Open Enrollment for Employers

If an employee's January 1, 2025 pay warrant does not reflect the proper premium payment of a health plan change, the premium payment will be adjusted during a subsequent pay period.

Advise the employee they should've discontinued using their prior plan after December 31, 2024. Verify that myCalPERS reflects the appropriate enrollment and advise the employee that the payroll discrepancy will be resolved.

Health plan ID cards for members enrolled in a PPO plan were mailed mid-December 2024. If members enrolled in PERS Gold or Platinum didn’t receive their ID card by January 1, 2025, they should contact Included Health.

As the designated health benefits officer or assistant health benefits officer, you're the authorized point of contact to process CalPERS health transactions and provide health eligibility and enrollment information to your employees. Encourage your employees to reach out to you directly for any questions or assistance related to Open Enrollment transactions.

To ensure successful ongoing CalPERS health benefits and communication, all employees should:

• Have a myCalPERS account.
• Maintain a current email address, health eligibility ZIP code, and communication preference.
• Submit supporting documentation needed to verify their dependents.
• Confirm their new health plan and monthly premium adjustments in their January 2025 paycheck.

You have a fiduciary responsibility to manage the CalPERS Health Program by ensuring that only eligible employees and their dependents are covered. Employers are responsible for obtaining and maintaining records of all supporting documentation that determines the eligibility of enrolled dependents. At the time of enrollment – or anytime thereafter – you have the right to request additional supporting documentation needed to verify a dependent's eligibility.

To find a list of eligible dependent types and for additional information, refer to the Health Program Guide (PDF).

All health enrollment transactions should be submitted through myCalPERS. If your employees are using online health enrollments self-service, you will need to review and approve those transactions in myCalPERS. Early submission and approval will ensure timely processing of health plan ID cards and proper payroll deductions. For more information on adding and updating health transactions review our myCalPERS Student Guides.

• The deadline for processing all Open Enrollment transactions was 11:59 p.m. (Pacific Time) on Friday, November 8, 2024.
• Your employees may choose to use their employer ZIP code as their health eligibility ZIP code when they first enroll in CalPERS health, upon a move, or during any Open Enrollment period.
• If you're unable to complete all Open Enrollment transactions before the processing deadline, contact us at 888 CalPERS (or 888-225-7377). Don't forward unprocessed Open Enrollment request forms to us.

During Open Enrollment, you're responsible for submitting transactions for former employees or their dependents enrolled in COBRA continuation coverage who want to change or cancel health plans or add/delete eligible dependents.

You're also responsible for submitting transactions during Open Enrollment for employees on a leave of absence who want to change plans or add/delete dependents. Employees who do not change plans or add/delete dependents during Open Enrollment may do so within 60 days from the date they return to regular pay status.

You can rescind health transactions when the effective date of the transaction occurs in the future. For example, before the January 1, 2025 effective date, if an employee decided they no longer want to change health plans, you could’ve rescinded the transaction in myCalPERS.

Rescinded transactions must have been updated before the December 2024 cutoff date. Open Enrollment transactions rescinded after the December 2024 cutoff date will be adjusted during a subsequent pay period.

State and CSU Agencies

Visit Civil Service Benefits Cutoff Calendar to access the State Controller's Office (SCO) benefit cutoff dates.

Contracting Agencies and Schools

Refer to the 2025 Health Billing Cutoff Dates, Contracting School Districts and Public Agencies (PDF) attachment linked in Circular Letter 600-005-25 for 2025 health billing cutoff dates and payment information.

To register for a class, log in to your myCalPERS business partner account, then select Education. Participate in the Health Business Rules class to increase your understanding of the following:

• Eligibility & enrollment requirements
• Health Plan options
• Health benefits into retirement
• Best ways to manage resources

Review Health Premium Adjustments

• If an employee's January 1, 2025 pay warrant does not reflect the proper premium payment of a health plan change, the premium payment will be adjusted during a subsequent pay period.
• Advise the employee they should've discontinued using their prior plan after December 31, 2024. Verify that myCalPERS reflects the appropriate enrollment and advise the employee that the payroll discrepancy will be resolved.