CalPERS Health Plan Open Enrollment Begins September 12
Posted On: Sep 08, 2016
Members now have convenient online access to annual Health Plan Statements
SACRAMENTO, CA - The California Public Employees' Retirement System (CalPERS) annual health Open Enrollment period for the 2017 calendar year is September 12 - October 7, 2016. As it does every year, the retirement system is providing members with information on its six Health Maintenance Organization (HMO) and three self-funded Preferred Provider Organization (PPO) health plans.
CalPERS' Basic (non-Medicare) health plan options include HMO plans through Anthem Blue Cross, Blue Shield of California, Health Net, Kaiser Permanente, Sharp Health Plan and UnitedHealthcare. The System's three Basic PPO plans, offered through third-party administrator Anthem Blue Cross, are PERS Select, PERS Choice, and PERSCare. Medicare health plans are offered through Blue Shield, Kaiser, and UnitedHealthcare.
Members may enroll in the CalPERS Health Program, add eligible family members, or make changes to their existing health plans during the Open Enrollment period. The coverage becomes effective January 1, 2017.
CalPERS members will note a few significant changes with their health plan information for 2017.
Beginning this year, a majority of CalPERS members automatically have direct online access to their annual Health Plan Statement and Open Enrollment materials. The statement describes details of their current health coverage, their 2017 premium if they remain enrolled in their current health plan, and all health plans available to them in 2017 based on their ZIP code.
Members are able to use their my|CalPERS accounts to access, download and print any of the CalPERS Open Enrollment publications designed to help them make informed health plan choices. Some members elected to continue receiving their statement and Open Enrollment materials by mail; their materials were mailed to them on August 22.
The change will save CalPERS an estimated $1 million a year, but it wasn't made solely for cost savings, said Donna Lum, deputy executive officer for Customer Services and Support. "In response to member comments and requests, we have taken steps over the past few years to provide more online access to health plan information. We are taking it to the next level by providing them with secure online access to their individual Health Plan Statements."
CalPERS is also transitioning to a new Pharmacy Benefit Manager (PBM). Effective January 1, 2017, OptumRx will replace CVS/caremark as the CalPERS PBM, administering prescription drug benefits for nearly 500,000 members and their dependents. All health plans except the Kaiser and Blue Shield HMO plans, and the UnitedHealthcare Medicare Advantage PPO plan will be affected by this change. OptumRx was awarded a five-year contract that ends December 31, 2021, following a competitive bid process.
"We are confident that OptumRx will provide excellent service and meet the needs of our members," said Kathy Donneson, chief of CalPERS' Health Plan Administration Division. "Our team will work with OptumRx and CVS/caremark to ensure that the transition for our members and physicians will be as smooth as possible." For more information on the transition to OptumRx, view Pharmacy Benefit Changes.
Finally, Blue Shield will no longer offer its NetValue plan as of January 2017. Members currently enrolled in NetValue who wish to remain with Blue Shield won't need to take any action - they will be automatically enrolled into the Blue Shield Access+ health plan. Most providers currently participating in NetValue also participate in Access+. Any member who wishes to select another health plan may do so during Open Enrollment.
View the CalPERS Board Meeting Highlights video, in which Carene Carolan, chief of the CalPERS Member Account Management Division, comments on the impact of members' online access to their annual Health Plan Statements and other Open Enrollment resources.
CalPERS also offers an online tool called the Health Plan Chooser for members who need additional help selecting a health plan. They can connect with all Open Enrollment information - including contact telephone numbers for all CalPERS health plans - either through their my|CalPERS accounts, or in Health Benefits for active members or Health & Medicare for retirees.
For more than eight decades, CalPERS has built retirement and health security for state, school, and public agency members who invest their lifework in public service. Our pension fund serves more than 1.8 million members in the CalPERS retirement system and administers benefits for more than 1.4 million members and their families in our health program, making us the largest defined-benefit public pension in the U.S. CalPERS' total fund market value currently stands at approximately $303 billion. For more information, visit www.calpers.ca.gov.