Select contracts between Blue Shield of California and two health care providers — the UC Health System and Hoag Health Network — are set to expire on June 30, 2025. While these negotiations are separate and ongoing, we want to make you aware of which plans would be impacted and what CalPERS members can expect.
Who would be affected by a UC or Hoag health system contract termination?
If there’s a contract termination, it would affect CalPERS members who are insured by select Blue Shield of California plans who receive their care through the UC or Hoag health systems.
Specifically, this would impact Blue Shield of California members who are enrolled in:
- PERS Platinum PPO
- PERS Gold PPO
- Blue Shield Access+ HMO and EPO
- Trio HMO
Would Medicare members be impacted by this potential termination?
There would be no impact to CalPERS members enrolled in the PERS Gold and PERS Platinum Medicare Supplement plans. Members enrolled in Blue Shield’s Medicare Advantage PPO plan will receive letters informing them of the potential contract termination. However, these members may continue to see any provider, hospital, or medical facility that accepts Medicare.
Which hospitals would be impacted?
The University of California (UC) Health System includes UC Davis, UCLA, UC San Diego, UC San Francisco, UC Irvine, and UC Riverside hospitals as well as associated children’s hospitals, facilities, and medical groups.
The Hoag Health Network includes any Hoag hospital, clinic, and specialty center such as Hoag Hospital Newport Beach, Hoag Hospital Irvine, Hoag Medical Group, and the Hoag Orthopedic Institute.
How will CalPERS members be updated on the contract negotiations?
Blue Shield mailed letters to potentially impacted HMO members on May 1, 2025, notifying them of the possibility of contract terminations. Members in PPO plans will be sent letters at a later date. If no new deal is reached, Blue Shield will match members with new primary care physicians to ensure access to care.
CalPERS remains committed to ensuring members receive timely updates on contract negotiations.
Would this impact Blue Shield members who are being treated for ongoing or long-term conditions?
By state and federal law, health contracts must provide for continuity of care. This means members with certain specific conditions — such as those who are pregnant or with a newborn, individuals with chronic conditions, significant mental health issues, and those undergoing treatment for a potentially terminal illness — will continue to be able to see their current providers in-network for the time specified by the continuity of care provisions.
For a full list of covered conditions contact customer service at the number on your member ID card or call the Department of Managed Health Care at 1-888-466-2219 for more information.
Would a termination be considered a qualifying event, allowing CalPERS members to change health plans?
No, contract terminations are not considered a qualifying event to change health plans. Members would not be able to change health plans because of a termination. They would be eligible to change their coverage during our regularly scheduled Open Enrollment period from September 15 through October 10, with coverage effective January 1, 2026.
What is CalPERS’ policy on health provider disruptions?
The CalPERS policy on potential provider disruptions (PDF) allows the parties to continue negotiations and work toward resolution, without favoring one side over the other by intervening. CalPERS believes strongly that it is inappropriate for providers and health plans to involve members in contract disputes and has communicated that position during these negotiations.