PEMHCA/CERBT

2022 CalPERS Medical Premiums

08-02-2021 |

CalPERS Board approves 2022 health plan premium rates

On July 1​3th, the CalPERS Board approved the 2022 health plan premium rates. 

Summary

CalPERS stated the combined weighted average increase for 2022 was 4.86% for its program.  The average increase for non-Medicare HMO plans is 4.69% and 8.67% for non-Medicare PPO plans.  Premiums for Medicare HMO plans decreased on average 6.37%, and Medicare PPO plans increased 5.48%.  CalPERS reported that COVID19 related health care costs for 2022 are projected to be modest. Cost drivers for the overall 2022 premium increases include medical inflation, pharmaceutical inflation, and buydown adjustments to premiums made in 2021.

Basic plan premiums reflect a new portfolio rating approach approved by the Board in November 2020. Per CalPERS, this new risk mitigation strategy better aligns plan premiums with the value of benefits and network instead of the mix of healthy or unhealthy lives in a plan. Portfolio rating will be phased-in over two years starting in 2022, and when fully implemented, CalPERS expects it to result in less year-over-year premium volatility over time. 

Premium increases/decreases varied significantly by region and plan.  By plan, the largest increases for basic plan premiums were for PERS Select across all three regions.  The biggest decreases for basic plan premiums were for PERSCare plans across all regions. The largest increase for Medicare plan premiums was for PERS Choice and the largest decrease was for PORAC.

 

Phanges for 202​2 include: 

Basic Plans (non-Medicare)

Blue Shield Access+ reenters 8 Bay Area counties it previously exited in 2019 (Alameda, Contra Costa, Marin, San Francisco, San Mateo, Santa Clara, Sonoma, and Solano), and BS Trio has been expanded into the counties of Orange, Santa Cruz, and Stanislaus.

Western Health Advantage HMO plan is now offered in Humboldt county and Blue Shield EPO plan expanded into Shasta and Lassen counties.  A new plan UnitedHealthcare Harmony plan is offered in the counties of Los Angeles, Orange, Riverside, San Bernardino and San Diego.

PERSCare and PERS Choice have been combined into a single PERS Platinum plan, which retains the same 90/10 benefit design and network as PERSCare/PERS Choice.  PERS Select has become PERS Gold, but retains the same benefit design and network.

Medicare Plans

There are several new plans: a Blue Shield Medicare Advantage PPO, UnitedHealthcare Edge, and Western Health Advantage (only offered in the same 9 northern California counties the Basic plan was offered in – prior to the Basic Plan’s expansion to Humboldt).  A few supplemental benefits have been added to the Anthem Medicare Preferred and Blue Shield Medicare Advantage plans.  The Anthem Medicare Preferred plan has expanded into 21 counties so that now all 58 California counties are covered. PERSCare and PERS Choice have been combined into a single new plan PERS Platinum, and PERS Select has become PERS Gold. There are no changes to benefit design or network for either of these new plans.

Here is a comparison of the 202​1 and 2022 CalPERS medical premiums for contracting Public Agencies, by region: 

2022 PEMHCA Premiums

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

PEMHCA Premium History

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202​1 Bartel Associates, LLC

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