Update from CalPERS: State Active and Annuitant Health Formulas - Mix of Plans

For active members

Effective January 1, 2021, PERS Select will be replacing PERSChoice in the current mix of the four largest Basic health plans (Kaiser, PERS Choice, Blue Shield Access+ and Unitedhealthcare) by enrollment that are used to calculate the 80/80 and 85/80 state actives contributions.

Due to this change, the state contributions for actives under the 80/80 and 85/80 formula will likely be decreasing, and active member out-of-pocket costs will likely increase.

For state annuitants (retired)

The four largest Basic health plans by enrollment (Kaiser, PERS Choice, Blue Shield Access+ and Unitedhealthcare) that are used to calculate the 100/90 state annuitant contributions or the four largest Medicare health plans by enrollment (Kaiser, Unitedhealthcare, PERS Choice, and PERSCare) that are used to calculate the 80/80 Medicare state annuitant contributions will not change for the 2021 plan year.

• NOTE: a handful of people hired after January 1, 2016, or January 1, 2017, who retired on disability under PEMHCA, Article 7, Section 22871.3 (a) or (b) will be impacted by PERS Select replacing PERSChoice as one of the four largest Basic health plans used to calculate the 80/80 state contributions.

CalHR oversees the process of determining the four largest plans for actives and calculating the 80/80 and 85/80 state contribution amounts. CalPERS oversees the process of determining the four largest plans for annuitants and calculating the 100/90 and 80/80 Medicare retiree state annuitant contributions.