Medical Plans

Medical Insurance Plans

Employees that are benefits eligible may enroll in one of several medical plans for themselves and their eligible dependents:

  • Monthly plan premium costs shared by the CSU and the employee.
  • Employee contribution rates vary depending on the plan selected and the number of dependents enrolled.
  • Before enrolling, review the current Health Plan Rates and the information provided below on each plan.
  • To find health plans available in your area go to the CalPERS Health Plan Search by Zip Code.
  • Use Provider Phone/Website List to contact providers for more information.
  • Need help choosing a medical plan? Log in to your MyCalPERS to use the Find a Medical Plan tool. 

Health Maintenance Organizations (HMOs)

Employees select a primary care physician who coordinates all care including referral to specialists.

Anthem Blue Cross Traditional HMO California and Anthem Blue Cross Select HMO California

  • Dedicated to delivering quality care and great value.
    • Both plans offer 360° Health, a program that helps members become involved in their health and wellness.  
  • For more information, call (855) 839-4524.

Blue Shield Access+ HMO

  • Access to more than 11,000 personal physicians and 300 hospitals.
  • No annual deductible; copayment at each physician visit.
  • For more information, call (800) 334-5847.

Blue Shield Trio HMO

  • The Trio plan is designed to give you affordable access to a quality, local network of doctors and hospitals in six counties*-- Los Angeles, Sacramento, El Dorado, Placer, Nevada and Yolo.
  • No annual deductible; copayment at each physician visit.
  • For more information, call (800) 334-5847.

Health Net Salud y Mas California and Health Net SmartCare California

  • Budget-friendly HMO plans with a tailored list of quality providers for selected California counties.
  • Ideal for employees who want one primary care physician to coordinate all their medical care. 
  • For more information, call (888) 926-4921.

Kaiser

  • Integrated health care system.
  • No annual deductible; copayment at each physician visit.
  • For more information, call (800) 464-4000.

Sharp Performance Plus California

  • Local HMO plan serving residents of San Diego.
  • Commitment to healthcare delivered in a convenient and cost-effective manner. 
  • For more information, call (855) 995-5004.

United Healthcare Alliance HMO California

  • Quality patient-centered healthcare at lower costs.
  • Distinct network of providers offers collaborative care and health management. 
  • For more information, call (877) 359-3714.

Western Health Advantage HMO

  • Offers an affordable health plan with a quality network and flexibility.
  • Access to:
    • Mercy Medical Group
    • Woodland Clinic
    • Hill Physicians
    • NorthBay Healthcare 
    • Meritage Medical Network
  • For more information, call (888) 942-7377.

Preferred Provider Organization (PPO)

PERS Platinum (administered by Anthem Blue Cross of California) 

  • Choose your health care providers and pharmacy without referral.
  • Offers significant savings through a preferred provider network (doctors and hospitals that agree to charge a pre-negotiated rate for everyone on the plan). Non-network providers may be used, but co-payments will be higher.
  • PERS Choice pays 80 percent of allowable amount (in-network), member pays 20 percent; cop-pays are applicable.
  • PERS Care pays 90 percent of allowable amount (in-network), member pays 10 percent; co-pays are applicable.
  • Annual deductibles must be met before some benefits apply.
  • For more information, call (877) 737-7776.

PERS Gold (administered by Anthem Blue Cross of California)

  • Same level of benefits as PERS Choice at a lower monthly premium cost.
  • Not available out-of-state.
  • Access a list of preferred providers through the PERS Select network.
  • For more information, call (877) 737-7776.

Exclusive Provider Organization (EPO)

Anthem Blue Cross EPO

  • Available only in Del Norte County
  • Same Benefits as Anthem Blue Cross Traditional HMO Plan
  • For more information, call (855) 839-4524

Blue Shield Access+ EPO

  • Available only in Colusa, Mendocino and Sierra counties
  • Same benefits as Access+ HMO Plan
  • For more information, call (800) 334-5847

Prescription Drug Information

OptumRx

  • Is the Pharmacy Benefit Manager for:
    • PERS Select/Choice/Care PPO
    • Anthem Blue Cross HMO & EPO
    • Health Net HMO
    • United HealthCare HMO
    • Sharp Health Plan HMO
  • For more information, call (855) 505-8110

CSU Health Insurance Miscellaneous Information: