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.

2025

We’re providing you with information on the 2025 health plan proposals (PDF) approved in November 2023 (PDF) and June 2024 (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 and Health Benefits Committee will review preliminary 2025 health premiums and any additional proposed plan and benefit changes and approve final premiums and changes in July 2024.

For a full list of our available health plans, view the Plans & Rates page.

Basic Plans

Health Maintenance Organization (HMO)
Health Plan Changes
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:
*Pending Department of Managed Health Care approval.
Preferred Provider Organization Plans (PPO)
Health Plan Changes

PERS Gold

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

PERS Platinum Supplement to Medicare Plan

Blue Shield of California will be the new 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.

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 Update to standardize 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).

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 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