Benefits Tip: How our health plan rates are determined

Every year, all of the medical providers participating in CalPERS determine their own premium rates for the coming calendar year, based on market conditions and their own bottom line. Neither CFA, nor CalPERS, has any influence in determining rates.

Then, the California State Department of Human Resources determines which are the four highest-enrolled medical plans statewide, and computes a 4-plan weighted average premium rate.

California State University faculty’s monthly medical premiums are subsidized by the CSU up to 100% of this 4-plan weighted average (90% for dependents). We must pay the difference out of pocket if we are in a plan with premiums higher than the 4-plan weighted average.

Other state employees have their medical premiums subsidized at 80% of this 4-plan weighted average, and must pay out of pocket for all premium costs that exceed that 80% threshold.

In 2017, the 4-plan weighted average will be $707 a month.

If what you pay for medical coverage is a concern, you should take advantage of the CalPERS Open Enrollment Period that ends on October 7 this year to switch to a medical plan with lower premiums.

Click here to compare CalPERS medical plans and/or to change plans