Health Benefits

Fast Facts to Know About CalPERS Health Benefits

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Today, we are sharing the third post in a series of Fast Facts for CalPERS members.

CalPERS releases the annual Facts at a Glance at the end of each fiscal year to provide members, stakeholders, and the public with a wide range of data and information about the state of the system.

Here are some important facts about our health benefits program:

  • CalPERS is the largest public employer purchaser of health benefits in California and the second largest employer purchaser in the nation after the federal government. In 2019, we spent $9.2 billion to purchase health benefits for our 1.5 million members.
  • Out of the 1.5 million people, 58% are state members, 28% are public agency members, and 14% are school members.
  • Our 2021 overall Medicare and Basic (non-Medicare) rate increased an average of 4.32% overall. The overall impact of COVID-19 on CalPERS’ 2021 rates was 0.57%. Factors included in projecting COVID-19’s impact included the savings due to delayed and deferred care in 2020, which CalPERS was able to use to reduce rate increases for 2021.
  • Close to 1,200 employers contract with us for health benefits, while we have more than 2,800 employers that contract for retirement benefits.
  • We have saved approximately $8 million annually since 2011 through innovative health care approaches. This includes optimizing our reference pricing program for value-based medical procedures in our self-funded PPO basic plans.
  • The average out-of-pocket cost for health care services and prescription drugs that CalPERS members paid in 2019 was $329.
  • Over the past 10 years, total enrollment in CalPERS health plans has increased by 12%.
  • Population age, gender, geographic location, chronic conditions, and hospital and pharmaceutical use are the top drivers of CalPERS health plan premium costs.
  • The CalPERS population on average is older and has a higher prevalence of chronic conditions when compared to other insured populations.

Learn more about CalPERS health benefits by reading Facts at a Glance on Health Benefits (PDF) and our Health Benefits Program Annual report (PDF). You can also read our Facts at a Glance on Pension & Retirement (PDF), Investment & Pension Funding (PDF), and About CalPERS (PDF).