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 in the fall.
2025
We’re providing you with information on the 2025 health plan proposals (PDF) approved in November 2023 by the CalPERS Board of Administration.
There’s no action for you to take now.
These proposals become part of our rate development process when we set health premiums. The Pension and Health Benefits Committee will review preliminary 2025 health premiums and any additional proposed plan and benefit changes in June 2024 and approve final premiums and changes in July 2024.
For a full list of our available health plans, view the Plans & Rates page.
Basic Plan Expansions
Health Plan | Changes |
---|---|
Blue Shield Trio | Expansion into:
|
Health Net Salud y Más | Expansion into Imperial county* |
Kaiser Permanente | Expansion into 14 ZIP codes in Monterey county* |
UnitedHealthcare SignatureValue Harmony | Expansion into:
|
Benefit Design Changes
Benefit | Changes |
---|---|
Doula Benefit for all Pregnant and Postpartum Members | New benefit for all pregnant and postpartum Basic plan members to receive health education, advocacy, physical and emotional non-medical support before, during and after pregnancy, miscarriage, stillbirth, and abortions. |
Travel Benefit for Medically Necessary Care | Update to standardize travel and lodging coverage for eligible medically necessary services including, but not limited to abortion services, gender affirming care, complex surgeries, and cancer care that cannot be accessed within 50 miles from the member’s residence for all Basic and Medicare plan members, up to $5,000 per occurrence. This includes transportation, lodging, and meals for the member and a companion (both parents/guardians when patient is under 18). |
2024
We’re providing you with information on the 2024 health plan changes approved in November 2022 (PDF) and March 2023 (PDF) by the CalPERS Board of Administration.
There’s no action for you to take now.
These proposals become part of our rate development process when we set health premiums. The Pension & Health Benefits Committee approved final premiums in July 2023.
Health plans indicated below will have changes in 2024. There are no other changes to our health plans or benefits except those described here. For a full list of our available health plans, view the Plans & Rates page.
Basic Plans
Health Plan | Changes |
---|---|
Anthem Blue Cross Select | Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications |
Anthem Blue Cross Traditional |
Exits Glenn County* Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications |
Blue Shield Access+ EPO | Expansion into Del Norte and San Benito counties |
Health Net Salud y Más | Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications |
Health Net SmartCare of California | Exits all counties; no longer part of CalPERS health plan offerings* |
Sharp Health Plan Performance Plus | Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications |
UnitedHealthcare SignatureValue Alliance |
Expansion into 12 counties for public agencies and schools members: Alameda, Contra Costa, Marin, Merced, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma, and Stanislaus Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications |
UnitedHealthcare SignatureValue Harmony |
Expansion into Santa Clara and Santa Cruz counties Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications |
Western Health Advantage | Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications |
Health Plan | Changes |
---|---|
PERS Gold |
Site of care lab services incentive waives coinsurance when members use preferred lab providers for routine lab tests Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications Basic PPO out-of-network deductible will increase from $1,000 to $2,500 |
PERS Platinum |
Site of care lab services incentive waives coinsurance when members use preferred lab providers for routine lab tests Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications Basic PPO out-of-network deductible will increase from $500 to $2,000 |
Medicare Plans
Health Plan | Changes |
---|---|
Anthem Blue Cross Medicare Preferred PPO | New supplemental benefits: Personal Emergency Response System (PERS) devices and in-home support services |
Kaiser Permanente Senior Advantage Summit | Expansion into eight out-of-state regions: Colorado, Hawaii, Georgia, Northwest (Oregon, Washington), Mid-Atlantic (Virginia, Maryland, District of Columbia), and Washington |
UnitedHealthcare Medicare Advantage Edge | Changing from $0 to a $50 copay for emergency room visits |
Western Health Advantage MyCare Select | Expansion into Humboldt County |