News

2019 and Historical CalPERS Medical Premiums

06-26-2018 |

CalPERS Board approves 2019 health plan premium rates

On June 20th, the CalPERS Board approved the 2019 health plan premium rates. 

Summary

CalPERS stated the combined weighted average increase for 2019 was 1.16% for the entire program, the lowest increase in more than 20 years.  The average increase for non-Medicare HMO plans is 0.37% and 2.83% for non-Medicare PPO plans.  Medicare plans on average saw a 1.37% increase.

Several large HMO plans are moving out of various counties:

  • HealthNet will no longer be in Sacramento County
  • Blue Shield Access+ will be moving out of 8 counties in the Bay Area
  • UnitedHealthcare will no longer be in Bay Area or Other Northern California regions
In addition, a couple of HMOs are saving money by no longer including UCDavis Medical Group.

For the PPOs (the self-funded CalPERS plans PERS Select, PERS Choice and PERSCare), this marks the first year since 2013 when the premiums were not risk-adjusted.  In other words, there was cross-subsidization across plans in prior years.  This year there was no risk adjustment, resulting in the PERSCare pre-Medicare plan having an average increase of 38.1%.  The Board voted to use some excess reserves to "buy down" the rate, resulting in only a 19.8% increase.  Other excess reserves were used to buy down the Medicare rates and pay for administrative expenses.  In contrast, the PERS Select plan showed a 25.6% decrease, also the result of the end of risk adjustments.

Basic Plans

Premium increases/decreases varied significantly by region and plan.  By plan, the largest increases were for Anthem Traditional and PERSCare followed by UnitedHealthcare and Blue Shield Access+.  PERS Select had very large decreases. By region, premiums in northern California regions continue to be significantly higher than those in southern California regions.

Medicare Plans

Premium increases/decreases for Medicare plans range from a 9.5% decrease in the UnitedHealthcare premium to a 5.4% increase in the PORAC premium.  In general, the HMOs decreased overall while the PPOs showed moderate 3%-4% increases.  Excess reserves were used for the PPO plans to help buy down to lower rates.

Here is a comparison of the 2018 and 2019 CalPERS medical premiums for contracting Public Agencies, by region: 
2019 PEMHCA Premiums 

Here is a historical list of CalPERS medical premiums for contracting Public Agencies, by region:

PEMHCA Premium History

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