At the recent CalPERS Board of Administration meeting on Tuesday, July 15, the Board approved health plan premiums for the 2026 calendar year with an overall weighted premium rate increase of 8.21% which is 2.58% lower than the 10.79% increase from 2025.
Premium Rate Increases
Revenue changes from the Centers for Medicare and Medicaid Services (CMS) in addition to increased utilization of medical services further impact costs for both Medicare Advantage and Medicare Supplemental plans.
Specialty and brand name drugs continue to be a driving factor in rate changes across all plans due to utilization and cost increases.
Plan Adjustments
In addition, members in the PERS Gold PPO plan can continue to receive in-patient deductible credits of up to $500 for completing an expanded menu of preventive care activities including cancer and depression screenings, vaccinations, among others.
The following tables represent the overall percentage premium change for each health plan between 2025 and 2026 using the state, single-party premium.
|
Basic Plans
|
% Premium Change
|
|
Anthem Blue Cross Select HMO
|
6.78%
|
|
Anthem Blue Cross Traditional HMO
|
4.88%
|
|
Blue Shield Access+ HMO and EPO
|
12.70%
|
|
Blue Shield Trio
|
3.02%
|
|
Health Net Salud y Más HMO
|
4.70%
|
|
Kaiser Permanente HMO
|
5.05%
|
|
Kaiser Permanente HMO Out-of-State
|
-1.64%
|
|
PERS Gold PPO
|
10.56%
|
|
PERS Platinum PPO
|
13.24%
|
|
Sharp Performance Plus HMO
|
5.50%
|
|
UnitedHealthcare Alliance HMO
|
9.03%
|
|
UnitedHealthcare Harmony HMO
|
12.28%
|
|
Western Health Advantage HMO
|
6.05%
|
|
Total Basic Weighted Average Change
|
7.76%
|
|
Medicare Plans
|
% Premium Change
|
|
Anthem Medicare Preferred PPO
|
17.26%
|
|
Blue Shield Medicare PPO
|
20.33%
|
|
Kaiser Permanente Senior Advantage
|
4.01%
|
|
Kaiser Permanente Senior Advantage Out-of-State
|
3.99%
|
|
Kaiser Permanente Senior Advantage Summit
|
4.41%
|
|
Kaiser Permanente Senior Advantage Summit Out-of-State
|
4.40%
|
|
PERS Gold Medicare Supplement
|
9.42%
|
|
PERS Platinum Medicare Supplement
|
13.82%
|
|
Sharp Direct Advantage HMO
|
6.95%
|
|
UnitedHealthcare Group Medicare Advantage PPO
|
8.83%
|
|
Total Medicare Weighted Average Change
|
10.78%
|
CalPERS members can shop health plans and make changes during Open Enrollment, September 15 through October 10. Beginning September 8, members can find Open Enrollment information on the CalPERS website and customized information in their myCalPERS accounts. Using the Search Health Plans tool in myCalPERS, members can compare plan monthly premiums and copays, and search for primary care doctors and specialists to see which plan works best for them. Premiums will take effect January 1, 2026.