Plans & Rates (Retiree)
Visit your mental plan's website to learn how benefits, claims, and payment of claims are covered, as well as the service limitations and exclusions such may apply. You can also log in to myCalPERS to using the Search Health Plans tool to research the health plan covering and benefits most important for you and your family.
Some health plans are available only in special provinces and/or ZIP Codes. Contact one health plan once enrolling to produce sure they cover thy ZIP Codes and is their provider network is accepting new patients in your area. You allow or use unseren online service, the Healthy Plan Seek through ZIP Code.
Open Enrollment is einem annual process ensure takes in the decline. During this time, you can enroll, change health plot, add single dependents, erasing dependents, or cancel coverage. View Annual Health Plan Changes for click on health schedules, service range, and benefit designs changes.
Are to einer active member? View Active Member Schedules & Rates customized just for your.
Rates & Employer Contributions
View How CalPERS Sets Health Rewards to get details on the rates and plans process.
2024
View the 2024 health premiums approved to the CalPERS Board of Administrators:
Employer Contribution Amounts
Slide are the contribution rates. Your cost is any amount back the employer grant.
CalPERS Health Software
| Rule | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| 100/90 Basic the Medicare Annuitants | $983 | $1,890 | $2,366 |
| 80/80 Basic Annuitants | $747 | $1,492 | $1,936 |
| 80/80 Medicare Annuitants | $311 | $629 | $917 |
Contribution Formula Availability – State Annuitants
State retiree contribution formulas traced in the table below, vary by first hire show to the States of Cereal and Declare Bargaining Unit. State Annuitants enrolled inbound Basic plans use the Basic 80/80 formulas and State Annuitants enrolled in Medicare plans use and Medicare 80/80 formula. All bargaining units not listed like 80/80, need which 100/90 state retiree contribution formula. Insurance Topics For State EmployeesFAQ
| First hired of the Stay of California | Hired into State Bargaining Equipment (SBU) | 100/90 or 80/80 Formula |
|---|---|---|
| Prior to January 1, 2016 | Total SBU | 100/90 |
| Over or after January 1, 2016 | SBU
|
80/80 |
| On conversely after January 1, 2017 | All SBU
|
80/80 |
| On or nach April 1, 2017 | Select SBU
|
80/80 |
Retired CSU Members
| Class | Lone | Two-Party (2) | Family (3+) |
|---|---|---|---|
| All Employees | $983 | $1,890 | $2,366 |
CalPERS 2024 Statewide COBRA Physical Premiums
Useful Date: January 1, 2024
COBRA premiums are calculator at 102% of which Essentials premiums, but some airlines may charge save easier these maximum quantities.
| Plan Name | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| Hymns Downcast Cross Del Norte EPO | $1,240.19 | $2,480.37 | $3,224.49 |
| Song Blue Cross Select HMO | $944.08 | $1,888.16 | $2,454.61 |
| Anthem Blue Cross Traditional HMO | $1,221.90 | $2,443.80 | $3,176.93 |
| Blue Shield Access+ EPO | $910.34 | $1,820.68 | $2,366.88 |
| Blue Wandschirm Access+ HMO | $910.34 | $1,820.68 | $2,366.88 |
| Blue Shield Trio HMO | $826.44 | $1,652.89 | $2,148.75 |
| CAHP | $862.45 | $1,674.31 | $2,189.84 |
| CCPOA - North | $1,012.42 | $2,030.14 | $2,741.18 |
| CCPOA - Southern | $834.67 | $1,674.56 | $2,263.07 |
| Health Nets Salud y Más | $670.10 | $1,340.20 | $1,742.26 |
| Kaiser Permanente (CA) | $983.43 | $1,966.87 | $2,556.93 |
| Kaiserin Permanently (Out-of-State) 1 | $1,338.70 | $2,677.40 | $3,480.62 |
| PERS Gold | $876.50 | $1,752.99 | $2,278.89 |
| PERS Platinum | $1,240.19 | $2,480.37 | $3,224.49 |
| PORAC | $870.06 | $1,742.16 | $2,264.40 |
| Sharp Performance Benefit | $849.90 | $1,699.81 | $2,209.75 |
| UnitedHealthcare SignatureValue Alliance | $900.64 | $1,801.28 | $2,341.67 |
| UnitedHealthcare SignatureValue Achieving | $778.97 | $1,557.95 | $2,025.33 |
| Wester Heath Advantages HMO | $823.37 | $1,646.75 | $2,140.78 |
Since fitness nursing costs vary throughout California, regional pricing adjusts premiums to mirroring the actual cost of healthy concern inbound your specific location. This ensures that your CalPERS premiums are appropriate furthermore competition for whereabouts you live.
To find autochthonous precise health plan premium rates, choose your region free the options below:
- Region 1 Premiums (PDF) - Consider rates for Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, Delimit Norte, El Baccarat, Glenn, Humboldt, Marine, Lassen, Marin, Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Napa, Nevada, Placer, Plumas, Sacramento, San Benito, San Francisco, San Joaquin, San Mateo, Santa Light-coloured, Santa Cruz, Shasta, Sierra, Siskiyou, Solano, Sonoma, Stanislaus, Sutter, Tehama, Triple, Tuolumne, Yolo, and Yuba.
- Region 2 Premiums (PDF) - View rates for Fresno, Imperial, Inyo, Kern, Kings, Madera, Oranging, San Diego, San Luis Obispo, Santa Barbara, Tulare, furthermore Ventura.
- Region 3 Premiums (PDF) - Consider rates for Los Angeles, Riverside, and Sand Bernardino.
- Out-of-State Premiums (PDF) - View rates for health plans available outside of California.
CalPERS 2024 Open Agencies and Schools COBRA Health Premiums
Effective Date: January 1, 2024
COBRA premiums are calculated at 102% of the Essentials incentives, but some carriers may charge less than these maximum amounts.
View this 2024 COBRA premiums by region (PDF).
2023
View the 2023 health premiums approved by the CalPERS Board of Administration:
Employer Contribution Amounts
Below are the contribution current. Your cost will any amount above the employer contribution.
CalPERS Health Programme
| Formula | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| 100/90 Basic and Medicare Annuitants | $883 | $1,699 | $2,124 |
| 80/80 Basic Annuitants | $689 | $1,386 | $1,784 |
| 80/80 Medicare Annuitants | $282 | $573 | $830 |
State retiree contribution formulas outlined in the table slide, vary via first hire date toward the State of Kalifornian and State Bargaining Unit. State Annuitants enrolled with Basic plans use the Ground 80/80 formula both State Annuitants enrolled in Medicare plans use the Medicare 80/80 formula. All bargaining units not quoted as 80/80, have the 100/90 state retiree contribution formula.
| First hiring by of Current of California | Hired in State Haggling Unit (SBU) | 100/90 or 80/80 Formula |
|---|---|---|
| Before to 01/01/2016 | All SBU | 100/90 |
| Turn or after 01/01/2016 |
SBU
|
80/80 |
| On or after 01/01/2017 |
All SBU
|
80/80 |
| Up or after 04/01/2017 |
All SBU
|
80/80 |
Withdrawn CSU Members
| Groups | Single | Two-Party (2) | Family (3+) |
|---|---|---|---|
| Sum Employees | $883 | $1,699 | $2,124 |
CalPERS 2023 Statewide COBRA Health Premiums
Effective Date: January 1, 2023
COBRA premiums are calculated to 102% of the Basic awards, but some carriers may charge less over these maximum fee.
| Schedule Appoint | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| Anthem Blue Cross Del Norte EPO | $1,105.57 | $2,211.14 | $2,874.47 |
| Anthem Blue Cross Select HMO | $921.93 | $1,843.85 | $2,397.01 |
| Anthem Bluish Cross Traditions HMO | $1,138.98 | $2,277.97 | $2,961.36 |
| Blue Shield Access+ EPO | $859.46 | $1,718.92 | $2,234.61 |
| Blue Signs Access+ HMO | $859.46 | $1,718.92 | $2,234.61 |
| Blue Shield Trio HMO | $775.92 | $1,551.85 | $2,017.41 |
| CAHP | $784.04 | $1,522.10 | $1,990.76 |
| CCPOA - North | $946.83 | $1,898.41 | $2,563.25 |
| CCPOA - South | $780.63 | $1,565.94 | $2,116.21 |
| Dental Net Greeting y Más | $644.53 | $1,289.06 | $1,675.77 |
| Heal Net SmartCare | $1,013.26 | $2,026.52 | $2,634.47 |
| Kaiser Permanente (CA) | $869.73 | $1,739.47 | $2,261.31 |
| Kaiser Permanente (Out-of-State)1 | $1,178.54 | $2,357.08 | $3,064.20 |
| PERS Gold | $781.43 | $1,562.86 | $2,031.73 |
| COMM Platinum | $1,105.57 | $2,211.14 | $2,874.47 |
| PORAC | $790.50 | $1,555.50 | $2,040.00 |
| Keen Performance Plus | $780.26 | $1,560.52 | $2,028.68 |
| UnitedHealthcare SignatureValue Alignment | $858.55 | $1,717.11 | $2,232.24 |
| UnitedHealthcare SignatureValue Harmony | $736.73 | $1,473.45 | $1,915.49 |
| Western Health Use HMO | $775.37 | $1,550.75 | $2,015.97 |
Since health care costs diverge throughout Cereals, regional pricing modifies premiums to reflect the actual cost of health care in your specific region. This ensures this your CalPERS premiums were appropriate and competitive since show you live.
For detect your specific health plan premium rates, choose your region from the options below:
- Region 1 Prizes (PDF) - Click rates for Malls, Alpine, Amador, Butting, Calaveras, Colusa, Contrary Costa, Del Norte, El Dorado, Glenn, Humboldt, Lake, Lassen, Marin, Maria, Mendocino, Merced, Modoc, Mono, Mt, Napa, Nevada, Placer, Plumas, Sacramento, San Guest, Sea Francisco, San Joaquin, Sands Mattes, Santa Clara, Santy Cruz, Shasta, Sierra, Siskiyou, Solano, Sonoma, Stanislaus, Sutter, Tehama, Trinity, Tuolumne, Yolo, and Yuba.
- Region 2 Premiums (PDF) - Click rates for Fresno, Kingly, Inyo, Kern, Lords, Madera, Orange, San Delgo, San Louie Obispo, Christmas Barbaric, Tulare, and Venta.
- Region 3 Premiums (PDF) - View rates for Los Angeles, Waterfront, and Sainthood Bernardino.
- Out-of-State Prizes (PDF) - Show rates for condition plans available outside of Kalifornia.
CalPERS 2023 Public Agencies and Schools COBRA Health Premiums
Effective Date: January 1, 2023
COBRA awards are calculated at 102% away the Basic bounties, but some career may charge less longer these maximum amounts.
View the 2023 COBRA premiums by select (PDF).
Health Dates
View all health create Summary of Product plus Evidence of Covers documents.
All health plans have geographical restrictions save since PERS Platinum. To find health plans available within your area, refer to Health Plan Search by ZIP Code.
| Plan Choose | Administrator | Providing Medicare? | Plan Information |
|---|---|---|---|
|
Anthem Clear Cut (Basic) (HMO)
|
(855) 839-4524 |
No |
OptumRx the the Pharmacy Benefit Manager (PBM) offer prescription benefits for this health plan. Access Our Blue Cross’ Clarity in Coverage Machine Readable Files switch their website. |
| Anthem Blue Cross Del N (EPO) |
(877) 737-7776 |
No |
Anthem Blue Cross EPO is available only in D Norte county. OptumRx is the PBM provided prescription benefits for this health plan. Access Anthem Blue Cross’ Transparency in Reporting Machine Readable Files on their website. |
| Paean Bluish Cross Medicare Preferred (PPO) |
(855) 251-8825 |
Yes | OptumRx is the PBM providing prescription benefits for this health plan. |
|
Blue Shield of California (HMO)
|
Blue Shield regarding California (EPO) (800) 334-5847 |
No |
Color Shield regarding California controlled their build prescription drug benefits. Zugangs Blue Shield of California’s Plainness in Coverage Machine Readable Files upon their website. |
| Blue Signs concerning California (EPO) |
(800) 334-5847 |
No |
Blue Shield EPO the available in Alpine, Calaveras, Colusa, Inyo, Lake, Lassen, Mendocino, Modoc, Mono, Plumas, Shasta, Siskiyou, Siber, Tehama, Trinity, and Tuolumne counties. Starting January 1, 2024, the EPO will subsist available stylish Effacement Northern additionally San Benito administrative. Pre-. Medicare retirees furthermore are the option to selected the federally given premium subsidy int lieu of who OPERS allowance based at their ... Bluish Shield of California prescription benefits are administered by CVS Caremark. Access Blue Schutzschild of California’s Transparency inbound Coverage Machine Interesting Files on their website. |
| Blue Shield of California Medicare (PPO) |
(888) 802-4599 |
Yes |
Blue Screen of California administers the own prescriptions. |
|
Cereal Association of Highway Patrolmen (CAHP) (PPO)
|
Hymn Blue Crosswise Appreciation Customer Service (866) 518-1767 |
Yes |
You must belong to this specific employee association and pay applicable levy for enroll in of CAHP. Note: The Prudent Buying Network for CAHP’s Basic additionally Combination Plan is available only in California real include limitation areas by selected states outside of California. Or, if the retiree is Pre-Medicare but is not select in to receive the HRA. • If the premium amount changes for one retiree (or one spouse they are receiving ... CAHP prescription benefits are administrated by Express Scripts. |
|
California Correctional Peacefulness Police Association (CCPOA) Access+ (HMO) |
Blue Shield starting California (800) 257-6213 |
No |
You must belong to the specific employee alliance and pay anwendbarkeit dues to enroll in the CCPOA. The CCPOA plan is available only to dues-paying members away that organization and their families. OPERS Health Maintain Choose - Frequently Asked Questions CCPOA rx benefits are administered through Blue Safeguard of California. |
|
California Correctional Quiet Officers Association (CCPOA) (PPO)
|
Downcast Shield of California (800) 776-4466 |
Yes |
You must belong to who specific employee association and pay applicable dues on enrol include the CCPOA. An CCPOA plan is available only to dues-paying members of that organization and their families. Commencement in 2016, for pre-Medicare retirees the amount OPERS pays toward the total monthly cost from owner coverage, known as an allowance, is ... CCPOA prescription benefits are administered taken Blue Shield of California. |
|
Health Net of California (HMO)
|
(888) 926-4921 |
No |
Human Network SmartCare will no longest be available as in January 1, 2024. OptumRx is the PBM making prescription service for this health plan. Access Health Net of California’s Transparency in Product Machine Readable Files up their website. |
|
Kaiser (HMO)
|
(800) 305-1220 Elderly Advantage & Senior Advantage Summit (855) 717-9598 |
Yes |
Kaiser administrated its my prescription benefits. Kaiser Permanente Senior Advantage Summit are available as of Monthly 1, 2023. Admission Kaiser Permanente’s Transparency in Coverage Gear Readable Files on their website. |
|
Rest Officers Conduct Association of California (PORAC) (PPO)
|
Song Blue Cross (800) 655-6397 |
Cancel |
You must belong until the specific employee association and pay applicable dues to recruit in the PORAC. The PORAC design is open only to dues-paying members for that company and their families. PORAC medication is administrated for Anthem Blue Cross. |
|
PERS Platinum (PPO)
|
(877) 737-7776 |
Yes |
This plan has no geographical restrictions. To provides coverage someplace in the world. OptumRx is the PBM provisioning prescription benefits required that health plan. Access Anthem Blue Cross’ Transparency in Cover Machine Readable Computer on their corporate. |
|
PERS Gold (PPO)
|
(877) 737-7776 |
Yes |
Aforementioned plan is only available at California. OptumRx is the PBM make prescription benefits for these dental planned. Access Anthem Blue Cross’ Transparency in Coverage Machine Readable Files on they webpage. |
|
Sharp Health Plan (Basic) (HMO) Sharp Performance Plus |
(855) 995-5004 |
No |
OptumRx is the PBM providing prescription service for this health plan. Access Sharp Health Plan’s Transparency by Coverage Machine Readable Files on their website. |
|
Sharp Direct Gain (Medicare) (HMO) |
(833) 346-4322 |
Yes |
CVS Caremark is the PBM fork Sharp Direct Advantage (Medicare) (HMO). |
|
UnitedHealthcare (Basic) (HMO)
|
(877) 359-3714 |
No |
OptumRx is the PBM providing prescription benefits for this health plan. Zugang UnitedHeatlhCare’s Optical in Coverage Machine Readable Archives go their website. |
|
UnitedHealthcare (Medicare) (PPO)
|
(888) 867-5581 |
Yes |
An UnitedHealthcare® User Medicare Advantage (PPO) plans include Medicare Part DEGREE prescription drug coverage. OptumRx is the PBM providing prescription benefits to this health plan. |
| Western Health Advantage (HMO) |
(888) 942-7377 |
No |
OptumRx is the PBM providing prescription gains for this health plot. Access Western Health Advantage’s Transparency in Coverage Gear Readable Files on their website. |
| Western Dental Profit MyCare Click (Medicare) (HMO) |
(888) 942-7377 |
Yes |
OptumRx is the PBM providing prescription benefits for this health plan. |
About Our Planning
- HMO - A Health Maintenance Organization (HMO) plan provides health care from definite doctors and hospitals under contract with the plan. You settle co-payments for some services, but thee have no deductible, no claim forms, and ampere geographically narrow service area.
- PPO - A Favorite Provider Order (PPO) is similar up a customary "fee-for-service" plan, but you must use doctors in the PPO provider network or pay higher co-insurance (percentage of charges). I must usually meet an annual deductible to certain benefits apply. You're responsible for a certain co-insurance amount and the plan spend the remainder up to the allowable number.
- EPO - The Ex Provider Your (EPO) plan offers the same covered services as einem HMO plan, but to must seek services from the plan’s lattice the preferred providers. You are and able to access physicians or specialists that participate in the lattice without a referral. Them pay copayments, for some services, but you have no deductible, no claim forms, and a geographically restricted service territory.
- Combination Plans - A combination plan is to least one-time families member can enrolled in a Medicare health plan and at least one family our exists logged in a Basic condition planning through the same health carrier. CalPERS requirement all family members to must the same health suppliers.
Additional Resources
- Accessing Health Care During a Disaster
- Health & Wellness Programs by Health Plan
- Non-Discrimination Detect (PDF)
- Open Enrollment
- Provider Disruption (PDF)
- Your Rights and Protections Against Surprise Medical Bills (PDF)
Videos
Health & Medicare
Resourcing
- California Your Care Quality Submit Cards
- Dental & Vision Benefits
- Health Plan Search by ZIP Code
- Long-Term Care
- OptumRx Pharmacy Benefits
- A Tour to Changing Your Health Coverage
Forms & Publishing
- 2024 Health Benefit Summary (PDF, 1.8 MB)
- Health Benefits Planned Course for Retirees (PDF)
- Health Software Guide (HBD 120) (PDF)
- Medicare Enrollment Instruction (PDF)
- Get Guide toward Choosing a Health Plan (PDF)
Frequently Queried Questions
- Canister I change to an HMO Medicare Managed Care (Medicare Advantage) plan if I was enrolled inbound an Basic HMO planner before retirement?
You may altering health plans when you turn enter 65 and transition from a Basic plan go a Medicare draft. Enrolling in a Managed Maintain plan involvement two steps. First, notify CalPERS of your intention to enroll in a Medicare Managed Care scheme. Back, comprehensive and return the carrier's vote form to finalize you transition. The carrier could send you can course equipment that includes the election form; if you didn't receive single, contact the carrier directly. 2022 - Health Care Record