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 health plan changes impact your decisions during Open Enrollment and we'll communicate all health plan or premium changes to you prior to Open Enrollment.
Below is information on the 2026 health plan proposals presented at the CalPERS Pension & Health Benefits Committee on June 17, 2025.
These proposals become part of our rate development process when we set health premiums. Final premiums and changes will be approved in July 2025.
There’s no action for you to take now.
For a full list of our available health plans, visit the Plans & Rates page.
Basic Plan Changes
| Health Plan | Changes |
|---|---|
| Blue Shield Access+ | Expansion into Monterey County1 |
| Blue Shield Trio | Exits Monterey County |
Benefit Design Changes
| Benefit | Changes |
|---|---|
| Value-Based Insurance Design (VBID) | Will continue with deductible in-patient credits of up to $500 for completing preventive care activities, while adding the following activities: participation in the Diabetes Prevention Program, if eligible, as well as depression or anxiety screening. |
Endnotes
- Contingent upon approval from the Department of Managed Health Care (DMHC). (1)
We’re providing you with changes to health plans for 2025 that were approved by the CalPERS Board of Administration. There are no other changes to our health plans or benefits except those described here. For a full list of available health plans and premiums, view the Plans & Rates page.
There's no action for you to take now.
Basic Plans
| Health Plan | Changes |
|---|---|
| Anthem Blue Cross Del Norte | Third-party administrator transition removes Anthem Blue Cross Del Norte plan; no longer part of CalPERS health plan offerings1 |
| Blue Shield Trio | Expansion into:
|
| Health Net Salud y Más | Expansion into Imperial county |
| Kaiser Permanente | Expansion into 14 ZIP codes in Monterey county |
| UnitedHealthcare SignatureValue Harmony | Expansion into:
|
| Health Plan | Changes |
|---|---|
| PERS Gold | Blue Shield of California will be the new Third-Party Administrator for all PPO plans. For members in a basic plan they are partnering with Included Health to provide member services, including answering inquiries, guiding members to the most appropriate in-network and high-quality providers, and providing care coordination services for members, particularly those with complex health conditions. Included Health will also expand access to care through their supplemental virtual primary care and behavioral health care services. There are no changes to copays, coinsurance, or deductibles with this transition to Blue Shield. You can learn more about this announcement from the article recently posted on PERSpective. |
| PERS Platinum | Blue Shield of California will be the new administrator for all PPO plans. For members in a basic plan, they are partnering with Included Health to provide member services, including answering inquiries, guiding members to the most appropriate in-network and high-quality providers, and providing care coordination services for members, particularly those with complex health conditions. Included Health will also expand access to care through their supplemental virtual primary care and behavioral health care services. There are no changes to copays, coinsurance, or deductibles with this transition to Blue Shield. You can learn more about this announcement from the article recently posted on PERSpective. |
Medicare Plans
| Health Plan | Changes |
|---|---|
| PERS Gold Supplement to Medicare Plan | Blue Shield of California will be the new Third Party Administrator for all PPO plans. For Medicare members, provider networks and care coordination provided by their doctors will not change. There are no changes to copays or coinsurance with this transition to Blue Shield. You can learn more about this announcement from the article recently posted on PERSpective. |
| PERS Platinum Supplement to Medicare Plan | Blue Shield of California is the new Third Party Administrator for all PPO plans. For Medicare members, provider networks and care coordination provided by their doctors will not change. There are no changes to copays or coinsurance with this transition to Blue Shield. You can learn more about this announcement from the article recently posted on PERSpective. |
| UnitedHealthcare Medicare Advantage Edge | Exits all counties; no longer part of CalPERS health plan offerings2 |
| Western Health Advantage MyCare Select | Exits all counties; no longer part of CalPERS health plan offerings2 |
Benefit Design Changes
| Benefit | Changes |
|---|---|
| Doula Benefit for all Pregnant and Postpartum Members | New benefit for all pregnant and postpartum Basic plan members to receive health education, advocacy, physical and emotional non-medical support before, during and after pregnancy, miscarriage, stillbirth, and abortions. |
| Travel Benefit for Medically Necessary Care | Standardized travel and lodging coverage for eligible medically necessary services including, but not limited to abortion services, gender affirming care, complex surgeries, and cancer care that cannot be accessed within 50 miles from the member’s residence for all Basic and Medicare plan members, up to $5,000 per occurrence. This includes transportation, lodging, and meals for the member and a companion (both parents/guardians when patient is under 18). |
1Regardless of the health plan you enroll in, continuity of care coverage as outlined by the Department of Managed Health Care may be available to you if your current doctor, medical group, or hospital is not available and you meet certain eligibility criteria. This means you may be able to 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. For members who have had a provider disruption and do not qualify for DMHC Continuity of Care provisions, Blue Shield will also provide 12 months of office visits with out of network providers at the in network benefit.
2Regardless of the health plan you enroll in, continuity of care coverage may be available to you if your current doctor, medical group, or hospital is not available and you meet certain eligibility criteria. This means you may be able to continue to receive the medical and behavioral health services and medicines you need. Check with your health plan or Centers for Medicare & Medicaid Services at cms.gov for more information about continuity of care options.