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.

2023
2022

We’re providing you with information on the 2023 health plan proposals (PDF) approved in November 2021 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 2023 health premiums in June 2022 and approve final premiums in July 2022.

Health plans indicated below will have changes in 2023. 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
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.
Kaiser Permanente	Expansion into Monterey County*

Medicare Plans

Health Plan	Changes
Anthem Blue Cross Medicare Preferred	Changes copays for acupuncture and chiropractic services to $10 (down from $15).
Kaiser Permanente Senior Advantage	Expansion into Monterey County* New Senior Advantage $0 Copay Plan offering the same network and coverage areas as the existing Kaiser Permanente Senior Advantage plan. Quarterly $70 over the counter (OTC) allowance for OTC medications, vitamins and supplements, and other certain mobility and home care supplies.
Western Health Advantage MyCare Select Medicare Advantage	New supplemental benefit: Meal delivery following hospital stay of up to 56 meals, four times per year

*Pending Department of Managed Health Care or Centers for Medicare and Medicaid (CMS) approval.

Benefit Design Changes**

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	New benefit for members under the age of 26 providing medically necessary and clinically appropriate hearing aids in both ears at 100% coverage every 36 months.
Match Preferred Provider Organization (PPO) Members with Primary Care Providers	New match to a Primary Care Provider (PCP) for PPO members. Members would be free to choose a different PCP and it would not change the ability to see a specialist anytime.

**To be evaluated. More information will be available at a later date.

The following health plan changes were approved (PDF) in November 2020 by the CalPERS Board of Administration for the 2022 plan year.

These changes took effect January 1, 2022.

Basic Plans

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

Health Plan	Changes
Blue Shield Access+	Reenter into eight Bay Area counties: Alameda, Contra Costa, Marin, San Francisco, San Mateo, Santa Clara, Sonoma, and Solano
Blue Shield EPO	Expand into Lassen and Shasta counties
Blue Shield Trio	Expand into Santa Cruz, Stanislaus, and Orange counties
UnitedHealthcare SignatureValue Harmony	New plan to be available in Los Angeles, Orange, Riverside, San Bernardino, and San Diego counties
Western Health Advantage	Expand into Humboldt County

Preferred Provider Organization (PPO)

CalPERS three PPO plans, PERSCare, PERS Choice, and PERS Select, will transition to two plans, PERS Platinum and PERS Gold. The change is the result of a year-long analysis to stabilize the Basic plan portfolio, including engagement with members, employers, and stakeholders. The two PPO plans will offer more distinction in benefit design, networks, and premium pricing.

Health Plan	Changes
PERSCare	Transition to PERS Platinum. Retains the same 90/10 benefit design, and network as PERSCare/PERS Choice
PERS Choice	Transition to PERS Platinum. Offers a 90/10 benefit design, and retains the network of PERSCare/PERS Choice
PERS Select	Transition to PERS Gold. Retains the same 80/20 benefit design and network as PERS Select

Medicare Plans

Health Plan	Changes
Anthem Blue Cross Medicare Preferred	Expand into 21 additional counties for coverage in all 58 counties New supplemental benefits: 12 telephone nutritional counseling sessions 1 monthly shipment of recommended healthy non-perishable staples Non-emergency medical transportation to medical appointments, SilverSneakers locations, and pharmacies. Twelve one-way trips, up to 60 miles per trip, per year
Blue Shield Medicare Advantage	New plan to be available nationwide Additional supplemental benefits: Quarterly $80 over-the-counter drug benefit Personal emergency response system Post-discharge meals 24 non-emergency medical transportation one-way trips
PERSCare Supplement to Medicare Plan	Transition to PERS Platinum Supplement to Medicare Plan. No changes to benefit design or network.
PERS Choice Supplement to Medicare Plan	Transition to PERS Platinum Supplement to Medicare Plan. No changes to benefit design or network.
PERS Select Supplement to Medicare Plan	Transition to PERS Gold Supplement to Medicare Plan. No change to benefit design or network.
UnitedHealthcare Medicare Advantage Edge	New nationwide plan with OptumRx pharmacy benefit manager
Western Health Advantage (WHA) MyCare Select Medicare Advantage	New plan to be available 9 counties (Sacramento, Yolo, Solano, El Dorado, Placer, Colusa, Marin, Napa, Sonoma)