CalPERS Health Program Begins Open Enrollment; Changes for 2004 October 1-31.

Business Editors

SACRAMENTO, Calif.--(BUSINESS WIRE)--Oct. 1, 2003

The California Public Employees' Retirement System (CalPERS) today opened a one-month window for members who want to make health plan changes for 2004 coverage.

For the first time this year, all members received a personalized Health Plan Statement well before the October 1-31 open enrollment period. The Statement listed members, dependents, their health plans, and all plans' 2004 premiums. It included a prepaid postcard to return if members wanted to receive open enrollment packets for more specific details about making plan changes and premiums, health plans, geographical coverage areas, and benefits.

The purpose of the new Health Plan Statement was to spare people from having to wade through booklets that they didn't want or need, and to save on costs.

Typically, only 3 percent to 5 percent of active State, public agency, school district, or retired employees switch plans for themselves and their dependents - provided there are no major changes in the System's HMO lineup.

For 2004, CalPERS anticipates that as many as 50,000 CalPERS enrollees, including dependents, may switch from Blue Shield to Western Health Advantage (WHA), the lowest-cost HMO in the greater Sacramento area. Most of those people would be able to retain their current primary care doctor since they contract with Blue Shield as well as WHA. Others may join WHA from the CalPERS PPOs, PERS Choice and PERSCare.

WHA, which has approximately 5,000 CalPERS enrollees, is prepared to serve up to an additional 70,000 enrollees, having upgraded its technology and telephone capacity. It also has launched a CalPERS customer service phone number, expanded facilities, added equipment, and hired new employees.

Besides Blue Shield and WHA, Kaiser also is available for HMO coverage. Three other plans serve public safety officers of the California Association of Highway Patrolmen (CAHP), California Correctional Peace Officers Association (CCPOA), and Peace Officers Research Association of California (PORAC).

Beginning January 1, 2004, premiums for all enrollees in HMO, PPO, and Association plans will rise by an average of 16.4 percent, and by 10 percent for their Medicare supplements. Basic plan premiums will cost 18 percent more for HMOs, on average, 13.2 percent more for PPOs, and 11.6 percent more for the Associations. Medicare supplement premiums for HMOs will rise by 26.8 percent and by 15 percent for Associations, but decline by 1.2 percent for PPOs. There are new $50 copayments for emergency room visits and copay increases for prescription drugs that aren't on plans' preferred lists.

The share of premiums to be paid by active employees depends on employer contributions, which are determined by collective bargaining. Current public agency contributions vary.

The State's monthly contribution for most employees in 2004 will be $258 for single-party coverage, $514 for two-party coverage, and $661 for family coverage, according to the California Department of Personnel Administration.

For other State employees, the State contribution will remain at the 2003 level while their bargaining units continue to negotiate new labor contracts. The 2003 levels are $226 per month for single members, $450 for a member and one party, and $589 for families with children. The State contribution for retired State members in 2004 will be $331 for one-party coverage, $621 for two-party coverage, and $780 for family coverage.

CalPERS is the nation's second largest purchaser of public employee health care after the federal government. For more information on CalPERS, visit the System's Web site at www.calpers.ca.gov.