More in Plans & Rates (Active Member)

Annual Health Plan Changes

We’re working to give members more choices for affordable health plans and to ensure our benefit coverage provides equitable, high-quality health care. We realize that any changes to health plans impact your decisions during Open Enrollment. We will communicate all changes to plans and premiums to you prior to Open Enrollment in the fall.

2026

We’re providing you with information on the 2026 health plan proposals (PDF) approved in November 2024 by the CalPERS Board of Administration.

There’s no action for you to take now.

These proposals become part of our rate development process when we set health premiums. The Pension & Health Benefits Committee will review preliminary 2026 health premiums and any additional proposed plan and benefit changes in June 2025 and approve final premiums and changes in July 2025.

For a full list of our available health plans, view the Plans & Rates page.

Basic Plan Expansions

Health Maintenance Organization (HMO)
Health Plan Changes
Kaiser Permanente

Expansion into the remaining 23 ZIP Codes in Monterey County*

This expansion is contingent upon Kaiser successfully establishing the necessary provider contracts in Monterey County as well as subsequent approval from the DMHC.
UnitedHealthcare SignatureValue Harmony Expansion into El Dorado, Nevada, Placer, and San Joaquin County*

Medicare Plan Expansions

Health Maintenance Organization (HMO)
Health Plan Changes
Kaiser Permanente Senior Advantage

Expansion into the remaining 23 ZIP codes in Monterey County*

This expansion is contingent upon Kaiser successfully establishing the necessary provider contracts in Monterey County as well as subsequent approval from the DMHC.
Kaiser Permanente Senior Advantage Summit

Expansion into the remaining 23 ZIP codes in Monterey County*

This expansion is contingent upon Kaiser successfully establishing the necessary provider contracts in Monterey County as well as subsequent approval from the DMHC.

Benefit Design Changes for All Plans

Health Maintenance Organization (HMO)
Benefit Changes
Heath Care Treatment Following Rape or Sexual Assault

100% coverage of emergency room services and follow-up health care treatment for a member who is treated following a rape or sexual assault for the first nine months after the member initiates treatment.

*Pending Department of Managed Health Care approval.

2025

We’re providing you with changes to health plans for 2025 that were approved by the CalPERS Board of Administration. There are no other changes to our health plans or benefits except those described here. For a full list of available health plans and premiums, view the Plans & Rates page.

There's no action for you to take now.

Basic Plans

Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO)
Health Plan Changes
Anthem Blue Cross Del Norte Third-party administrator transition removes Anthem Blue Cross Del Norte plan; no longer part of CalPERS health plan offerings1
Blue Shield Trio Expansion into:
Health Net Salud y Más Expansion into Imperial county
Kaiser Permanente Expansion into 14 ZIP codes in Monterey county
UnitedHealthcare SignatureValue Harmony Expansion into:
Preferred Provider Organization Plans (PPO)
Health Plan Changes
PERS Gold

Blue Shield of California will be the new Third-Party Administrator for all PPO plans.

For members in a basic plan they are partnering with Included Health to provide member services, including answering inquiries, guiding members to the most appropriate in-network and high-quality providers, and providing care coordination services for members, particularly those with complex health conditions. Included Health will also expand access to care through their supplemental virtual primary care and behavioral health care services.

There are no changes to copays, coinsurance, or deductibles with this transition to Blue Shield.

You can learn more about this announcement from the article recently posted on PERSpective.
PERS Platinum

Blue Shield of California will be the new administrator for all PPO plans.

For members in a basic plan, they are partnering with Included Health to provide member services, including answering inquiries, guiding members to the most appropriate in-network and high-quality providers, and providing care coordination services for members, particularly those with complex health conditions. Included Health will also expand access to care through their supplemental virtual primary care and behavioral health care services.

There are no changes to copays, coinsurance, or deductibles with this transition to Blue Shield.

You can learn more about this announcement from the article recently posted on PERSpective.

Medicare Plans

Health Plan Changes
PERS Gold Supplement to Medicare Plan

Blue Shield of California will be the new Third Party Administrator for all PPO plans.

For Medicare members, provider networks and care coordination provided by their doctors will not change.

There are no changes to copays or coinsurance with this transition to Blue Shield.

You can learn more about this announcement from the article recently posted on PERSpective.
PERS Platinum Supplement to Medicare Plan

Blue Shield of California is the new Third Party Administrator for all PPO plans.

For Medicare members, provider networks and care coordination provided by their doctors will not change.

There are no changes to copays or coinsurance with this transition to Blue Shield.

You can learn more about this announcement from the article recently posted on PERSpective.
UnitedHealthcare Medicare Advantage Edge Exits all counties; no longer part of CalPERS health plan offerings2
Western Health Advantage MyCare Select Exits all counties; no longer part of CalPERS health plan offerings2

Benefit Design Changes

Benefit Changes
Doula Benefit for all Pregnant and Postpartum Members New benefit for all pregnant and postpartum Basic plan members to receive health education, advocacy, physical and emotional non-medical support before, during and after pregnancy, miscarriage, stillbirth, and abortions.
Travel Benefit for Medically Necessary Care Standardized travel and lodging coverage for eligible medically necessary services including, but not limited to abortion services, gender affirming care, complex surgeries, and cancer care that cannot be accessed within 50 miles from the member’s residence for all Basic and Medicare plan members, up to $5,000 per occurrence. This includes transportation, lodging, and meals for the member and a companion (both parents/guardians when patient is under 18).

Endnotes

1Regardless of the health plan you enroll in, continuity of care coverage as outlined by the Department of Managed Health Care may be available to you if your current doctor, medical group, or hospital is not available and you meet certain eligibility criteria. This means you may be able to continue to receive the medical and behavioral health services and medicines you need. Check with your health plan or call the Department of Managed Health Care at 1-888-466-2219 for more information about continuity of care options. For members who have had a provider disruption and do not qualify for DMHC Continuity of Care provisions, Blue Shield will also provide 12 months of office visits with out of network providers at the in network benefit.

2Regardless of the health plan you enroll in, continuity of care coverage may be available to you if your current doctor, medical group, or hospital is not available and you meet certain eligibility criteria. This means you may be able to continue to receive the medical and behavioral health services and medicines you need. Check with your health plan or Centers for Medicare & Medicaid Services at cms.gov for more information about continuity of care options.