $1,727 |
| Formula | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| 80/80 CoBen | $697 | $1,377 | $1,790 |
| 85/80 CoBen | $737 | $1,417 | $1,831 |
| 85/80 CoBen (Excluded) | $739 | $1,428 | $1,845 |
*CoBen is the employer-provided benefit allowance for employees in bargaining units 2, 7, 8, 16, 17, 18, and 19, and excluded employees, to offset the cost of health, dental, and vision benefits. For more information, visit CalHR. Check with your employer to determine your contribution amount.
Active CSU Members
| Group | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| All Employees (Except Unit 6) | $816 | $1,548 | $1,983 |
| Unit 6 | $821 | $1,558 | $2,003 |
CalPERS 2022 Statewide COBRA Health Premiums
Effective Date: January 1, 2022
COBRA premiums are calculated at 102% of the Basic premiums, but some carriers may charge less than these maximum amounts.
| Plan Name | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| Anthem Blue Cross Del Norte | $965.72 | $1,931.43 | $2,510.86 |
| Anthem Blue Cross Select | $865.04 | $1,730.08 | $2,249.11 |
| Anthem Blue Cross Traditional | $1,222.03 | $2,444.06 | $3,177.28 |
| Blue Shield Access+ | $918.22 | $1,836.45 | $2,387.38 |
| Blue Shield Trio | $757.55 | $1,515.11 | $1,969.64 |
| CAHP | $784.04 | $1,522.10 | $1,990.76 |
| CCPOA - North | $893.59 | $1,791.50 | $2,418.84 |
| CCPOA - South | $736.77 | $1,477.79 | $1,997.02 |
| Health Net Salud y Más | $496.24 | $992.48 | $1,290.23 |
| Health Net SmartCare | $1,027.27 | $2,054.55 | $2,670.91 |
| Kaiser (CA) | $820.76 | $1,641.53 | $2,133.98 |
| Kaiser (Out-of-State)1 | $1,161.73 | $2,323.46 | $3,020.50 |
| PERS Platinum | $965.72 | $1,931.43 | $2,510.86 |
| PERS Gold | $663.39 | $1,326.78 | $1,724.81 |
| PORAC | $765.00 | $1,477.98 | $1,965.54 |
| Sharp | $713.19 | $1,426.39 | $1,854.31 |
| UnitedHealthcare Alliance | $834.39 | $1,668.78 | $2,169.42 |
| UnitedHealthcare Harmony | $752.10 | $1,504.19 | $1,955.45 |
| Western Health Advantage | $756.09 | $1,512.17 | $1,965.83 |
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:
- Region 1 Premiums (PDF) - View rates for Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, Del Norte, El Dorado, Glenn, Humboldt, Lake, Lassen, Marin, Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Napa, Nevada, Placer, Plumas, Sacramento, San Benito, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Shasta, Sierra, Siskiyou, Solano, Sonoma, Stanislaus, Sutter, Tehama, Trinity, Tuolumne, Yolo, and Yuba.
- Region 2 Premiums (PDF) - View rates for Fresno, Imperial, Inyo, Kern, Kings, Madera, Orange, San Diego, San Luis Obispo, Santa Barbara, Tulare, and Ventura.
- Region 3 Premiums (PDF) - View rates for Los Angeles, Riverside, and San Bernardino.
- Out-of-State Premiums (PDF) - View rates for health plans available outside of California.
CalPERS 2022 Public Agencies and Schools COBRA Health Premiums
Effective Date: January 1, 2022
COBRA premiums are calculated at 102% of the Basic premiums, but some carriers may charge less than these maximum amounts.
View the 2022 COBRA premiums by region (PDF).
Health Plans
View all health plan Summary of Coverage and Evidence of Coverage documents.
All health plans have geographical restrictions except for PERS Platinum. To find health plans available in your area, refer to Health Plan Search by ZIP Code.
| Plan Name | Administrator | Offers Medicare? | Plan Information |
|---|---|---|---|
|
Anthem Blue Cross (Basic) (HMO)
|
(855) 839-4524 |
No |
OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. Access Anthem Blue Cross’ Transparency in Coverage Machine Readable Files on their website. |
| Anthem Blue Cross (EPO) |
(877) 737-7776 |
No |
Anthem Blue Cross EPO is available only in Del Norte county. OptumRx is the PBM providing prescription benefits for this health plan. Access Anthem Blue Cross’ Transparency in Coverage Machine Readable Files on their website. |
| Anthem Blue Cross Medicare Preferred (PPO) |
(855) 251-8825 |
Yes | OptumRx is the PBM providing prescription benefits for this health plan. |
|
Blue Shield of California (HMO)
|
(800) 334-5847 |
No |
Blue Shield of California administers their own prescription drug benefits. Access Blue Shield of California’s Transparency in Coverage Machine Readable Files on their website. |
| Blue Shield (EPO) |
(800) 334-5847 |
No |
Beginning January 1, 2023, Blue Shield EPO is available only in Alpine, Calaveras, Colusa, Inyo, Lake, Lassen, Mendocino, Modoc, Mono, Plumas, Siskiyou, Tehama, Tuolumne, Shasta, and Sierra Counties. Blue Shield of California prescription benefits are administered by CVS Caremark. Access Blue Shield of California’s Transparency in Coverage Machine Readable Files on their website. |
| Blue Shield of California Medicare (PPO) |
(888) 802-4599 |
Yes |
Blue Shield of California administers their own prescriptions. |
|
California Association of Highway Patrolmen (CAHP) (PPO)
|
Anthem Blue Cross (800) 759-5758 |
Yes |
You must belong to the specific employee association and pay applicable dues to enroll in the CAHP. Note: The Prudent Buyer Network for CAHP’s Basic and Combination Plan is available only in California and in limited areas of selected states outside of California. CAHP prescription benefits are administered by Express Scripts. |
|
California Correctional Peace Officers Association (CCPOA) (HMO)
|
Blue Shield of California (800) 257-6213 |
No |
You must belong to the specific employee association and pay applicable dues to enroll in the CCPOA. The CCPOA plan is available only to dues-paying members of that organization and their families. CCPOA prescription benefits are administered through Blue Shield of California. |
|
California Correctional Peace Officers Association (CCPOA) (PPO)
|
Blue Shield of California (800) 776-4466 |
Yes |
You must belong to the specific employee association and pay applicable dues to enroll in the CCPOA. The CCPOA plan is available only to dues-paying members of that organization and their families. CCPOA prescription benefits are administered through Blue Shield of California. |
|
Health Net of California (HMO)
|
(888) 926-4921 |
No |
OptumRx is the PBM providing prescription benefits for this health plan. Access Health Net of California’s Transparency in Coverage Machine Readable Files on their website. |
|
Kaiser (HMO) Kaiser Permanente Senior Advantage Kaiser Permanente Senior Advantage Summit |
(800) 305-1220 |
Yes |
Kaiser administers its own prescription benefits. Kaiser Permanente Senior Advantage Summit is available as of January 1, 2023. Access Kaiser Permanente’s Transparency in Coverage Machine Readable Files on their website. |
|
Peace Officers Research Association of California (PORAC) (PPO)
|
Anthem Blue Cross (800) 655-6397 |
Yes |
You must belong to the specific employee association and pay applicable dues to enroll in the PORAC. The PORAC plan is available only to dues-paying members of that organization and their families. PORAC prescription are administered by Anthem Blue Cross. |
|
PERS Platinum (PPO)
|
(877) 737-7776 |
Yes |
This plan has no geographical restrictions. It provides coverage anywhere in the world. OptumRx is the PBM providing prescription benefits for this health plan. Access Anthem Blue Cross’ Transparency in Coverage Machine Readable Files on their website. |
|
PERS Gold (PPO)
|
(877) 737-7776 |
Yes |
This plan is only available in California. OptumRx is the PBM providing prescription benefits for this health plan. Access Anthem Blue Cross’ Transparency in Coverage Machine Readable Files on their website. |
|
Sharp Health Plan (Basic) (HMO)
|
(855) 995-5004 |
No |
OptumRx is the PBM providing prescription benefits for this health plan. Access Sharp Health Plan’s Transparency in Coverage Machine Readable Files on their website. |
|
Sharp Direct Advantage (Medicare) (HMO) |
(833) 346-4322 |
Yes |
CVS Caremark is the PBM for Sharp Direct Advantage (Medicare) (HMO). |
|
UnitedHealthcare (Basic) (HMO)
|
(877) 359-3714 |
No |
OptumRx is the PBM providing prescription benefits for this health plan. Access UnitedHeatlhCare’s Transparency in Coverage Machine Readable Files on their website. |
|
UnitedHealthcare (Medicare) (PPO)
|
(888) 867-5581 |
Yes |
The UnitedHealthcare® Group Medicare Advantage (PPO) plans include Medicare Part D prescription drug coverage. OptumRx is the PBM providing prescription benefits for this health plan. |
| Western Health Advantage (HMO) |
(888) 942-7377 |
No |
OptumRx is the PBM providing prescription benefits for this health plan. Access Western Health Advantage’s Transparency in Coverage Machine Readable Files on their website. |
| Western Health Advantage MyCare Select (Medicare) (HMO) |
(888) 942-7377 |
Yes |
OptumRx is the PBM providing prescription benefits for this health plan. |
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 plan’s network of preferred providers. You are also able to access physicians and specialists that participate in the network without a referral. You pay copayments, for some services, but you have no deductible, no claim forms, and a geographically restricted service area.
- 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.
Additional Resources
- Accessing Health Care During a Disaster
- Health Plan Events & Resources
- Non-Discrimination Notice (PDF)
- Open Enrollment
- Provider Disruption (PDF)
- Your Rights and Protections Against Surprise Medical Bills (PDF)
