Health Benefits for Employers
The Public Employees' Medical & Hospital Care Act (PEMHCA) governs the CalPERS Health Program, which enables you to provide a quality health benefits program to your employees while reducing financial risk. The program covers state employees by law. Local public agencies and school employers can contract to have CalPERS provide these benefits to their employees, regardless of whether they contract for our retirement program. Visit Health Program Contracting Agencies for a list of agencies that’ve contracted for health benefits.
- We offer four types of health plans:
- Association Plans (for members of specific employee organizations)
- Exclusive Provider Organizations (EPOs)
- Health Maintenance Organizations (HMOs)
- Preferred Provider Organizations (PPOs)
- We also offer Medicare health benefits plans for those members eligible for Medicare.
- Catastrophic illnesses do not affect coverage or premium rates, which are negotiated on an annual basis.
- Health coverage for employees continues into retirement.
Online Health Enrollment for Active Employees
At your agency’s discretion, active employees can submit most health enrollment changes along with supporting documentation, online through their myCalPERS account. Visit Online Health Enrollment for Active Employees for more information.
Open Enrollment
Open Enrollment takes place each fall. The 2025 Open Enrollment dates are September 15 – October 10. Changes made during Open Enrollment will take effect January 1, 2026.
Sign up for Employer Bulletins to stay up to date on Open Enrollment information.
Health Resources
- Health Benefits (Active Members) - Access member health information including eligibility and enrollment, plans and rates, Medicare, and long-term care.
- Health Procedures - View guides and information on health policies and procedures including enrollment, retroactive health premium reimbursements, types of transactions, and enrollment reason codes.
Health Plan Codes & ZIP Codes
The following Cognos reports provide a listing of ZIP codes for HMO and PPO plans that are available in each county by health plan. Health plan codes for reporting and enrollment purposes are also included.
- Health ZIP Code Yes-No Report-HMO for PA-School
- Health ZIP Code Yes-No Report-PPO for PA-Schools
- Health ZIP Code Yes-No Report-State-CSU
To access the Cognos reports, log in to myCalPERS and select the Reports link within the Common Tasks left-side navigation menu.
For instructions on generating any Cognos report, refer to the myCalPERS Employer Reports (Cognos) (PDF) student guide.
Affordable Care Act
As your health benefits purchaser, CalPERS ensures our health plans comply with all relevant provisions of the Affordable Care Act (ACA) and provides information to our contracting agencies and schools. Employers have certain responsibilities to comply with the ACA and must become familiar with its requirements and effective dates and make policy decisions based on individual needs and practices.
To learn more about the ACA, see Affordable Care Act (ACA) Guidance and review our Circular Letters.
Administrative Fee for Fiscal Year 2024-25
Effective July 1, 2024, the CalPERS Board of Administration set the PEMHCA administrative fee to 0.24%. This administrative fee is calculated on both total active and retired health premiums each month.
Contribution Formula
Contracting agencies are required to provide an employer health contribution toward the cost of the monthly premium for all eligible employees and annuitants. PEMHCA requires minimum contribution amounts and allows for various contribution methods. Contact us to discuss the options available to you.
If your agency is interested in participating in the CalPERS Health Benefits Program, email calpershealth@calpers.ca.gov or call (916) 795-1233. To contract for health and retirement benefits, visit Contracts.
If your agency already has a CalPERS health resolution on file and you'd like to make changes to monthly employer health contributions, email the Health Resolutions and Compliance Unit at HealthContracts@calpers.ca.gov.
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