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
2023

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 approved 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 Maintenance Organization (HMO) and Exclusive Provider Organization (EPO)
Health Plan	Changes
Anthem Blue Cross Select	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* Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications
Blue Shield Access+ EPO	Expansion into Del Norte and San Benito counties
Health Net Salud y Más	Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications
Health Net SmartCare of California	Exits all counties; no longer part of CalPERS health plan offerings*
Sharp Health Plan Performance Plus	Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications
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 Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications
UnitedHealthcare SignatureValue Harmony	Expansion into Santa Clara and Santa Cruz counties Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications
Western Health Advantage	Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications

*Regardless of the health plan you enroll in, continuity of care coverage is available to you even if your current doctor, medical group, or hospital is not available. This means you’ll continue to receive the medical and behavioral health services and medicines you need. Check with your health plan or call the Department of Managed Health Care at 1-888-466-2219 for more information about continuity of care options.

Preferred Provider Organization (PPO)
Health Plan	Changes
PERS Gold	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 Basic PPO out-of-network deductible will increase from $1,000 to $2,500
PERS Platinum	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 Basic PPO out-of-network deductible will increase from $500 to $2,000

Medicare Plans

Health Plan	Changes
Anthem Blue Cross Medicare Preferred PPO	New supplemental benefits: Personal Emergency Response System (PERS) devices and in-home support services
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
UnitedHealthcare Medicare Advantage Edge	Changing from $0 to a $50 copay for emergency room visits
Western Health Advantage MyCare Select	Expansion into Humboldt County

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 Maintenance Organization (HMO) and Exclusive Provider Organization (EPO)
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

Preferred Provider Organization (PPO)
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

Medicare Plans
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 Region 1 9.21 – 12.07% premium increase for Public Agencies and Schools in Region 2 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 Design Changes for Basic Plans
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