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: