Visit your health plan's website to learn how benefits, claims, and payment of claims are covered, as well as the service limitations and exclusions that may apply. You can also log in to myCalPERS to use the Search Health Plans tool to research the health plan coverage and benefits most important to you and your family.

Some health plans are available only in certain counties and/or ZIP codes. Contact the health plan before enrolling to make sure they cover your ZIP codes and that their provider network is accepting new patients in your area. You may also use our online service, the Health Plan Search by ZIP Code.

Open Enrollment is an annual process that occurs in the fall. During this time, you can enroll, change health plans, add eligible dependents, delete dependents, or cancel coverage. View Annual Health Plan Changes for details on health plans, service areas, and benefit design changes.

Are you an active member? View Active Member Plans & Rates customized just for you.

Rates & Employer Contributions

View How CalPERS Sets Health Premiums to get details on the rates and plans process.

2025

2024

Health Plans

View all health plan Summary of Coverage and Evidence of Coverage documents.

All health plans have geographical restrictions except for PERS Platinum. To find health plans available in your area, refer to Health Plan Search by ZIP Code.

Plan Name Administrator Offers Medicare? Plan Information

Anthem Blue Cross (Basic) (HMO)

  • Select HMO
  • Traditional HMO

Anthem Blue Cross

(855) 839-4524

No

OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan.

Access Anthem Blue Cross’ Transparency in Coverage Machine Readable Files on their website.

Anthem Blue Cross Del Norte (EPO)

Anthem Blue Cross

(877) 737-7776

No

Anthem Blue Cross Del Norte (EPO) will no longer be available as of January 1, 2025.

OptumRx is the PBM providing prescription benefits for this health plan.

Access Anthem Blue Cross’ Transparency in Coverage Machine Readable Files on their website.

Anthem Blue Cross Medicare Preferred (PPO)

Anthem Blue Cross

(855) 251-8825

Yes OptumRx is the PBM providing prescription benefits for this health plan.

Blue Shield of California (HMO)

  • Blue Shield Access+ HMO
  • Blue Shield Trio HMO

Blue Shield of California (EPO)

(800) 334-5847

No

Blue Shield of California administers their own prescription drug benefits.

Access Blue Shield of California’s Transparency in Coverage Machine Readable Files on their website.

Blue Shield of California (EPO)

Blue Shield of California

(800) 334-5847

No

Blue Shield EPO is available in Alpine, Calaveras, Colusa, Del Norte, Inyo, Lake, Lassen, Mendocino, Modoc, Mono, Plumas, San Benito, Shasta, Siskiyou, Sierra, Tehama, Trinity, and Tuolumne counties.

Blue Shield of California prescription benefits are administered by CVS Caremark.

Access Blue Shield of California’s Transparency in Coverage Machine Readable Files on their website.

Blue Shield of California Medicare (PPO)

Blue Shield of California

(888) 802-4599

Yes

Blue Shield of California administers their own prescriptions.

California Association of Highway Patrolmen (CAHP) (PPO)

  • CAHP Basic Health Plan 
  • CAHP Supplement to Medicare
  • CAHP Medicare PDP

Anthem Blue Cross

Accolade Customer Service

(866) 518-1767

Yes

You must belong to the specific employee association and pay applicable dues to enroll in the CAHP. Note: The Prudent Buyer Network for CAHP’s Basic and Combination Plan is available only in California and in limited areas of selected states outside of California. 

CAHP prescription benefits are administered by Express Scripts.

California Correctional Peace Officers Association (CCPOA) Access+ (HMO)

Blue Shield of California

(800) 257-6213

No

You must belong to the specific employee association and pay applicable dues to enroll in the CCPOA. The CCPOA plan is available only to dues-paying members of that organization and their families.

CCPOA prescription benefits are administered through Blue Shield of California.

California Correctional Peace Officers Association (CCPOA) (PPO)

  • CCPOA Medical Plan Medicare (PPO)

Blue Shield of California

(800) 776-4466

Yes

You must belong to the specific employee association and pay applicable dues to enroll in the CCPOA. The CCPOA plan is available only to dues-paying members of that organization and their families.

CCPOA prescription benefits are administered through Blue Shield of California.

Health Net of California (HMO)

  • Salud y Más HMO

Health Net of California

(888) 926-4921

No

OptumRx is the PBM providing prescription benefits for this health plan.

Access Health Net of California’s Transparency in Coverage Machine Readable Files on their website.

Kaiser (HMO)

  • Kaiser Permanente Basic Plan
  • Kaiser Permanente Senior Advantage & Senior Advantage Summit

Kaiser Permanente

(800) 305-1220

Senior Advantage & Senior Advantage Summit

(855) 717-9598

Yes

Kaiser administers its own prescription benefits.

Access Kaiser Permanente’s Transparency in Coverage Machine Readable Files on their website.

Peace Officers Research Association of California (PORAC) (PPO)

  • PORAC Prudent Buyer Health Plan
  • PORAC Out-of-State Basic Health Plan
  • PORAC Supplement to Original Medicare 
  • PORAC Medicare PDP

Anthem Blue Cross

(800) 655-6397

Yes

You must belong to the specific employee association and pay applicable dues to enroll in the PORAC. The PORAC plan is available only to dues-paying members of that organization and their families.

PORAC prescription are administered by Anthem Blue Cross. 

PERS Platinum (PPO)

  • PERS Platinum Basic Plan
  • PERS Platinum Supplement to Medicare Plan
  • PERS Platinum Medicare PDP

As of January 1, 2025

Blue Shield of California

(800) 405-2127

TTY 711

&

Included Health

(855) 633-4436

TTY 711

For the 2024 contract year

Anthem Blue Cross

(877) 737-7776

Yes

Effective January 1, 2025 Blue Shield of California will be the new administrator for the CalPERS PPO plans.

Included Health will be your point of contact for Basic plan information and Blue Shield will be your point of contact for Supplement to Medicare plan information. Visit the 2025 PPO Administrators for Basic Plan Members webpage for more information on this change.

This plan has no geographical restrictions. It provides coverage anywhere in the world.

OptumRx is the PBM providing prescription benefits for this health plan.

Access Anthem Blue Cross’ Transparency in Coverage Machine Readable Files on their website.

PERS Gold (PPO)

  • PERS Gold Basic Plan
  • PERS Gold Supplement to Medicare Plan
  • PERS Gold Medicare PDP

As of January 1, 2025

Blue Shield of California

(800) 405-2127

TTY 711

&

Included Health

(855) 633-4436

TTY 711

For the 2024 contract year

Anthem Blue Cross

(877) 737-7776

Yes

Effective January 1, 2025 Blue Shield of California will be the new administrator for the CalPERS PPO plans.

Included Health will be your point of contact for Basic plan information and Blue Shield will be your point of contact for Supplement to Medicare plan information. Visit the 2025 PPO Administrators for Basic Plan Members webpage for more information on this change.

This plan is only available in California.

OptumRx is the PBM providing prescription benefits for this health plan.

Access Anthem Blue Cross’ Transparency in Coverage Machine Readable Files on their website.

Sharp Health Plan (Basic) (HMO) Sharp Performance Plus

Sharp Health Plan

(855) 995-5004

No

OptumRx is the PBM providing prescription benefits for this health plan.

Access Sharp Health Plan’s Transparency in Coverage Machine Readable Files on their website.

Sharp Direct Advantage (Medicare) (HMO)

Sharp Health Plan

(833) 346-4322

Yes

CVS Caremark is the PBM for Sharp Direct Advantage (Medicare) (HMO).

UnitedHealthcare (Basic) (HMO)

  • UnitedHealthcare SignatureValue Alliance
  • UnitedHealthcare SignatureValue Harmony

UnitedHealthcare

(877) 359-3714

No

OptumRx is the PBM providing prescription benefits for this health plan.

Access UnitedHealthcare’s Transparency in Coverage Machine Readable Files on their website.

UnitedHealthcare (Medicare) (PPO)

  • UnitedHealthcare Group Medicare Advantage
  • UnitedHealthcare Medicare Advantage Edge

UnitedHealthcare

(888) 867-5581

Yes

UnitedHealthcare Medicare Advantage Edge will no longer be available as of January 1, 2025.

The UnitedHealthcare® Group Medicare Advantage (PPO) plans include Medicare Part D prescription drug coverage.

OptumRx is the PBM providing prescription benefits for this health plan.

Western Health Advantage (HMO)

Western Health Advantage

(888) 942-7377

TTY: 711

No

OptumRx is the PBM providing prescription benefits for this health plan.

Access Western Health Advantage’s Transparency in Coverage Machine Readable Files on their website.

Western Health Advantage MyCare Select (Medicare) (HMO)

Western Health Advantage

(888) 942-7377

Yes

Western Health Advantage MyCare Select will no longer be available as of January 1, 2025.

OptumRx is the PBM providing prescription benefits for this health plan.

About Our Plans

  • HMO - A Health Maintenance Organization (HMO) plan provides health care from specific doctors and hospitals under contract with the plan. You pay co-payments for some services, but you have no deductible, no claim forms, and a geographically restricted service area.
  • PPO - A Preferred Provider Organization (PPO) is similar to a traditional "fee-for-service" plan, but you must use doctors in the PPO provider network or pay higher co-insurance (percentage of charges). You must usually meet an annual deductible before some benefits apply. You're responsible for a certain co-insurance amount and the plan pays the balance up to the allowable amount.
  • EPO - The Exclusive Provider Organization (EPO) plan offers the same covered services as an HMO plan, but you must seek services from the plan’s network of preferred providers. You are also able to access physicians and specialists that participate in the network without a referral. You pay copayments, for some services, but you have no deductible, no claim forms, and a geographically restricted service area.
  • Combination Plans - A combination plan means at least one family member is enrolled in a Medicare health plan and at least one family member is enrolled in a Basic health plan through the same health carrier. CalPERS requires all family members to have the same health carrier.

Check out our article HMO, PPO, and EPO – What’s the Difference and Why Does It Matter? for information on the different types of plans.

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