As Open Enrollment approaches this year, it may be time to consider looking at other health plans and making a change. Maybe you want a plan with a lower premium or out-of-pocket costs. It’s possible your doctor is in a plan with a lower premium. You may also want access to different provider networks and hospitals. Whether you want to consider a change or confirm your plan is still right for you, we can help.
We have a variety of tools and resources to help you make an informed decision. From understanding where to start to comparing plans, here are six resources to help you pick the best coverage for you.
1. Health Plan Statement with Plan Premiums
On September 12, your 2023 health plan statement will be available in your myCalPERS account. It provides your monthly premium for 2023 if you don’t change plans. It also informs you of any changes to your plan for next year as well as lists your dependents. With this starting point, you may decide to explore other plans available to you and see if there’s a better option.
2. Search Health Plans
To explore and compare plans, monthly premiums, and search for doctors and specialists, log in to your myCalPERS account. With our easy-to-use Search Health Plans tool, you can see available plans based on your eligibility ZIP code, review side-by-side benefit costs, and see health plan member satisfaction ratings.
3. Health Benefit Summary
For an easy-to-read side by side comparison of health plans and benefits, view or download the Health Benefit Summary publication, which will be on our website September 12. The benefit comparison charts on pages 16-31 summarize benefit information such as copays, coinsurance, and deductibles for each health plan. All CalPERS Basic Health Maintenance Organization (HMO) plans provide the same benefit design, and all plans offer diabetes prevention programs, acupuncture, and chiropractic benefits. The Health Benefit Summary also includes information on how CalPERS health plans work and a health plan directory if you have questions about a specific plan’s benefits, providers, or coverage.
4. Your Guide to Choosing a Health Plan
This one-page checklist (PDF) includes factors to consider when choosing a plan as well as a list of tools and resources available to help you choose the best plan for you.
5. Summary of Benefits and Coverage & Evidence of Coverage
These booklets available on the CalPERS website describe what the plan pays for and what you pay for. They also describe the terms and conditions of coverage including which services are covered as well as the limitations and exclusions that apply to the plan. The 2023 Evidence of Coverage booklets will be on our website September 12.
6. Health Plan Choice Worksheet
Page 12 of the Health Benefit Summary publication features a worksheet that guides you through steps to compare factors such as premiums, estimated out-of-pocket cost, availability, benefits, quality of care, and wellness across the plans you’re interested in. With this more complete view comparing the plans, you’ll be able to make a well-informed decision and select or confirm the plan that’s right for you.
Get Ready for Open Enrollment
You can make a change during Open Enrollment, September 19 – October 14. You will find additional resources on the actives and retirees Open Enrollment pages on our website.
Make your changes online through myCalPERS. Active employees with their employer’s approval can also now make changes online through their myCalPERS account.
If you don’t plan to make any changes, no action is needed.