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.
Are you a retiree? View Retiree Plans & Rates customized just for you.
Rates & Employer Contributions
View How CalPERS Sets Health Rates to get details on the rates and plans process.
2021
View the 2021 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. 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
State Employer Health Benefit Contributions
| Formula | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| 80-80 Formula | $607 | $1,216 | $1,567 |
| 85-80 Formula | $645 | $1,254 | $1,605 |
Consolidated Benefits (CoBen)*
| Formula | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| 80/80 CoBen | $653 | $1,291 | $1,671 |
| 85/80 CoBen | $691 | $1,329 | $1,709 |
| 85/80 CoBen (Excluded) | $693 | $1,340 | $1,723 |
*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.
State Employer Health Benefit Contributions
Active CSU Members
| Group | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| All Employees (Except Unit 6) | $798 | $1,519 | $1,937 |
| Unit 6 | $803 | $1,529 | $1,957 |
CalPERS 2021 Statewide COBRA Health Premiums
Effective Date: January 1, 2021
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 EPO Del Norte | $866.21 | $1,732.43 | $2,252.16 |
| Anthem Select HMO | $816.56 | $1,633.12 | $2,123.06 |
| Anthem Traditional HMO | $1,244.73 | $2,489.45 | $3,236.29 |
| Blue Shield Access+ | $957.74 | $1,915.48 | $2,490.13 |
| Blue Shield Trio | $737.01 | $1,474.02 | $1,916.23 |
| CAHP | $784.04 | $1,522.10 | $1,990.76 |
| CCPOA - North | $847.21 | $1,698.35 | $2,293.02 |
| CCPOA - South | $698.56 | $1,400.98 | $1,893.17 |
| Health Net Salud y Más | $433.52 | $867.04 | $1,127.15 |
| Health Net SmartCare | $942.85 | $1,885.69 | $2,451.41 |
| Kaiser (CA) | $776.85 | $1,553.70 | $2,019.81 |
| Kaiser (Out-of-State)1 | $1,060.95 | $2,121.91 | $2,758.48 |
| PERS Choice | $866.21 | $1,732.43 | $2,252.16 |
| PERS Select | $537.94 | $1,075.88 | $1,398.63 |
| PERSCare | $1,134.11 | $2,268.21 | $2,948.68 |
| PORAC | $765.00 | $1,477.98 | $1,965.54 |
| Sharp | $644.92 | $1,289.83 | $1,676.78 |
| UnitedHealthcare | $770.72 | $1,541.44 | $2,003.88 |
| Western Health Advantage | $772.16 | $1,544.32 | $2,007.62 |
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 Rates (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 Rates (PDF) - View rates for Fresno, Imperial, Inyo, Kern, Kings, Madera, Orange, San Diego, San Luis Obispo, Santa Barbara, Tulare, and Ventura.
- Region 3 Rates (PDF) - View rates for Los Angeles, Riverside, and San Bernardino.
- Out-of-State Rates (PDF) - View rates for health plans available outside of California.
CalPERS 2021 Public Agencies and Schools COBRA Health Premiums
Effective Date: January 1, 2021
COBRA premiums are calculated at 102% of the Basic premiums, but some carriers may charge less than these maximum amounts.
View the 2021 COBRA premiums by region (PDF).
2020
View the 2020 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
State Employer Health Benefit Contributions
| Formula | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| 80-80 Formula | $609 | $1,223 | $1,585 |
| 85-80 Formula | $647 | $1,261 | $1,623 |
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.
State Employer Health Benefit Contributions
Active CSU Members
| Group | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| All Employees (Except Unit 6) | $767 | $1,461 | $1,868 |
| Unit 6 | $772 | $1,471 | $1,888 |
COBRA Rates
If you have continued health coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA), contact your employer for your monthly premium. Refer to COBRA for information on continuing health coverage for yourself and your dependents if you involuntarily lose your health benefits.
COBRA premiums are calculated at 102% of the Basic premiums, but some carriers may charge less than these maximum amounts.
State Premiums for January 1, 2020 to December 31, 2020
| Plan Name | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| Anthem EPO Del Norte | $802.74 | $1,605.48 | $2,087.12 |
| Anthem Select HMO | $803.55 | $1,607.09 | $2,089.22 |
| Anthem Traditional HMO | $1,138.07 | $2,276.13 | $2,958.97 |
| Blue Shield Access+ | $928.36 | $1,856.73 | $2,413.75 |
| Blue Shield EPO | $928.36 | $1,856.73 | $2,413.75 |
| Blue Shield Trio | $715.08 | $1,430.16 | $1,859.22 |
| CAHP | $732.75 | $1,422.52 | $1,860.53 |
| CCPOA - North | $820.53 | $1,644.76 | $2,220.64 |
| CCPOA - South | $676.58 | $1,356.79 | $1,833.43 |
| Health Net Salud y Más | $411.62 | $823.24 | $1,070.21 |
| Health Net SmartCare | $878.18 | $1,756.36 | $2,283.27 |
| Kaiser (CA) | $744.65 | $1,489.30 | $1,936.09 |
| Kaiser (Out-of-State)1 | $1,015.09 | $2,030.19 | $2,639.24 |
| PERS Choice | $802.74 | $1,605.48 | $2,087.12 |
| PERS Select | $502.08 | $1,004.17 | $1,305.42 |
| PERSCare | $1,009.68 | $2,019.36 | $2,625.16 |
| PORAC | $738.48 | $1,477.98 | $1,965.54 |
| Sharp | $618.14 | $1,236.28 | $1,607.16 |
| UnitedHealthcare | $741.49 | $1,482.98 | $1,927.87 |
| Western Health Advantage | $746.60 | $1,493.20 | $1,941.16 |
1These premiums cover all Kaiser out-of-state areas.
View the 2020 COBRA rates by region (PDF).
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 Rates (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 Rates (PDF) - View rates for Fresno, Imperial, Inyo, Kern, Kings, Madera, Orange, San Diego, San Luis Obispo, Santa Barbara, Tulare, and Ventura.
- Region 3 Rates (PDF) - View rates for Los Angeles, Riverside, and San Bernardino.
- Out-of-State Rates (PDF) - View rates for health plans available outside of California.
Employer Contribution Amounts
Contributions vary by employer. Contact your employer to find out how much they contribute toward your monthly premium rate.
Health Plans
View all health plan Summary of Coverage and Evidence of Coverage documents.
All health plans have geographical restrictions except for PERS Choice and PERSCare. 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. |
| Anthem Blue Cross (EPO) |
(855) 839-4524 |
No |
Anthem Blue Cross EPO is available only in Del Norte county. OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. |
| Anthem Blue Cross Medicare Preferred (PPO) |
(855) 251-8825 |
Yes | OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. |
|
Blue Shield of California (HMO)
|
(800) 334-5847 |
No |
Blue Shield of California administers their own prescriptions. |
| Blue Shield (EPO) |
(800) 334-5847 |
No |
Blue Shield EPO is available only in Colusa, Mendocino and Sierra counties. Blue Shield of California administers their own prescriptions. |
|
California Association of Highway Patrolmen (PPO)
|
Anthem Blue Cross (800) 759-5758 |
Yes |
You must belong to the specific employee association and pay applicable dues to enroll in the California Association of Highway Patrolmen (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 pharmacy benefits are administered by Express Scripts. |
|
California Correctional Peace Officers Association (HMO)
|
Blue Shield of California (800) 257-6213 |
Yes |
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. CCPOA pharmacy benefits are administered by Blue Shield. |
|
Health Net of California (HMO)
|
(888) 926-4921 |
No |
OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. |
| Kaiser (HMO) |
(800) 305-1220 |
Yes |
Kaiser administers their own prescriptions. |
|
Peace Officers Research Association of California (PPO)
|
Anthem Blue Cross (800) 288-6928 |
Yes |
You must belong to the specific employee association and pay applicable dues to enroll in the Peace Officers Association of California (PORAC). The PORAC plan is available only to dues-paying members of that organization and their families. PORAC pharmacy benefits are administered by Anthem Blue Cross. |
|
PERSCare (PPO)
|
(877) 737-7776 |
Yes |
This plan has no geographical restrictions. It provides coverage anywhere in the world. OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. |
|
PERS Choice (PPO)
|
(877) 737-7776 |
Yes |
This plan has no geographical restrictions. It provides coverage anywhere in the world. OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. |
|
PERS Select (PPO)
|
(877) 737-7776 |
Yes | OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. |
|
Sharp Health Plan (Basic) (HMO)
|
(855) 995-5004 |
No |
OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. |
|
Sharp Direct Advantage (Medicare) (HMO) |
(833) 346-4322 |
Yes |
CVS Caremark is the Pharmacy for Sharp Direct Advantage (Medicare). |
|
UnitedHealthcare (Basic) (HMO)
|
(877) 359-3714 |
No | OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. |
| UnitedHealthcare Medicare Advantage (PPO) |
(888) 867-5581 |
Yes | The UnitedHealthcare® Group Medicare Advantage (PPO) plans include Medicare Part D prescription drug coverage. |
| Western Health Advantage (HMO) |
(888) 942-7377 |
No | OptumRx is the Pharmacy Benefit Manager (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 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.
Additional Resources
- Accessing Health Care During a Disaster
- Health Plan Events & Resources
- Non-Discrimination Notice (PDF)
- Open Enrollment
- Provider Disruption (PDF)
