What Kind of Health Benefits Are Offered Under CalPERS?

As an employee, securing employer-sponsored health benefits is important. With rising costs of healthcare and increasing life expectancy, having your employer cover health benefit costs ensures access to the medical care you need to maintain your quality of life. As a municipal employee, you gain access to California Public Employees’ Retirement System (CalPERS) health benefits during your working years and into retirement.

Find out how the program works and the benefits it may provide you.

CalPERS Health Program Eligibility

The Public Employees’ Medical & Hospital Care Act (PEMHCA) governs the CalPERS Health Program. The program provides government employees with quality health benefits with reduced financial risk. All health plans offer Medicare health benefits for eligible members. Catastrophic illnesses don’t affect coverage or premium rates.

Types of CalPERS Health Plans

CalPERS offers four types of health plans. Association Plans are for members of specific employee organizations. Exclusive Provider Organizations (EPOs) provides access to a select network of healthcare providers, including doctors, hospitals, labs, and pharmacies. Health Maintenance Organizations (HMOs) contract with providers to offer services at a fixed price. You may have copayments for specific services but no deductible, claim forms, or geographic restrictions for your service area. Preferred Provider Organizations (PPOs) give you access to a preferred network of providers. Similar to a traditional fee-for-service plan, if you use providers outside the network, you pay a higher percentage of charges. You typically have to meet an annual deductible before certain benefits apply. You also are responsible for a set coinsurance amount before the plan pays the balance up to the allowable amount. Combination Plans mean at least one family member is enrolled in a Medicare health plan and at least one family member is enrolled in a Basic health plan through the same carrier. You can register for a CalPERS Health Program Workshop to learn more about the plans.

Importance of Having Employer-Provided Health Benefits

A survey conducted for America’s Health Insurance Plans shows that 56% of United States adults with employer-sponsored health benefits said that whether or not they like their health coverage is a key factor in deciding to stay at their current job. Also, 46% said health insurance was either the deciding factor or a positive influence in choosing their current job. Plus, 71% of employees reported being satisfied with their employer-provided coverage but concerned that the cost of their health plans will continue to rise. Benefits that mattered most were prescription drug coverage (51%), preventive care (47%), and emergency care (47%). Employer-provided coverage helps employees gain access to high-quality healthcare to fill their unique needs for staying healthy, engaged and productive.

Qualify for CalPERS Health Benefits

Qualify for CalPERS health benefits by finding a municipal job through MuniTemps. Our variety of municipal employers offer flexibility in both work responsibilities and health benefits. See which municipal roles are open today!


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