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.
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 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 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 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. |
2022
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:
|
Blue Shield Medicare Advantage | New plan to be available nationwide
Additional supplemental benefits:
|
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) |