When

Sept. 16th – Oct. 11th, 2024

What is Open Enrollment?

The annual enrollment period when benefit eligible employees can make changes to their health benefits. Eligible employees can enroll in coverage, cancel coverage, change health plans, add eligible dependents or delete dependents.

If you do not have a CalPERS health insurance plan and receive Cash In Lieu, you will receive a separate email in October requesting that you complete the Cash in Lieu affidavit and submit it to the Benefits Office along with a copy of your medical insurance card. The Cash in Lieu affidavit must be completed annually.

Open Enrollment for voluntary insurance products and Flexible Spending Accounts offered through American Fidelity will take place in October/November. We will notify you of those dates soon.

What if I don’t need to make any changes?

You do not need to do anything if you are not making any changes.   

All changes made during open enrollment are effective January 1, 2025.

What’s new for health benefits?

Medical 

• Blue Shield of California and Included Health will assume the role of administrators for CalPERS PPO members. This new partnership marks a major milestone in CalPERS' continuing efforts to control healthcare costs, improve quality, and address the vital need for health equity. Blue Shield and Included Health will have strong financial incentives to improve the care that CalPERS members receive. Please click here for additional information.

• Rates increased across the board for all plans. 

  • Blue Shield Access+ 9.49% increase

  • Blue Shield Trio 4.74% increase

  • Kaiser Permanente 7.06% increase

  • Anthem Select HMO 9.01% increase

  • Anthem Traditional HMO 5.21% increase

  • United HealthCare Alliance HMO 4.84% increase

  • United HealthCare Harmony HMO 2.93% increase

  • PERS Platinum PPO 11.69% increase

  • PERS Gold PPO 10.55% increase

The primary drivers of this year's rate changes are the higher cost of providing services and the increased use of high-cost specialty and brand name drugs. In addition, Medicare premiums are being driven higher by significant changes in the way the federal government reimburses employer plans, which is adding new costs for plan sponsors like CalPERS.

Another factor in this year's rate change is that CalPERS will be completing its transition to a single risk pool to improve the stability of its Basic PPO plans. The change is expected to stabilize enrollment across the HMOs and PPOs by pricing the plans based on the value of their benefits and network instead of the mix of healthy or unhealthy members in a plan.

Member added Benefits:

• Doula Services: Provides non-medical care for pregnant and postpartum members to improve health education and provide physical and emotional support before, during and after pregnancy. In addition, the doula service will improve health equity and decrease the known disparities in maternal and infant health care, especially for Black, Native American, and Pacific-Islander communities.

• Travel for Medically Necessary Care: Standardizes coverage of travel and lodging for eligible medically necessary services that cannot be accessed locally for all Basic and Medicare members.

• The monthly cap for medical insurance is $900- for full-time employees.

• Part-time employees working four or more hours per day/20 hours per week will receive a prorated share of the cap based on the number of hours served weekly.

VSP Vision Care

There are no changes to our vision plan for 2025. Rates will decrease slightly.

Delta Dental

There are no changes to our dental plan for 2025. Rates will decrease slightly.

How do I make changes?

Health Enrollment Self-Service is available for all eligible active employees through your myCalPERS account at www.calpers.ca.gov. During Open Enrollment you will be able to make the following changes to your medical insurance online:

• Enroll yourself and your eligible dependents into health benefits (If you are adding a spouse and/or dependents you must upload a copy of your marriage certificate and/or copies of dependent(s) birth certificates)

• Add or remove dependents

• Change health plans

• Cancel coverage

For information on signing up for a myCalPERS account and submitting a health enrollment or change request visit the CalPERS website.

If you do not wish to use the self-service option on myCalPERS you must complete the CalPERS enrollment/change form found on the Enrollment Forms tab and return it to the Benefits Office by October 11, 2024. If you are adding a spouse and/or dependents you must submit a copy of your marriage certificate and/or copies of dependent(s) birth certificates to the Benefits Office.

You may also add dependents to the dental/vision plan by completing the dental/vision enrollment form found on the Enrollment Forms tab. 

More Information

www.mycalpers.ca.gov

You can access the 2025 Health Benefit Summary on-line or on the Summaries tab.

QUESTIONS

Contact Mindy Bloom at 661-294-5300 ext. 5192 or by email at mbloom@saugususd.org.