CALPERS 2022 HEALTH PLAN PREMIUMS PECG’s 85/80 Reimbursement Formula Best in State Service Continued on page 4... E ach spring, the California Public Employees’ Retirement System (CalPERS) meets with the various health plan providers to negotiate premiums that take effect on January 1 of the following year. Recently, CalPERS announced that the average premium will go up 4.86% in 2022, however, rate changes vary widely from plan to plan. Last year, the average rate increase was 4.32%. The state’s contribution to your health care premium is set by PECG’s current Memorandum of Understanding (MOU). For Unit 9 employees, the state’s contribution is based on what is known as the 85/80 formula. In arriving at its reimbursement rate, the state first calculates the weighted average premium for the four plans with the highest participation by active state civil service employees. For 2022, that includes Kaiser Permanente, UnitedHealthcare, Blue Shield Access+ HMO, and California Correctional Peace Officers Association (CCPOA) South. CCPOA South replaces PERS Select in the top four plans for 2022. Given that CCPOA South costs more than PERS Select, the change actually increases the reimbursement rates for all state employees. The state then pays 85% of the premium amount for Unit 9 employees and 80% of the additional premium costs for their family members. This is the best health care reimbursement rate in state service. As shown in the tables on pages 2 and 3 of this Informer, in 2022, the state’s monthly contribution according to the 85%/80% formula will increase to $691 for employee only, $1,342 for two-party, and $1,727 for family coverage. If the premium for the plan you select is higher than that, you would then pay the difference each month. Please carefully review the monthly health plan premiums on the following pages to determine the impact on you and your family. If you would like to make changes to your plan provider for 2022, the open Health Plan Changes for 2022 Blue Shield Access+ returns to eight Bay Area counties: Alameda, Contra Costa, Marin, San Francisco, San Mateo, Santa Clara, Sonoma, and Solano. Blue Shield Trio will expand to Santa Cruz, Stanislaus, and Orange counties. A new plan, UnitedHealthcare Signature Harmony, will be available in Los Angeles, Orange, Riverside, San Bernardino, and San Diego counties. Western Health Advantage will be available in Humboldt County. PERSCare will become PERS Platinum. It will retain the same 90/10 benefit design and network as PERSCare. PERS Choice also will transition to PERS Platinum. It will offer a 90/10 benefit option and will keep its provider network. PERS Select will transition to PERS Gold. It will keep the same 80/20 benefit design and provider network as PERS Select. PECG Delivers! 1 INFORMER Professional Engineers in California Government Issue 8 . September 2021
Transcript
CALPERS 2022 HEALTH PLAN PREMIUMSPECG’s 85/80 Reimbursement Formula Best in State Service
Continued on page 4...
E ach spring, the California Public Employees’ Retirement System (CalPERS) meets with
the various health plan providers to negotiate premiums that take effect on January 1 of the following year. Recently, CalPERS announced that the average premium will go up 4.86% in 2022, however, rate changes vary widely from plan to plan. Last year, the average rate increase was 4.32%.
The state’s contribution to your health care premium is set by PECG’s current Memorandum of Understanding (MOU). For Unit 9 employees, the state’s contribution is based on what is known as the 85/80 formula. In arriving at its reimbursement rate, the state first calculates t h e w e i g h t e d a v e r a g e premium for the four plans with the highest participation by active state civil service employees. For 2022, that includes Kaiser Permanente, UnitedHealthcare, Blue Shield Access+ HMO, and California Correctional Peace Officers Association (CCPOA) South. CCPOA South replaces PERS Select in
the top four plans for 2022. Given that CCPOA South costs more than PERS Select, the change actually increases the reimbursement rates for all state employees.
The state then pays 85% of the premium amount for Unit 9 employees and 80% of the additional premium costs for their family members. This is the best health care reimbursement rate in state service. As shown in the tables on pages 2 and 3 of this Informer, in 2022, the state’s monthly contribution according to the 85%/80% formula will increase to $691 for employee only, $1,342 for two-party, and $1,727 for family coverage. If the premium for the plan you select is higher than that, you would then pay the difference each month.
Please carefully review the monthly health plan premiums on the following pages to determine the impact
on you and your family. If you would like to make changes to your plan provider for 2022, the open
Health Plan Changes for 2022
Blue Shield Access+ returns to eight Bay Area counties: Alameda, Contra
Costa, Marin, San Francisco, San Mateo, Santa Clara, Sonoma, and Solano.
Blue Shield Trio will expand to Santa Cruz, Stanislaus, and Orange counties.
A new plan, UnitedHealthcare Signature Harmony, will be available in Los Angeles, Orange, Riverside,
San Bernardino, and San Diego counties.
Western Health Advantage will be available in Humboldt County.
PERSCare will become PERS Platinum. It will retain the same 90/10 benefit design and network as PERSCare.
PERS Choice also will transition to PERS Platinum. It will offer a 90/10 benefit
option and will keep its provider network.
PERS Select will transition to PERS Gold. It will keep the same 80/20 benefit design
and provider network as PERS Select.
PECG Delivers!1
INFORMERProfessional Engineers
in CaliforniaGovernment
Issue 8 . September 2021
Blue Shield Access+
Premium Single Two-Party Family
2022 $900 $1,800 $2,341
2021 $939 $1,878 $2,441
Out-of-Pocket Cost
2022 $209 $458 $614
2021 $294 $624 $836
Anthem HMO Traditional
Premium Single Two-Party Family
2022 $1,198 $2,396 $3,115
2021 $1,220 $2,441 $3,173
Out-of-Pocket Cost
2022 $507 $1,054 $1,388
2021 $575 $1,187 $1,568
Anthem HMO Select
Premium Single Two-Party Family
2022 $848 $1,696 $2,205
2021 $801 $1,601 $2,081
Out-of-Pocket Cost
2022 $157 $354 $478
2021 $156 $347 $476
Blue Shield Trio
Premium Single Two-Party Family
2022 $743 $1,485 $1,931
2021 $723 $1,445 $1,879
Out-of-Pocket Cost
2022 $52 $143 $204
2021 $78 $191 $274
PERS Platinum*
Premium Single Two-Party Family
2022 $947 $1,894 $2,462
2021 $849 $1,698 $2,208
Out-of-Pocket Cost
2022 $256 $552 $735
2021 $204 $444 $603
Kaiser Permanente
Premium Single Two-Party Family
2022 $805 $1,609 $2,092
2021 $762 $1,523 $1,980
Out-of-Pocket Cost
2022 $114 $267 $365
2021 $117 $269 $375
Health Net SmartCare
Premium Single Two-Party Family
2022 $1,007 $2,014 $2,619
2021 $924 $1,849 $2,403
Out-of-Pocket Cost
2022 $316 $672 $892
2021 $279 $595 $798
Health Net Salud y Más
Premium Single Two-Party Family
2022 $487 $973 $1,265
2021 $425 $850 $1,105
Out-of-Pocket Cost
2022 $0 $0 $0
2021 $0 $0 $0
PERS Gold**
Premium Single Two-Party Family
2022 $650 $1,301 $1,691
2021 $527 $1,055 $1,371
Out-of-Pocket Cost
2022 $0 $0 $0
2021 $0 $0 $0
Western Health Advantage
Premium Single Two-Party Family
2022 $741 $1,483 $1,927
2021 $757 $1,514 $1,968
Out-of-Pocket Cost
2022 $50 $141 $200
2021 $112 $260 $363
United Healthcare Signature Alliance
Premium Single Two-Party Family
2022 $818 $1,636 $2,127
2021 $756 $1,511 $1,965
Out-of-Pocket Cost
2022 $127 $294 $400
2021 $111 $257 $360
Sharp
Premium Single Two-Party Family
2022 $699 $1,398 $1,818
2021 $632 $1,265 $1,644
Out-of-Pocket Cost
2022 $8 $56 $91
2021 $0 $11 $39
United Healthcare Signature Harmony
Premium Single Two-Party Family
2022 $737 $1,475 $1,917
2021 $0 $0 $0
Out-of-Pocket Cost
2022 $46 $133 $190
2021 $0 $0 $0
Health Plan Monthly Premiums for Unit 9 Employees
State Employer Contribution for 2022
Employee Only
$691$645 (in 2021)
Two-Party
$1,342$1,254 (in 2021)
Family
$1,727$1,605 (in 2021)
Anthem Medicare Preferred
Premium Single Two-Party Family
2022 $360 $720 $1,081
2021 $383 $767 $1,150
Out-of-Pocket Cost
2022 $0 $0 $0
2021 $0 $0 $0
Health Plan Changes for 2022Blue Shield Access+ returns to eight Bay Area counties: Alameda, Contra
Costa, Marin, San Francisco, San Mateo, Santa Clara, Sonoma, and Solano.
Blue Shield Trio will expand to Santa Cruz, Stanislaus, and Orange counties.
A new plan, UnitedHealthcare Signature Harmony, will be available in Los Angeles, Orange, Riverside,
San Bernardino, and San Diego counties.
Western Health Advantage will be available in Humboldt County.
PERSCare will become PERS Platinum. It will retain the same 90/10 benefit design and network as PERSCare.
PERS Choice also will transition to PERS Platinum. It will offer a 90/10 benefit
option and will keep its provider network.
PERS Select will transition to PERS Gold. It will keep the same 80/20 benefit design
and provider network as PERS Select.
*Replaces PERS Care and PERS Choice plans. **Replaces PERS Select plan.
Return Service Requested455 Capitol Mall, Suite 501Sacramento, CA 95814
Professional Engineers
in CaliforniaGovernment
INFORMER
enrollment period starts on September 20 and closes on October 15, 2021. Beginning September 13, you may log in to your my|CalPERS account to access customized health information and explore your 2022 health plan options.
Supervisors and managers are covered by what is known as CoBen. The state makes a contribution which the individual can then apply to health and dental premiums. For 2022, the CoBen benefit allowance is $697 for the employee only, $1,377 for two-party, and $1,790 for families. To find Dental Plan rates for 2022, you may visit the CalHR website. The state pays the Vision Care premium.
CALPERS 2022 HEALTH PLAN PREMIUMS
...continued from page 1
CALPERS 2022 Health Plan Premiums
IN THIS INFORMER CONTACT USSACRAMENTO(916) 446-0400(800) 338-1480
