Plans & Rates (Retiree)
Visit your health plan's website to learn how benefits, claims, and payment of claims are covered, as well as the service limitations and exclusions that may apply. You can also log in to myCalPERS to use the Search Health Plans tool to research the health plan coverage and benefits most important to you and your family.
Some health plans are available only in certain counties and/or ZIP codes. Contact the health plan before enrolling to make sure they cover your ZIP codes and that their provider network is accepting new patients in your area. You may also use our online service, the Health Plan Search by ZIP Code.
Open Enrollment is an annual process that occurs in the fall. During this time, you can enroll, change health plans, add eligible dependents, delete dependents, or cancel coverage. View Annual Health Plan Changes for details on health plans, service areas, and benefit design changes.
Are you an active member? View Active Member Plans & Rates customized just for you.
Rates & Employer Contributions
View How CalPERS Sets Health Premiums to get details on the rates and plans process.
2025
Access the 2025 health premiums approved by the CalPERS Board of Administration:
Employer Contribution Amounts
Below are the contribution rates. Your cost is any amount above the employer contribution.
CalPERS Health Program
| Formula | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| 100/90 Basic and Medicare Annuitants | $1,060 | $2,039 | $2,551 |
| 80/80 Basic Annuitants | $809 | $1,615 | $2,097 |
| 80/80 Medicare Annuitants | $377 | $764 | $1,099 |
Contribution Formula Availability – State Annuitants
State retiree contribution formulas outlined in the table below, vary by first hire date to the State of California and State Bargaining Unit. State annuitants enrolled in Basic plans use the Basic 80/80 formula and state annuitants enrolled in Medicare plans use the Medicare 80/80 formula. All bargaining units not listed as 80/80, have the 100/90 state retiree contribution formula.
| First hired by the State of California | Hired into State Bargaining Unit (SBU) | 100/90 or 80/80 Formula |
|---|---|---|
| Prior to January 1, 2016 | All SBU | 100/90 |
| On or after January 1, 2016 | SBU
|
80/80 |
| On or after January 1, 2017 | All SBU
|
80/80 |
| On or after April 1, 2017 | All SBU
|
80/80 |
Retired CSU Members
| Group | Single | Two-Party (2) | Family (3+) |
|---|---|---|---|
| All Employees | $1,060 | $2,039 | $2,551 |
CalPERS 2025 Statewide COBRA Health Premiums
Effective Date: January 1, 2025
COBRA premiums are calculated at 102% of the Basic premiums, but some carriers may charge less than these maximum amounts.
| Plan Name | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| Anthem Blue Cross Select HMO | $1,042.14 | $2,084.29 | $2,709.58 |
| Anthem Blue Cross Traditional HMO | $1,335.25 | $2,670.50 | $3,471.65 |
| Blue Shield Access+ EPO | $985.18 | $1,970.35 | $2,561.46 |
| Blue Shield Access+ HMO | $985.18 | $1,970.35 | $2,561.46 |
| Blue Shield Trio HMO | $927.28 | $1,854.56 | $2,410.93 |
| CAHP | $948.69 | $1,841.74 | $2,408.82 |
| CCPOA - North | $1,088.13 | $2,182.17 | $2,946.54 |
| CCPOA - South | $897.04 | $1,799.92 | $2,432.58 |
| Health Net Salud y Más | $768.79 | $1,537.59 | $1,998.86 |
| Kaiser Permanente (CA) | $1,066.10 | $2,132.21 | $2,771.87 |
| Kaiser Permanente (Out-of-State) 1 | $1,450.71 | $2,901.41 | $3,771.84 |
| PERS Gold | $962.57 | $1,925.15 | $2,502.69 |
| PERS Platinum | $1,362.01 | $2,724.01 | $3,541.22 |
| PORAC | $911.88 | $1,824.78 | $2,371.50 |
| Sharp Performance Plus | $885.82 | $1,771.64 | $2,303.13 |
| UnitedHealthcare SignatureValue Alliance | $980.58 | $1,961.15 | $2,549.50 |
| UnitedHealthcare SignatureValue Harmony | $836.53 | $1,673.07 | $2,174.99 |
| Western Health Advantage HMO | $932.56 | $1,865.11 | $2,424.64 |
1These premiums cover all Kaiser out-of-state areas.
Since health care costs vary throughout California, regional pricing adjusts premiums to reflect the actual cost of health care in your specific region. This ensures that your CalPERS premiums are appropriate and competitive for where you live.
To find your specific health plan premium rates, choose your region from the options below:
- Region 1 Premiums (PDF) - View rates for Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, Del Norte, El Dorado, Glenn, Humboldt, Lake, Lassen, Marin, Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Napa, Nevada, Placer, Plumas, Sacramento, San Benito, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Shasta, Sierra, Siskiyou, Solano, Sonoma, Stanislaus, Sutter, Tehama, Trinity, Tuolumne, Yolo, and Yuba.
- Region 2 Premiums (PDF) - View rates for Fresno, Imperial, Inyo, Kern, Kings, Madera, Orange, San Diego, San Luis Obispo, Santa Barbara, Tulare, and Ventura.
- Region 3 Premiums (PDF) - View rates for Los Angeles, Riverside, and San Bernardino.
- Out-of-State Premiums (PDF) - View rates for health plans available outside of California.
CalPERS 2025 Public Agencies & Schools COBRA Health Premiums
Effective Date: January 1, 2025
COBRA premiums are calculated at 102% of the Basic premiums, but some carriers may charge less than these maximum amounts.
Access the 2025 COBRA premiums by region (PDF).
2024
View the 2024 health premiums approved by the CalPERS Board of Administration:
Employer Contribution Amounts
Below are the contribution rates. Your cost is any amount above the employer contribution.
CalPERS Health Program
| Formula | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| 100/90 Basic and Medicare Annuitants | $983 | $1,890 | $2,366 |
| 80/80 Basic Annuitants | $747 | $1,492 | $1,936 |
| 80/80 Medicare Annuitants | $311 | $629 | $917 |
Contribution Formula Availability – State Annuitants
State retiree contribution formulas outlined in the table below, vary by first hire date to the State of California and State Bargaining Unit. State Annuitants enrolled in Basic plans use the Basic 80/80 formula and State Annuitants enrolled in Medicare plans use the Medicare 80/80 formula. All bargaining units not listed as 80/80, have the 100/90 state retiree contribution formula.
| First hired by the State of California | Hired into State Bargaining Unit (SBU) | 100/90 or 80/80 Formula |
|---|---|---|
| Prior to January 1, 2016 | All SBU | 100/90 |
| On or after January 1, 2016 | SBU
|
80/80 |
| On or after January 1, 2017 | All SBU
|
80/80 |
| On or after April 1, 2017 | All SBU
|
80/80 |
Retired CSU Members
| Group | Single | Two-Party (2) | Family (3+) |
|---|---|---|---|
| All Employees | $983 | $1,890 | $2,366 |
CalPERS 2024 Statewide COBRA Health Premiums
Effective Date: January 1, 2024
COBRA premiums are calculated at 102% of the Basic premiums, but some carriers may charge less than these maximum amounts.
| Plan Name | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| Anthem Blue Cross Del Norte EPO | $1,240.19 | $2,480.37 | $3,224.49 |
| Anthem Blue Cross Select HMO | $944.08 | $1,888.16 | $2,454.61 |
| Anthem Blue Cross Traditional HMO | $1,221.90 | $2,443.80 | $3,176.93 |
| Blue Shield Access+ EPO | $910.34 | $1,820.68 | $2,366.88 |
| Blue Shield Access+ HMO | $910.34 | $1,820.68 | $2,366.88 |
| Blue Shield Trio HMO | $826.44 | $1,652.89 | $2,148.75 |
| CAHP | $862.45 | $1,674.31 | $2,189.84 |
| CCPOA - North | $1,012.42 | $2,030.14 | $2,741.18 |
| CCPOA - South | $834.67 | $1,674.56 | $2,263.07 |
| Health Net Salud y Más | $670.10 | $1,340.20 | $1,742.26 |
| Kaiser Permanente (CA) | $983.43 | $1,966.87 | $2,556.93 |
| Kaiser Permanente (Out-of-State) 1 | $1,338.70 | $2,677.40 | $3,480.62 |
| PERS Gold | $876.50 | $1,752.99 | $2,278.89 |
| PERS Platinum | $1,240.19 | $2,480.37 | $3,224.49 |
| PORAC | $870.06 | $1,742.16 | $2,264.40 |
| Sharp Performance Plus | $849.90 | $1,699.81 | $2,209.75 |
| UnitedHealthcare SignatureValue Alliance | $900.64 | $1,801.28 | $2,341.67 |
| UnitedHealthcare SignatureValue Harmony | $778.97 | $1,557.95 | $2,025.33 |
| Western Health Advantage HMO | $823.37 | $1,646.75 | $2,140.78 |
Since health care costs vary throughout California, regional pricing adjusts premiums to reflect the actual cost of health care in your specific region. This ensures that your CalPERS premiums are appropriate and competitive for where you live.
To find your specific health plan premium rates, choose your region from the options below:
- Region 1 Premiums (PDF) - View rates for Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, Del Norte, El Dorado, Glenn, Humboldt, Lake, Lassen, Marin, Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Napa, Nevada, Placer, Plumas, Sacramento, San Benito, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Shasta, Sierra, Siskiyou, Solano, Sonoma, Stanislaus, Sutter, Tehama, Trinity, Tuolumne, Yolo, and Yuba.
- Region 2 Premiums (PDF) - View rates for Fresno, Imperial, Inyo, Kern, Kings, Madera, Orange, San Diego, San Luis Obispo, Santa Barbara, Tulare, and Ventura.
- Region 3 Premiums (PDF) - View rates for Los Angeles, Riverside, and San Bernardino.
- Out-of-State Premiums (PDF) - View rates for health plans available outside of California.
CalPERS 2024 Public Agencies and Schools COBRA Health Premiums
Effective Date: January 1, 2024
COBRA premiums are calculated at 102% of the Basic premiums, but some carriers may charge less than these maximum amounts.
View the 2024 COBRA premiums by region (PDF).
Health Plans
View all health plan Summary of Coverage and Evidence of Coverage documents.
All health plans have geographical restrictions except for PERS Platinum. To find health plans available in your area, refer to Health Plan Search by ZIP Code.
| Plan Name | Administrator | Offers Medicare? | Plan Information |
|---|---|---|---|
|
Anthem Blue Cross (Basic) (HMO)
|
(855) 839-4524 |
No |
OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. Access Anthem Blue Cross’ Transparency in Coverage Machine Readable Files on their website. |
| Anthem Blue Cross Del Norte (EPO) |
(877) 737-7776 |
No |
Anthem Blue Cross Del Norte (EPO) will no longer be available as of January 1, 2025. OptumRx is the PBM providing prescription benefits for this health plan. Access Anthem Blue Cross’ Transparency in Coverage Machine Readable Files on their website. |
| Anthem Blue Cross Medicare Preferred (PPO) |
(855) 251-8825 |
Yes | OptumRx is the PBM providing prescription benefits for this health plan. |
|
Blue Shield of California (HMO)
|
Blue Shield of California (HMO) (800) 334-5847 |
No |
Blue Shield of California administers their own prescription drug benefits. Access Blue Shield of California’s Transparency in Coverage Machine Readable Files on their website. |
| Blue Shield of California (EPO) |
(800) 334-5847 |
No |
Blue Shield EPO is available in Alpine, Calaveras, Colusa, Del Norte, Inyo, Lake, Lassen, Mendocino, Modoc, Mono, Plumas, San Benito, Shasta, Siskiyou, Sierra, Tehama, Trinity, and Tuolumne counties. Blue Shield of California prescription benefits are administered by CVS Caremark. Access Blue Shield of California’s Transparency in Coverage Machine Readable Files on their website. |
| Blue Shield of California Medicare (PPO) |
(888) 802-4599 |
Yes |
Blue Shield of California administers their own prescriptions. |
|
California Association of Highway Patrolmen (CAHP) (PPO)
|
Anthem Blue Cross Accolade Customer Service (866) 518-1767 |
Yes |
You must belong to the specific employee association and pay applicable dues to enroll in the CAHP. Note: The Prudent Buyer Network for CAHP’s Basic and Combination Plan is available only in California and in limited areas of selected states outside of California. CAHP prescription benefits are administered by Express Scripts. |
|
California Correctional Peace Officers Association (CCPOA) Access+ (HMO) |
Blue Shield of California (800) 257-6213 |
No |
You must belong to the specific employee association and pay applicable dues to enroll in the CCPOA. The CCPOA plan is available only to dues-paying members of that organization and their families. CCPOA prescription benefits are administered through Blue Shield of California. |
|
California Correctional Peace Officers Association (CCPOA) (PPO)
|
Blue Shield of California (800) 776-4466 |
Yes |
You must belong to the specific employee association and pay applicable dues to enroll in the CCPOA. The CCPOA plan is available only to dues-paying members of that organization and their families. CCPOA prescription benefits are administered through Blue Shield of California. |
|
Health Net of California (HMO)
|
(888) 926-4921 |
No |
OptumRx is the PBM providing prescription benefits for this health plan. Access Health Net of California’s Transparency in Coverage Machine Readable Files on their website. |
|
Kaiser (HMO)
|
(800) 305-1220 Senior Advantage & Senior Advantage Summit (855) 717-9598 |
Yes |
Kaiser administers its own prescription benefits. Access Kaiser Permanente’s Transparency in Coverage Machine Readable Files on their website. |
|
Peace Officers Research Association of California (PORAC) (PPO)
|
Anthem Blue Cross (800) 655-6397 |
Yes |
You must belong to the specific employee association and pay applicable dues to enroll in the PORAC. The PORAC plan is available only to dues-paying members of that organization and their families. PORAC prescription are administered by Anthem Blue Cross. |
|
PERS Platinum (PPO)
|
As of January 1, 2025 Basic (855) 633-4436 TTY 711 & Supplement to Medicare (800) 405-2127 TTY 711 For the 2024 contract year (877) 737-7776 |
Yes |
Effective January 1, 2025 Blue Shield of California will be the new administrator for the CalPERS PPO plans. Included Health will be your point of contact for Basic plan information and Blue Shield will be your point of contact for Supplement to Medicare plan information. Visit the 2025 PPO Administrators for Basic Plan Members webpage for more information on this change. This plan has no geographical restrictions. It provides coverage anywhere in the world. OptumRx is the PBM providing prescription benefits for this health plan. Access Anthem Blue Cross’ Transparency in Coverage Machine Readable Files on their website. |
|
PERS Gold (PPO)
|
As of January 1, 2025 Basic (855) 633-4436 TTY 711 & Supplement to Medicare (800) 405-2127 TTY 711 For the 2024 contract year (877) 737-7776 |
Yes |
Effective January 1, 2025 Blue Shield of California will be the new administrator for the CalPERS PPO plans. Included Health will be your point of contact for Basic plan information and Blue Shield will be your point of contact for Supplement to Medicare plan information. Visit the 2025 PPO Administrators for Basic Plan Members webpage for more information on this change. This plan is only available in California. OptumRx is the PBM providing prescription benefits for this health plan. Access Anthem Blue Cross’ Transparency in Coverage Machine Readable Files on their website. |
|
Sharp Health Plan (Basic) (HMO) Sharp Performance Plus |
(855) 995-5004 |
No |
OptumRx is the PBM providing prescription benefits for this health plan. Access Sharp Health Plan’s Transparency in Coverage Machine Readable Files on their website. |
|
Sharp Direct Advantage (Medicare) (HMO) |
(833) 346-4322 |
Yes |
CVS Caremark is the PBM for Sharp Direct Advantage (Medicare) (HMO). |
|
UnitedHealthcare (Basic) (HMO)
|
(877) 359-3714 |
No |
OptumRx is the PBM providing prescription benefits for this health plan. Access UnitedHealthcare’s Transparency in Coverage Machine Readable Files on their website. |
|
UnitedHealthcare (Medicare) (PPO)
|
(888) 867-5581 |
Yes |
UnitedHealthcare Medicare Advantage Edge will no longer be available as of January 1, 2025. The UnitedHealthcare® Group Medicare Advantage (PPO) plans include Medicare Part D prescription drug coverage. OptumRx is the PBM providing prescription benefits for this health plan. |
| Western Health Advantage (HMO) |
(888) 942-7377 TTY: 711 |
No |
OptumRx is the PBM providing prescription benefits for this health plan. Access Western Health Advantage’s Transparency in Coverage Machine Readable Files on their website. |
| Western Health Advantage MyCare Select (Medicare) (HMO) |
(888) 942-7377 |
Yes |
Western Health Advantage MyCare Select will no longer be available as of January 1, 2025. OptumRx is the PBM providing prescription benefits for this health plan. |
About Our Plans
- HMO - A Health Maintenance Organization (HMO) plan provides health care from specific doctors and hospitals under contract with the plan. You pay co-payments for some services, but you have no deductible, no claim forms, and a geographically restricted service area.
- PPO - A Preferred Provider Organization (PPO) is similar to a traditional "fee-for-service" plan, but you must use doctors in the PPO provider network or pay higher co-insurance (percentage of charges). You must usually meet an annual deductible before some benefits apply. You're responsible for a certain co-insurance amount and the plan pays the balance up to the allowable amount.
- EPO - The Exclusive Provider Organization (EPO) plan offers the same covered services as an HMO plan, but you must seek services from the plan’s network of preferred providers. You are also able to access physicians and specialists that participate in the network without a referral. You pay copayments, for some services, but you have no deductible, no claim forms, and a geographically restricted service area.
- Combination Plans - A combination plan means at least one family member is enrolled in a Medicare health plan and at least one family member is enrolled in a Basic health plan through the same health carrier. CalPERS requires all family members to have the same health carrier.
Check out our article HMO, PPO, and EPO – What’s the Difference and Why Does It Matter? for information on the different types of plans.
Additional Resources
- Accessing Health Care During a Disaster
- Health & Wellness Programs by Health Plan
- Non-Discrimination Notice (PDF)
- Open Enrollment
- Provider Disruption (PDF)
- Your Rights and Protections Against Surprise Medical Bills (PDF)
Videos
Health & Medicare
Resources
- California Health Care Quality Report Cards
- Dental & Vision Benefits
- Health Plan Search by ZIP Code
- Long-Term Care
- OptumRx Pharmacy Benefits
- A Guide to Changing Your Health Coverage
Forms & Publications
- 2025 Health Benefit Summary (PDF)
- Health Benefits Plan Enrollment for Retirees (PDF)
- Health Program Guide (HBD 120) (PDF)
- Medicare Enrollment Guide (PDF)
- Your Guide to Choosing a Health Plan (PDF)
Frequently Asked Questions
- Can I change to an HMO Medicare Managed Care (Medicare Advantage) plan if I was enrolled in a Basic HMO plan before retirement?
You may change health plans when you turn age 65 and transition from a Basic plan to a Medicare plan. Enrolling in a Managed Care plan involves two steps. First, notify CalPERS of your intention to enroll in a Medicare Managed Care plan. Second, complete and return the carrier's election form to finalize your transition. The carrier may send you an enrollment kit that includes the election form; if you didn't receive one, contact the carrier directly.