Health Benefits

How and When to Make Health Changes Outside of Open Enrollment

2 days ago
Smiling gay couple on couch with sleeping child

You’re likely familiar with CalPERS’ annual health Open Enrollment process, which takes place each fall for our active members and retirees who have CalPERS health benefits. But did you know you can make health plan changes outside of Open Enrollment under certain circumstances?

Special Enrollment Examples

When life happens, that’s when special enrollment comes in. Special enrollment includes specific opportunities to change or enroll in health plans when a qualifying life event arises outside of Open Enrollment, such as:

  • Adding or changing spouses, domestic partners, and dependents — If you’re working, contact your personnel office as soon as possible; if you’re retired, contact CalPERS directly as soon as possible.
  • Moving — If you or one of your dependents move, you can choose a health plan available in your new location. If you are an active employee or a working CalPERS retiree, you can enroll in a health plan using either your residential or work ZIP code; members enrolled in Medicare plans must use their residential ZIP code.
  • Retirement — You have a 60-day window from your retirement date to change your health plan.
  • Medicare eligibility — When you become eligible for Medicare, you may choose a new CalPERS Medicare health plan.
  • Coverage loss — If your health benefits are canceled due to an involuntary loss of coverage, you must provide proof that your previous coverage ended. Eligible dependents can also be added due to a loss of coverage.

Things to Remember

If you have a special enrollment need now or in the future, keep these reminders in mind:

  • 60 days — If you experience a qualifying life event, you have 60 days from the date of the life event to submit a change request, so don’t delay!
  • Using myCalPERS — Retirees can now make many health plan changes and special enrollment requests online via myCalPERS. Some active members also can make changes via myCalPERS — contact your employer and ask if they offer this online option.

When change comes your way, CalPERS can help. Call us at 888 CalPERS (or 888-225-7377), or send us a secure message via your myCalPERS account (find out more about using myCalPERS).