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:

  • Access our Health Plan Chooser to find doctor directories, estimate costs, and view satisfaction ratings.
  • 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 2016 Health Benefit Summary (PDF) to compare features of the different health plans.

Are you retired? View Retiree Plans & Rates customized just for you.

Rates & Employer Contributions

2016

View this year's 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 2016 estimated contribution amounts are:

  • 85/80 - One-Party: $597; Two-Party: $1,163; Family: $1,504
  • 80/80 - One-Party: $562; Two-Party: $1,128; Family: $1,469

Please check with your employer to determine your contribution amount.

Active CSU Members

Contact your personnel office for your employer contribution amount.

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 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.

2017

The CalPERS Board reviews health plan contracts annually to determine health plans, covered benefits, monthly rates, and co-payments.

Check back in late June for next year's rates.

Health Plans

2016

Blue Shield EPO is available only in Colusa, Mendocino, and Sierra counties.

Administrator: Blue Shield of California
Offers Medicare? No

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

Basic Publications

Medicare Publication

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

Basic Publications

Medicare Publications

This plan is available in some states. Refer to the Evidence of Coverage for service area information.

Administrator: Kaiser Permanente
Offers Medicare? Yes

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

Basic Publications

Medicare Publication

This plan has no geographical restrictions. It provides coverage anywhere in the world. Visit CalPERS | Compare to shop for doctors, hospitals, medical services, and prescriptions.

Administrator: Anthem Blue Cross
Offers Medicare? Yes
Prescription Drug Services: CVS/caremark

Basic Publications

Medicare Publications

This plan has no geographical restrictions. It provides coverage anywhere in the world. Visit CalPERS | Compare to shop for doctors, hospitals, medical services, and prescriptions.

Administrator: Anthem Blue Cross
Offers Medicare? Yes
Prescription Drug Services: CVS/caremark

Basic Publications

Medicare Publications

This plan has no geographical restrictions. It provides coverage anywhere in the world. Visit CalPERS | Compare to shop for doctors, hospitals, medical services, and prescriptions.

Administrator: Anthem Blue Cross
Offers Medicare? Yes
Prescription Drug Services: CVS/caremark

Basic Publications

Medicare Publications

Administrator: UnitedHealthcare
Offers Medicare? Yes

Basic Publications

The UnitedHealthcare Group Medicare Advantage PPO Plan is new in 2016. Review Medicare Plan Changes for more information.

2017

The CalPERS Board reviews health plan contracts annually to determine health plans, covered benefits, monthly rates, and co-payments.

Check back in the fall for next year's health plan information.

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.


Resources

Forms & Publications

Frequently Asked Questions