Health Benefits

Your Health Open Enrollment Starting Point

Physician examining child with stethoscope

2020 Health Open Enrollment Starts September 21 and Ends October 16.

Open Enrollment is your time to enroll in or change health plans, add eligible dependents, or delete dependents. Whether you plan to make a change or not, it’s a good time to review your current health coverage and discover your options.

Log in to your myCalPERS account to access Open Enrollment information and resources. Use the Search Health Plans tool to explore available health plans based on your eligibility ZIP code, search for your doctor or specialist, and review side-by-side benefit costs. Medicare members will need to contact the plans or their doctors directly for availability.

You can also view your Health Plan Statement in myCalPERS, which lists your 2020 premium and 2021 premium should you remain with the same health plan, plus a wealth of other customized information.

View our brief demonstration on where to find your Open Enrollment information in myCalPERS.

On the Plans & Rates page you can compare 2021 health plan options and premiums, find Evidence of Coverage and Summary of Benefits publications, access provider websites, and research networks of doctors and covered services. You can also find the employer contribution rates on this page. Your cost is any amount above the employer contribution.

What You Can Do During Open Enrollment

During Open Enrollment, you may enroll in or change health plans, add eligible dependents, or delete dependents.

  • Active Employees: Contact your employer’s personnel specialist or health benefits officer for required forms and documentation to make health plan changes.
  • Retirees: You may change your health plan online during Open Enrollment in myCalPERS. You may also mail your request to CalPERS’ Health Account Management Division at P.O. Box 942715, Sacramento, CA 94229-2715, or call us toll-free at 888 CalPERS (or 888-225-7377).

If you want to remain with your current health plan, you don’t need to take any action.  

CalPERS Announces Health Premiums for 2021

The CalPERS Board of Administration has approved the health plan premiums for 2021, at an overall average increase of 4.32%.

Here are the average premium increases by health plan type:

  • Members enrolled in CalPERS’ Basic (non-Medicare) Health Maintenance Organization (HMO) health plans will see a 4.44% average premium increase.
  • Members enrolled in Basic Preferred Provider Organization (PPO) plans will see an overall average increase of 8.54%.
  • Rates for CalPERS’ Medicare plans are decreasing across the board from the previous year. Medicare HMO and PPO plans will see premiums decrease by 4.46% and 0.65%, respectively.

The following chart represents the percentage premium change for each health plan, between 2020 and 2021. Note this reflects only the state, single-party premiums. The complete chart of 2021 premiums is available here.

Basic Plans
Anthem EPO Del Norte +7.91%
Anthem HMO Select +1.62%
Anthem HMO Traditional +9.37%
Blue Shield Access+ +3.16%
Blue Shield Trio +3.07%
Health Net Salud y Más +5.32%
Health Net SmartCare +7.36%
Kaiser Permanente +4.32%
PERS Choice +7.91%
PERS Select +7.14%
PERSCare +12.32%
Sharp +4.33%
United Healthcare +3.94%
Western Health Advantage +3.42%

 

Medicare Plans
Anthem Medicare Preferred -1.23%
Kaiser -4.40%
PERS Choice -0.40%
PERS Select -o.40%
PERS Care -0.92%
Sharp* N/A
United Healthcare -4.73%

*Sharp Direct Advantage Medicare is a new plan for 2021, therefore no comparison to the prior year is available.

Notable Health Plan Changes for 2021

Blue Shield Trio: Expands into Santa Barbara, San Luis Obispo, and Ventura counties where a lower cost HMO option doesn’t currently exist.

Anthem Blue Cross Medicare Preferred: Expands the service area to 23 counties. The change allows Anthem Select subscribers who are enrolled in a combination plan an option to choose either Anthem Select or Anthem Traditional plans to remain in the Anthem network.

Kaiser Permanente Senior Advantage: Adds supplemental benefits of post-hospital discharge meal service, post-discharge transportation, and routine transportation to medical care.

UnitedHealthcare Group Medicare Advantage: Adds post-hospital discharge meal delivery, post-discharge transportation, and non-skilled in-home care benefits.

Sharp Direct Advantage Medicare plan: Will be offered in San Diego County to allow members to remain in the Sharp network when they become eligible for Medicare. Dental benefits will be an option, for an additional $12 fee, to Medicare covered contracting agency members.

There are no co-pay or co-insurance changes for 2021, with the exception of association plans.

For the Association plans, the 2021 weighted average premium increase for Basic plans is 3.63% and 4.52% for the Association Medicare plans.

Additional Information for State Employees and Retirees

The Open Enrollment period for State of California and California State University (CSU) dental and vision plans starts September 21 and ends October 16, 2020.

State of California Employees and Retirees

The California Department of Human Resources (CalHR) administers the dental and vision programs for State of California active employees and retirees. For additional information about state employee dental and vision benefits, go to the CalHR website at www.calhr.ca.gov.

To enroll or make changes to State of California dental and vision plans, use the following methods:

State of California Dental Vision*
Active Employees Contact your human resources department Contact VSP at stateofcaemployee.vspforme.com or call (800) 877-7195
Retirees Contact us at 888 CalPERS (or 888-225-7377) Contact VSP at stateofcaretiree.vspforme.com or call (800) 877-7195

*VSP Open Enrollment materials will be mailed directly to you prior to Open Enrollment.

California State University Employees and Retirees

The CSU Office of the Chancellor administers the dental and vision programs for CSU active employees and retirees. For additional information for CSU active employees regarding dental and vision benefits, please contact your campus benefits office. CSU retirees should visit csuretirees.calstate.edu for specific plan information.

To enroll or make changes to your CSU-sponsored dental and vision plans, use the following methods:

CSU Dental Vision
Active Employees Contact your campus benefits office or human resources department Contact VSP at csuactives.vspforme.com or call (800) 877-7195
Retirees Contact us at 888 CalPERS (or 888-225-7377)

 

Contact VSP at csuretirees.vspforme.com or call (800) 400-4569

This post was updated 9/17/20