Annual Health Plan Changes
We’re working to give members more choices for affordable health plans and to ensure our benefit coverage provides equitable, high-quality health care. We realize that any changes to health plans impact your decisions during Open Enrollment. We will communicate all changes to plans and premiums to you prior to Open Enrollment in the fall.
2024
We’re providing you with information on the 2024 health plan changes approved in November 2022 (PDF) and March 2023 (PDF) by the CalPERS Board of Administration.
There’s no action for you to take now.
These proposals become part of our rate development process when we set health premiums. The Pension & Health Benefits Committee will review preliminary 2024 health premiums in June 2023 and approve final premiums in July 2023.
Health plans indicated below will have changes in 2024. There are no other changes to our health plans or benefits except those described here. For a full list of our available health plans, view the Plans & Rates page.
Basic Plans
| Health Plan | Changes |
|---|---|
| Basic HMO Plans with OptumRx pharmacy services | Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications |
| Anthem Blue Cross Traditional | Exits Glenn County |
| Blue Shield Access+ EPO | Expansion into Del Norte and San Benito counties |
| Health Net SmartCare of California | Exits all counties; no longer part of CalPERS health plan offerings |
| UnitedHealthcare SignatureValue Alliance | Expansion into 12 counties for public agencies and schools members: Alameda, Contra Costa, Marin, Merced, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma, and Stanislaus |
| UnitedHealthcare SignatureValue Harmony | Expansion into Santa Clara and Santa Cruz counties |
| Health Plan | Changes |
|---|---|
| Basic PPO Plans |
Site of Care lab services incentive, waives coinsurance when members use preferred lab providers for routine lab tests Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications |
| Health Plan | Changes |
|---|---|
| Kaiser Permanente Senior Advantage Summit | Expansion into eight out-of-state regions: Colorado, Hawaii, Georgia, Northwest (Oregon, Washington), Mid-Atlantic (Virginia, Maryland, District of Columbia), and Washington |
| Anthem Blue Cross Medicare Preferred PPO | New supplemental benefits: Personal Emergency Response System (PERS) devices and in-home support services |
| UnitedHealthcare Medicare Advantage Edge | Changing from $0 to a $50 copay for emergency room visits |
| Western Health Advantage MyCare Select | Expansion into Humboldt County |
2023
The Board of Administration approved final health plan premiums for 2023 in July.
The health plans indicated below will have premium increases of 9% or higher, changes to service areas, and benefit design changes in 2023. For a full list of our available health plans and premiums, view our Plans & Rates page.
Log in to myCalPERS to view customized health benefit information. Use the Search Health Plans tool to find health plans available in your area and whether your doctor accepts those plans.
Basic Plans
| Health Plan | Changes |
|---|---|
| Anthem Blue Cross Select |
11.13% premium increase for Public Agencies and Schools in Region 1 9.08% premium increase for Public Agencies and Schools in Region 3 |
| Anthem Blue Cross Del Norte EPO |
14.48% premium increase for State and California State Universities 13.54% premium increase for Public Agencies and Schools in Region 1 |
| Blue Shield Access+ EPO | Expansion into 11 counties: Alpine, Calaveras, Inyo, Lake, Modoc, Mono, Plumas, Siskiyou, Tehama, Trinity, and Tuolumne |
| Blue Shield Trio |
Expansion into seven counties: Butte, Kern, Kings, Monterey, Riverside, San Bernardino, and Tulare New pharmacy shared patient savings program featuring one month of plan savings for using a clinically equivalent, lower-cost drug alternative |
| Health Net Salud y Mas |
29.88% premium increase for State and California State Universities 27.48% premium increase for Public Agencies and Schools in Region 2 30.71% premium increase for Public Agencies and Schools in Region 3 |
| Sharp Performance Plus |
9.40% premium increase for State and California State Universities 9.40% premium increase for Public Agencies and Schools in Region 2 |
| Health Plan | Changes |
|---|---|
| PERS Gold |
17.79% premium increase for State and California State Universities 17.74% premium increase for Public Agencies and Schools in Region 1 18.4% premium increase for Public Agencies and Schools in Region 2 18.21% premium increase for Public Agencies and Schools in Region 3 |
| PERS Platinum |
14.48% premium increase for State and California State Universities 13.54% premium increase for Public Agencies and Schools in Region 1 15.03% premium increase for Public Agencies and Schools in Region 2 14.97% premium increase for Public Agencies and Schools in Region 3 18.42% premium increase for State and California State Universities and Public Agencies and Schools Out of State |
| Health Plan | Changes |
|---|---|
| Anthem Blue Cross Medicare Preferred |
Copays for acupuncture and chiropractic services to $10 down from $15 14.83% premium increase for State and California State Universities 14.83% premium increase for Public Agencies and Schools in Region 1 14.83% premium increase for Public Agencies and Schools in Region 2 14.83% premium increase for Public Agencies and Schools in Region 3 |
| Anthem Select Medicare Preferred |
14.83% premium increase for State and California State Universities 14.83% premium increase for Public Agencies and Schools in Region 1 14.83% premium increase for Public Agencies and Schools in Region 2 14.83% premium increase for Public Agencies and Schools in Region 3 |
| Anthem Select and Medicare Combination |
9.04 – 11.41% premium increase for State and California State Universities 11.8 – 13.13% premium increase for Public Agencies and Schools in 9.21 – 12.07% premium increase for Public Agencies and Schools in 10.52 – 12.76% premium increase for Public Agencies and Schools in Region 3 |
| California Correctional Peace Officers Association (CCPOA) Medicare Supplement | CCPOA is changing from a Medicare Supplement plan to a Medicare Advantage plan |
| Kaiser Permanente Senior Advantage | Quarterly $70 over the counter (OTC) allowance for OTC medications, vitamins and supplements, and other certain mobility and home care supplies |
| Kaiser Permanente Senior Advantage Summit |
This new plan will offer $0 copay for most services; however, copays for emergency room visits, pharmacy benefits, acupuncture, and chiropractic will remain Quarterly $70 over the counter (OTC) allowance for OTC medications, vitamins and supplements, and other certain mobility and home care supplies |
| PERS Gold and Medicare Combination |
10.41 – 14.14% premium increase for State and California State Universities 10.64 – 14.29% premium increase for Public Agencies and Schools in Region 1 10.33 – 14.29% premium increase for Public Agencies and Schools in Region 2 10.18 – 14.09% premium increase for Public Agencies and Schools in Region 3 |
| PERS Platinum and Medicare Combination |
11.89 – 13.57% premium increase for State and California State Universities 11.59 -12.88% premium increase for Public Agencies and Schools in Region 1 12.04 – 13.95% premium increase for Public Agencies and Schools in Region 2 11.99 – 13.88% premium increase for Public Agencies and Schools in Region 3 13.35 – 16.57% premium increase for State and California State Universities and Public Agencies and Schools Out of State |
| PERS Platinum Supplement to Medicare |
9.97% premium increase for State and California State Universities 9.97% premium increase for Public Agencies and Schools in Region 1 9.97% premium increase for Public Agencies and Schools in Region 2 9.97% premium increase for State and California State Universities and Public Agencies and Schools Out of State |
| Western Health Advantage MyCare Select Medicare Advantage |
New supplemental benefit: Meal delivery following hospital stay of up to 56 meals, four times per year |
| Benefit | Changes |
|---|---|
| Reproductive Health Equity Language | New benefit language providing all persons’ access to reproductive health benefits regardless of sex, sexual orientation, or gender identity |
| Fertility Care Health Equity Language | New benefit language updating the definition of infertility to provide access to infertility treatment to members regardless of age, sexual orientation, gender identity, or marital status |
| Hearing Aids | Hearing aids are covered at 100% in both ears every 36 months when medically necessary to prevent and treat speech and language development delay due to hearing loss |
| Match Preferred Provider Organization (PPO) Members with Primary Care Providers |
New match to a Primary Care Provider (PCP) for PPO members in a basic plan only and doesn’t apply to Medicare. Members will be free to choose a different PCP without affecting the ability to see a specialist anytime Members with an existing PCP assignment will keep that PCP, unless the member requests a new assignment through their health plan |