Open Enrollment occurred September 11 through October 6. The deadline for processing all Open Enrollment transactions is 11:59 p.m. (Pacific Time) on October 27, 2017. Changes made during Open Enrollment will take effect January 1, 2018.

Anthem Blue Cross Traditional HMO

Butte County Anthem Blue Cross combination plan subscribers can choose a new Medicare Advantage Plan called Anthem Medicare Preferred. It will be offered in combination with the Anthem Blue Cross Traditional HMO plan for non-Medicare members. If you are considering a change in health plans for 2018, an extended open enrollment period is available. Plan changes can be made between October 9 and November 9, 2017. No action is needed for members who want to remain enrolled in the PERSCare, PERS Choice or PERS Select PPO health plans.

If your employees want to make a health plan change due to the addition of the Anthem Medicare Preferred plan, they can by calling us at 888 CalPERS (or 888-225-7377).

Blue Shield Access+ HMO or EPO

Due to the Away From Home Care (AFHC) program no longer being available in 2018, members who had used it in the past have an extended enrollment period if they want to select another plan. Plan changes can be made between October 9 and November 9, 2017. No action is needed for members who want to remain enrolled in the HMO or EPO plan.

If your employees want to make a health plan change due to the AFHC program changes, they can by calling us at 888 CalPERS (or 888-225-7377).

The information below will provide you highlights of 2018 health benefit changes, approved health plans, and monthly premium rates.

Health Plans, Monthly Premium Rates, & COBRA Information

The CalPERS Board of Administration approved the 2018 health plans and monthly premium rates in June 2017. Visit Plans & Rates to view a list of all health plans in the CalPERS Health Program along with the monthly premium rates, and information about Consolidated Omnibus Budget Reconciliation Act (COBRA) premium rates.

Benefit Changes to Plans and/or Regions

  • Western Health Advantage: Western Health Advantage, a new plan partner for 2018, will provide coverage in the counties of Colusa, El Dorado, Marin, Napa, Placer, Sacramento, Solano, Sonoma, and Yolo.
  • Kaiser Permanente: Kaiser Permanente is expanding its coverage to 13 counties in Washington State in 2018: Grays Harbor, Island, King, Kitsap, Lewis, Mason, Pierce, San Juan, Skagit, Snohomish, Spokane, Thurston, and Whatcom.
  • Health Net SmartCare: Health Net SmartCare is moving into Placer County.
  • Anthem Blue Cross: Anthem Blue Cross Select HMO is adding Monterey County to replace the Anthem Monterey Exclusive Provider Organization Plan (subject to regulatory approval).
  • Anthem Medicare Preferred Plan: The new Anthem Medicare Preferred Plan will be available for 2018 in the 36 counties covered by Anthem Traditional HMO. Retired contracting agency members will have an option to purchase dental and vision benefits from Anthem when enrolling in this plan.

Employer Contributions

State & CSU Active Employees — For information regarding employer's contribution, review Rates & Employer Contributions.

State & CSU Retirees — For information regarding employer's contribution, review Rates & Employer Contributions.

Public Agency & School Members — CalPERS informs Public Agency & School members that contributions vary by employer, and to contact their employer to find out how much they contribute toward the monthly premium rate.

The information below outlines roles and responsibilities for processing enrollment transactions for your employees.

Health Benefits Officer Role

As the designated Health Benefits Officer (HBO) or assistant HBO, you are the authorized point of contact to process CalPERS health transactions and provide health eligibility and enrollment information to your employees.

To ensure successful ongoing CalPERS health benefits and communication, all employees should:

  • Have a my|CalPERS account
  • Maintain a current email address, health eligibility ZIP code, and communication preference
  • Know how to access their Health Plan Statement in my|CalPERS
  • Submit Open Enrollment changes from September 11 - October 6, 2017, to you, with the Health Benefit Plan Enrollment Form (Active) (HBD-12) (PDF) and supporting documentation needed to verify their dependents
  • Confirm their new health plan and monthly premium adjustments in their January 2018 paycheck

Verify and Maintain Supporting Documentation

You have a fiduciary responsibility to manage the CalPERS Health Program by ensuring that only eligible employees and their dependents are covered. Employers are responsible for obtaining and maintaining records of all supporting documentation that determines the eligibility of enrolled dependents. At the time of enrollment — or anytime thereafter — you have the right to request additional supporting documentation needed to verify a dependent's eligibility.

To find a list of eligible dependent types and for additional information, refer to the Health Program Guide (PDF).

Health Plan Comparison

Log in to my|CalPERS as a Business Partner to use the Premium Search tool to compare health plans. You can assist your employees with finding health plan options tailored to them and their eligible dependents.

All health enrollment transactions should be submitted through my|CalPERS. Early submission will ensure timely processing of health plan identification cards and proper payroll deductions. For more information on adding and updating health transactions view our my|CalPERS Student Guides.

Submit Transactions

  • All Open Enrollment requests must be received between the Open Enrollment dates of September 11 - October 6, 2017.
  • The deadline for processing all Open Enrollment transactions is 11:59 p.m. (Pacific Time) on October 27, 2017.
  • Your employees may choose to use their employer ZIP code as their health eligibility ZIP code when they first enroll in CalPERS health, upon a move, or during any Open Enrollment period.
  • If you are unable to complete all Open Enrollment transactions before the processing deadline, contact CalPERS at 888 CalPERS (or 888-225-7377). Do not forward unprocessed Open Enrollment request forms to CalPERS.

Anthem Blue Cross Select HMO

Anthem Blue Cross Select HMO is adding Monterey County to its service area and will not offer Anthem Blue Cross Monterey EPO after December 31, 2017. If an employee or retiree enrolled in Monterey EPO would like to be enrolled in Anthem Blue Cross Select HMO, no action is required. CalPERS will enroll the employee or retiree and their dependents in Anthem Blue Cross Select HMO, effective January 1, 2018. If the employee or retiree would like to select a health plan other than Anthem Blue Cross Select HMO, they may do so during Open Enrollment between September 11 and October 6, 2017.

All new Anthem Blue Cross Monterey EPO enrollments will be frozen on October 1, 2017.

COBRA

You may submit transactions for former employees or their dependents enrolled in Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation coverage who want to change health plans or add/delete eligible dependents during Open Enrollment.

Employees on Leave of Absence

You may also submit transactions during Open Enrollment for employees on a leave of absence who want to change plans or add/delete dependents. Employees who do not change plans or add/delete dependents during Open Enrollment may do so within 60 days from the date they return to regular pay status.

Rescind Transactions

You can rescind health transactions when the effective date of the transaction occurs in the future. For example, before the January 1, 2018, effective date, if an employee decides they no longer want to change health plans, you can rescind the transaction in my|CalPERS.

Rescinded transactions must be updated before the December 2017 cut-off date. Open Enrollment transactions rescinded after the December 2017 cut-off date will be adjusted during a subsequent pay period.

Refer to the information below for cut-off dates.

State and CSU Agencies

Visit the Civil Service Benefits Cut-off Calendar to view the State Controller's Office (SCO) payroll cut-off dates.

Contracting Agencies and Schools

Refer to the 2017 Health Billing Cut-Off Dates table, attachment to Circular Letter 600-001-17, 2017 Health Billing Cut-Off Dates and How Payments Are Applied.

Review Health Premium Adjustments

If an employee's January 1, 2018 pay warrant does not reflect the proper premium payment of a health plan change, the premium payment will be adjusted during a subsequent pay period.

Advise the employee to discontinue using their prior plan after December 31, 2017. Verify that my|CalPERS reflects the appropriate enrollment, and advise the employee that the payroll discrepancy will be resolved.

The information below will provide you access to Open Enrollment resources for you and your employees and communication reminders.

Health Plan Statement

Open Enrollment packets, which included a Health Plan Statement, were mailed on August 28, 2017 for those who updated their mailing preference by July 1, 2017.

Publication Ordering

Guide your employees to view, download, or print Open Enrollment publications. You may also provide an electronic copy.

If your employees want a printed publication, they can order by logging in to their my|CalPERS account.