Health Benefits

What’s New for CalPERS Health Plans and Benefits in 2023?

Starting next year, members will have even more health plan choices as well as benefit designs focused on equity and high-quality care.

In 2023, members living in every county throughout the state will have at least two health plans to choose from: our current Preferred Provider Organization (PPO) plans as well as a managed care plan. For the first time, members who live in more rural areas throughout the state may have the option to switch to a Health Maintenance Organization (HMO) or Exclusive Provider Organization (EPO) plan that offers lower cost share and possibly a lower monthly premium.

This is one of several changes we’re making to better serve you. There are no other changes to health plans or benefits except those described below. For a full list of current health plans available in 2022, view the Plans & Rates page on the CalPERS website.

What’s Next?

There’s no action for you to take now. We’re providing you with this information to help you make an informed decision during Open Enrollment, held September 19 through October 14.

The 2023 preliminary health plan premiums were presented to the Pension & Health Benefits Committee on June 14. On July 12, the board will adopt the final premiums, which will take effect January 1, 2023. The preliminary and final health premiums will be available on the Plans & Rates page.

Changes for 2023

  • Blue Shield Access+ EPO – Expansion into 11 counties: Alpine, Calaveras, Inyo, Lake, Modoc, Mono, Plumas, Siskiyou, Tehama, Trinity, and Tuolumne
  • Blue Shield Trio – Expansion into seven counties: Butte,* Kern, Kings, Monterey, Riverside, San Bernardino, and Tulare and new pharmacy shared patient savings program featuring one month of plan savings for using a clinically equivalent, lower-cost drug alternative.
  • Anthem Blue Cross Medicare Preferred – Reduced copays for acupuncture and chiropractic services to $10 (down from $15).
  • Kaiser Permanente Senior Advantage – New Senior Advantage Summit Plan available in California. The new plan will offer $0 copay for most services; however, copays for emergency room visits, pharmacy benefits, acupuncture, and chiropractic will remain.
  • Kaiser Permanente Senior Advantage & Senior Advantage Summit – Quarterly $70 over the counter (OTC) allowance for OTC medications, vitamins and supplements, and other certain mobility and home care supplies.
  • Western Health Advantage MyCare Select Medicare Advantage – New supplemental benefit of meal delivery following hospital stay of up to 56 meals, four times per year.
  • Reproductive Health Equity Language Change – New benefit language providing all persons access to reproductive health benefits regardless of sex, sexual orientation, or gender identity.
  • Fertility Care Language Change – New benefit language updating the definition of infertility to provide access to infertility treatment to members regardless of age, sexual orientation, gender identity, or marital status.
  • Hearing Aids Benefit Adjustment – New benefit for members under the age of 26 providing medically necessary and clinically appropriate hearing aids in both ears at 100% coverage every 36 months.
  • Match PPO Members with Primary Care Providers – New match to a Primary Care Provider (PCP) for PPO members. Members would be free to choose a different PCP and it would not change the ability to see a specialist anytime.

*Pending Department of Managed Health Care approval.

Make Health Enrollment Changes Online

Eligible active employees can now make most health changes online through their myCalPERS accounts. With employer approval and a qualifying event, you can:

  • Enroll yourself and your eligible dependents into health benefits Add or remove dependents
  • Change health plans
  • Recertify a parent-child relationship
  • Cancel coverage
  • Then, during Open Enrollment starting September 19, you can make any Open Enrollment changes online as well.

Learn more by visiting Health Enrollment Self-Service for Active Members.

Tell Us About Yourself

Create your Health Demographic Profile in your myCalPERS account. It takes less than five minutes. Your response will help us improve quality of care and health outcomes for all members. If you’ve already completed your profile, we thank you!

Stay Up to Date

Do we have your current email address? Check your contact information in your myCalPERS account to make sure you receive the latest Open Enrollment information. You can subscribe to newsletters and alerts using your email address.

Visit our website for the latest information on our health plans and to view board meetings.