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2020 and Historical CalPERS Medical Premiums

06-19-2019 |

CalPERS Board approves 2020 health plan premium rates

On June 19th, the CalPERS Board approved the 2020 health plan premium rates. 

Summary

CalPERS stated the combined weighted average increase for 2020 was 4.65% for the entire program.  The average increase for non-Medicare HMO plans is 5.98% and 3.28% for non-Medicare PPO plans.  The average increase for Medicare HMO plans was 6.08%, and Medicare PPO plans saw an average decrease of 2.52%.

There are no co-pay or benefit design changes for 2020.  A new HMO plan, Blue Shield Trio, has been added in the counties of Los Angeles, Sacramento, Placer, Nevada, El Dorado, and Yolo.

For the PPOs (the self-funded CalPERS plans PERS Select, PERS Choice and PERSCare), this marks the second year that the premiums were not risk-adjusted.  In other words, there was cross-subsidization across plans in years prior to 2019 (and after 2013).  As happened in 2019, the Board voted to use some excess reserves to "buy down" the PERSCare pre-Medicare rate.  Other excess reserves were used to buy down the Medicare rates and pay for administrative expenses.

Premium increases/decreases varied significantly by region and plan.  By plan, the largest increases were for basic Blue Shield Access+.

Regions

This is the first year of the new regional premium structure.  The prior 5 regions have been rearranged into 3 regions.  CalPERS did not publish percentage changes from 2019 to 2020 due to the change in regions.  We have calculated these increases based on the 2019 regions (works for all agencies except for agencies in the counties of Ventura and Riverside). 

Here is a comparison of the 2019 and 2020 CalPERS medical premiums for contracting Public Agencies, by region: 

2020 PEMHCA Premiums

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

PEMHCA Premium History

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