Active members and retirees: 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:

2015 Rates

2015 Health Plan Rates

Employer Contribution Amounts

Active State Members
Your cost is any amount above the employer contribution. The 2015 estimated contribution amounts are:

  • 85/80 - One-Party: $557; Two-Party: $1,083; Family: $1,401
  • 80/80 - One-Party: $524; Two-Party: $1,050; Family: $1,368

Please check with your employer to determine your contribution amount.

Active CSU Members
Contact your personnel office for your employer contribution amount.

Retired State and CSU Members
Your cost is any amount above the employer contribution. The 2015 estimated contribution is One-Party: $655; Two-Party: $1,246; Family: $1,605. Learn about vesting requirements that determine how much of the state's contribution you'll receive toward your health premium after retirement.

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.
  • Sacramento Area Rates (PDF) - View rates for El Dorado, Placer, Sacramento, and Yolo.
  • 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.
  • Los Angeles Area Rates (PDF) - View rates for Los Angeles, San Bernardino, and Ventura.
  • 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.

2016 Rates

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.
  • Sacramento Area Rates (PDF) - View rates for El Dorado, Placer, Sacramento, and Yolo.
  • 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.
  • Los Angeles Area Rates (PDF) - View rates for Los Angeles, San Bernardino, and Ventura.
  • 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.

HMO Health Plans

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.

You must belong to the specific employee association and pay applicable dues to enroll this Association Plan. The CCPOA plan is available only to dues-paying members of that organization and their families.

Administrator: Blue Shield of California

Medicare

PPO Health Plans

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.

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
Prescription Drug Services: CVS Caremark

Medicare

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
Prescription Drug Services: CVS Caremark

Medicare

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
Prescription Drug Services: CVS Caremark

Medicare

You must belong to the specific employee association and pay applicable dues to enroll in this Association Plan.

Administrator: Anthem Blue Cross

Medicare

You must belong to the specific employee association and pay applicable dues to enroll in this Association Plan. This plan is available outside of California. Refer to the plan's Evidence of Coverage for service area information.

Administrator: Anthem Blue Cross

Medicare

EPO Health Plans

The Exclusive Provider Organization (EPO) plan offers the same covered services as an HMO plan, but you must seek services from the plan's PPO network of preferred providers. You're not required to select a primary care physician.

CVS Caremark

CVS Caremark is the largest pharmacy health care provider in the United States and one of the country's largest Pharmacy Benefit Managers. For 2015, CVS Caremark will be administering the prescription benefit for all the HMO plans including United Healthcare, Health Net, Sharp Health Plan and Anthem Blue Cross on their PPO and HMO plans.

Administrator: CVS Caremark



Health Benefits

Resources

Forms & Publications

Frequently Asked Questions

  • When should I call my health plan directly?

    Contact your health plan whenever you need assistance with any aspects of your coverage, including:

    • Covered services; deductibles, maximums, and co-payments; and limitations and exclusions of your coverage

    • Evidence of Coverage publications

    • Individual conversion policies

    • Member identification cards

    • Service area boundaries (covered ZIP codes)

    • Verification of provider participation in the plan