Valued stakeholders – on Wednesday (8/17), we sent out a note letting you know that CalPERS would be mailing letters to members who would be seeing significant increases in their health care premiums. Those letters were mailed in waves and the last wave will be arriving in members’ mailboxes over the coming week.
Thanks to some swift stakeholder feedback, it’s become clear that the letters sent to PPO subscribers – both basic and Medicare –caused confusion regarding the PCP Match.
Here is the section of the PPO letters in question:
“Primary Care Physician (PCP) Match: Preferred Provider Organization (PPO) members and their dependents will be assigned a PCP – for example, a general practitioner, family practitioner, internist, or pediatrician – based on factors such as location, age, and primary language. You are free to choose a different PCP, and it does not change your ability to see a specialist at any time without a referral. This change will not impact your premium.”
Two points of clarification
- For Medicare PPO members: this paragraph does not apply. We will NOT be assigning PCPs for Medicare members.
- For Basic PPO members: if there is already a PCP selected by the member, they will keep that PCP automatically if they stay in that plan. They will not be re-assigned to a new PCP, or have to take any action to remain with their current PCP.
We will be sending a correction letter to impacted members in Medicare and Combo plans next week, that clarifies the two points above.
If any of your members, constituents or employees have questions, please share this information with them, and let them know a second letter is on the way. Our contact center has been briefed on this and is available for questions as well at 877-CALPERS.