September 5, 2019

Communications & Stakeholder Relations
Contact: Stephanie Buck, Information Officer
(916) 795-3991 - newsroom@calpers.ca.gov

Online tool enables members to now search for doctors by insurance plan

SACRAMENTO, Calif. – The annual CalPERS health Open Enrollment period starts Monday, September 9 and ends Friday, October 4. Changes made during this period affect health plans for the 2020 calendar year.

During Open Enrollment, members enrolled in CalPERS health plans have the opportunity to review health coverage options for 2020 from the system's seven Health Maintenance Organizations (HMO), three self-funded Preferred Provider Organization (PPO) health plans, and three association plans. Beginning Monday, September 9, members may enroll in or switch their CalPERS health plan, add eligible dependents, or delete dependents.

New health premiums will go into effect on January 1, 2020. CalPERS health plans will see an overall average premium increase of 4.65 percent next year, although individual plans may be higher. The CalPERS Board of Administration approved the rates in June.

New this year, members can search for the CalPERS health plans their doctor accepts. Using the Search Health Plans tool in my|CalPERS, they can also explore available health plans based on their eligibility ZIP code and review side-by-side benefit costs. For the initial launch, the search includes doctors in Basic health plans. Medicare members need to contact plans directly, as they do today, to verify their doctor is included in their Medicare plan.

CalPERS' Basic (non-Medicare) health plan options include 10 HMO plans through Anthem Blue Cross of California, Blue Shield of California, Health Net, Kaiser Permanente, Sharp Health Plan, UnitedHealthcare, and Western Health Advantage.

The system's three Basic PPO plans, offered through third-party administrator Anthem Blue Cross, are PERS Select, PERS Choice, and PERSCare. Medicare health plans are offered through Anthem, Kaiser, UnitedHealthcare, and the three PPO plans.

The plans made two notable service changes for 2020:

  • Blue Shield will introduce a new, narrow-network health plan called Trio for the following six counties: El Dorado, Los Angeles, Nevada, Placer, Sacramento, and Yolo.
  • Anthem will introduce a new Medicare and combination plan for Monterey County. Contracting agency Medicare members enrolling in this plan may include dental and vision benefits for an additional fee.

There are no co-pay, benefit, or co-insurance changes for 2020, with the exception of association plans which do not fall under CalPERS purview.

Members may access their health plan information through their my|CalPERS accounts. There they can review their customized Health Plan Statement, which details their current health coverage, their 2020 premium if they remain enrolled in their current health plan, and a list of the health plans offered in 2020.

Some members continue to receive their statements and Open Enrollment materials by mail; however, their information is also available to them through my|CalPERS. In addition, Open Enrollment information is available on our website.

To make changes to their health plans, active employees must contact their personnel specialist or health benefits officer for required forms and documentation. Retirees may elect changes through my|CalPERS, via their mobile devices at mobile.my.calpers.ca.gov, via mail, or by calling CalPERS toll free at 888 CalPERS (or 888-225-7377).

About CalPERS

For more than eight decades, CalPERS has built retirement and health security for state, school, and public agency members who invest their lifework in public service. Our pension fund serves more than 1.9 million members in the CalPERS retirement system and administers benefits for 1.5 million members and their families in our health program, making us the largest defined-benefit public pension in the U.S. CalPERS' total fund market value currently stands at approximately $378 billion. For more information, visit www.calpers.ca.gov.