Health Premium Increases Among Lowest in Industry
The CalPERS Board of Administration in June approved the health premium rates for 2019, with an overall average increase of 1.16 percent, our lowest premium increase in 21 years. Compared with national health care industry trends, the rate increase is remarkably low. According to PricewaterhouseCoopers’s Health Research Institute, health care costs for employers and insurers nationwide are projected to increase 6 percent in 2019.
By contrast, here are CalPERS’ average health rate increases:
- Health Maintenance Organization (HMO) plans will increase an average 0.37 percent overall.
- Preferred Provider Organization (PPO) plans will increase an average 2.83 percent overall.
- Medicare plans will increase an average 1.37 percent overall, excluding associations.
About 800,000 CalPERS HMO Basic members (excluding those in association plans) will see their premiums decline in 2019. In fact, overall rates for seven of the nine HMO plans will be less than the 2018 rates.
State premiums for Anthem Traditional HMO will increase by 22.96 percent, Blue Shield by 6.21 percent, and PERSCare Basic by 19.80 percent. State premiums for PERS Select Basic will decrease by 25.56 percent. Public agency and school premiums vary by region.
Notable Health Plan Changes for 2019
Health Net will leave the Sacramento region, which includes Placer, Sacramento, Yolo, and El Dorado counties. Blue Shield Access+ will exit eight counties in the Bay Area: Alameda, Contra Costa, Marin, San Francisco, San Mateo, Santa Clara, Solano, and Sonoma. UnitedHealthcare will exit Bay Area and Other Northern regions, but only for public agencies and schools, not for state.
The PERS Select Basic PPO plan will adopt a value-based insurance design (VBID). This leading-edge approach aims to improve quality and lower costs by emphasizing primary care and introducing cost incentives.
Our Commitment to Health Care Innovation
PPO Basic plan members will enjoy access to new programs that reflect our dedication to wellness:
- SpineZone, an online back and neck pain program. The non-surgical approach combines online assessment and coaching linked to a clinic. The goal is to empower members to use tools and build confidence to manage their pain without surgery or medication, when possible.
- WISDOM, a study to optimize breast cancer screening for women while reducing the unintended consequences of current cancer-screening practices for lower-risk patients. Participants may share their personal information gathered from the study with their physician to help guide their care.
How to Prepare for Open Enrollment
Discover your options. Beginning August 27, log in to your my|CalPERS account—or on your mobile device at mobile.my.calpers.ca.gov—to access Open Enrollment information and resources. Use the Find a Medical Plan tool within my|CalPERS to explore health plans available to you, plus:
- Research and compare available health plans and monthly premium rates, based on your eligibility ZIP code.
- Review side-by-side benefit costs.
- Save customized health searches for future use.
- During Open Enrollment, you may enroll in or change health plans, add eligible dependents, or delete dependents.
Contact your employer’s personnel specialist or health benefits officer for required forms and documentation to make health plan changes.
You may change your health plan online during Open Enrollment through my|CalPERS or on your mobile device. You may also mail your request to CalPERS’ Health Account Management Division at P.O. Box 942715, Sacramento, CA 94229-2715, or call us toll free at 888 CalPERS (or 888-225-7377).
Open Enrollment Goes Mobile
Today, we live on our mobile phones. Now you can make important health decisions there, too. This year, access our new mobile experience for customized Open Enrollment resources. Whether by phone or tablet, mobile.my.calpers.ca.gov helps you discover your options.
Additional Information for State Employees and Retirees
The Open Enrollment period for State of California and California State University (CSU) dental and vision plans is September 10 through October 5, 2018.
State of California Employees and Retirees
Dental and vision programs are administered by the California Department of Human Resources (CalHR). For additional information about state employee dental and vision benefits, visit the CalHR website.
|State of California||Dental||Vision|
|Active Employees||Contact your departmental personnel office||Contact VSP at
stateofcaemployee.vspforme.com or call (800) 877-7195
|Retirees||Contact us at 888 CalPERS (or 888-225-7377)||Contact VSP at
stateofcaretiree.vspforme.com or call (800) 877-7195
CSU Employees and Retirees
Dental and vision programs are administered by the CSU Office of the Chancellor. For additional information about CSU employee dental and vision benefits, contact your campus benefits office. CSU retirees are encouraged to visit the CSU page for specific plan information.
|Active Employees||Contact your campus benefits office or human resources department||Contact VSP at csuactives.vspforme.com or call (800) 877-7195|
|Retirees||Contact us at 888 CalPERS (or 888-225-7377)||Contact VSP at csuretirees.vspforme.com or call (800) 400-4569|