News from CalPERS
What it Means for CalPERS Members
On July 15, 2021, Dignity Health terminated its contract with Anthem Blue Cross. The termination affects roughly 14,000 members in CalPERS’ Anthem Basic plans – 9,500 PPO members and 4,500 HMO members. It does not impact Anthem Medicare Preferred and Supplemental members.
The termination is for all Dignity Hospital services and for services provided by Dignity employed physicians. It is statewide and impacts Anthem’s entire business with Dignity. The dispute is not limited to CalPERS’ health plans.
Here’s how CalPERS Basic PPO and HMO members in Anthem plans are impacted:
- For PPO members, Dignity in-network coverage ended on July 15, 2021. Anthem sent letters Friday, July 16, to all PPO members letting them know that, with important exceptions, Dignity was no longer an in-network provider. To find an in-network doctor or hospital, members are directed to log in to anthem.com/ca/CalPERS and select Find Care or call 877-737-7776.
- Anthem assures its members that they will have timely access to care. If a service is not available at an alternate participating provider, PPO members may request an out-of-network referral by contacting Anthem at 844-971-0117, or the toll-free member services number on their ID card. Requests will be reviewed on a case-by-case basis pursuant to Anthem’s out-of-network referral policy. When an out-of-network referral is approved by Anthem, the member’s in-network benefit levels will apply.
- For HMO members, the termination will be effective September 1, 2021. HMO members will be auto assigned to a geographically proximate provider and will also be able to select a physician if the assigned one is not desirable. A letter to HMO members was mailed out July 2 with this information.
By law, health contract terminations must provide for continuity of care. This means members with certain specified conditions – those who are pregnant or with a newborn, individuals with chronic conditions, significant mental health issues, and those undergoing treatment for a potentially terminal illness, for example – will continue to be able to see their current providers in-network.
The Anthem letters alert members to these protections. If a member began a course of treatment at Dignity Health before the contract termination date for certain conditions, the member can request continuity of care by calling Anthem Blue Cross at 844-971-0117 or the toll-free member services telephone number on their identification card.
A complete list of contracted hospitals, as well as ambulatory surgical centers and other facilities, can be found at www.anthem.com/ca. Also, Anthem Customer Service representatives can check the provider database for a physician’s admitting privileges at another nearby in-network facility.
March 21, 2018
Communications & Stakeholder Relations
Contact: Bill Madison, Information Officer
(916) 795-3991 - email@example.com
New PERS Select plan designed to increase engagement and improve health
SACRAMENTO, Calif. - The California Public Employees' Retirement System Board of Administration today took another step forward to bring innovative health benefits to its members. The board approved a value-based insurance design (VBID) plan for PERS Select.
VBID is designed to improve coordination of care through engagement with a personal doctor and uses incentives to improve member health and wellness.
"This is a major change and innovative way of delivering value-based insurance," said Priya Mathur, the president of the CalPERS Board. "Members still have a choice of plans, and this new PERS Select option encourages enrollees to be more engaged in their own health care, and enables them to make better informed health care decisions."
The new VBID design takes effect as a two-year pilot in the 2019 plan year for the PERS Select Preferred Provider Organization non-Medicare plan.
The board's decision revises the PERS Select PPO non-Medicare plan to a VBID approach that allows a member to choose a personal care physician to coordinate their health care, and ensures they are getting the proper care when needed. The new Select plan will also provide incentives for members to become more involved in their health decisions and earn credits to reduce their annual deductible costs.
Currently, over 50,000 CalPERS members are enrolled in the PERS Select non-Medicare plan. CalPERS estimates that those enrolled in the PERS Select plan will save between $221 and $277 annually on their premiums, for an overall savings of more than $3 million a year. The system estimates a total cost savings of nearly $10 million.
The new plan also allows members in rural areas with no Health Maintenance Organization (HMO) options to have HMO-type support. Currently, 18 counties in California are without an HMO in their area.
"A number of our members live in rural areas where an HMO-like option of having a personal physician will be appreciated," said Rob Feckner, chair of the CalPERS Pension and Health Benefits Committee. "They, too, will have access to a doctor who supports their care and guides them through the health care system, and an opportunity to participate in wellness activities to improve their overall health."
Members in PERS Select can also easily reduce their annual deductible costs by participating in up to five evidence-based health and wellness activities:
- Get anannual biometric screening
- Receive anannual flu shot
- Certify thatthey are non-smokers, or participating in a smoking cessation program
- Get a secondopinion for non-emergency elective surgeries
- Engage witha nurse manager for disease management (for those who can be treated bydisease management programs)
Members who participate in the incentives program can save between $500 and $1,000 per year on annual deductibles of $1,000 to $2,000 per year.
CalPERS will evaluate the PERS Select plan changes quarterly during the two-year period, and report the findings to the Board with recommendations to continue the plan as it is or modify the benefits.
The Cost-of-Living Adjustment (COLA) is a benefit to ensure your value of money at retirement keeps up with the rate of inflation. Typically, this benefit begins the second calendar year of retirement, although the annual rate of inflation and retirement law could affect the onset of your COLA. Under existing retirement law, retirees receive an annual COLA paid in the May 1 warrant each year.
|Year of Retirement||% COLA Increase Effective May 1, 2021||Year of Retirement||
% COLA Increase Effective May 1, 2021
|2% COLA||2003 & earlier||2%||3% COLA||1979 & earlier||3%|
|2016||1.62%||4% COLA||2019 & earlier||1.23%|
|2018-2019||1.23%||5% COLA||2019 & earlier||1.23%|
|2020||Not Eligible||2020||Not Eligible|
April 1, 2020
Subject: Update on CalPERS and COVID-19
Dear Valued Stakeholders,
CalPERS is in its third week of our COVID-19 response and I’m pleased to report that our operations are running well despite the circumstances. Approximately 78% of our workforce is working remotely while the remaining team members work in our Sacramento headquarters to conduct essential services with proper social distancing. Our regional offices continue to remain closed to the public for the safety of our members and employees.
I previously shared that we would continue working under our current operations through April 7, but we have decided to extend the date to April 30. Our decision was based on early signs that Governor Newsom’s stay-at-home order and social distancing are making a difference and helping to decrease the spread of COVID-19. Health officials have indicated that the next few weeks are critical to continue to effectively flatten the COVID-19 curve. Above all else, we want to protect our members and team members.
Below are a few updates for your information:
All April 1 retirement checks were successfully paid to members on time. As a reminder, the State Controller’s Office will not be printing and mailing direct deposit statements this month. Statements are available on-line through myCalPERS accounts.
Calls to our Contact Center continue to remain at lower than normal levels. We have not seen a general increase in wait times, but members should expect some longer wait times at peak hours.
We’ve also heard from some of you that employers are beginning to offer early retirement incentives and members have questions about the process for retirement with our headquarters and regional offices closed. Please encourage members to apply for retirement online through their myCalPERS account. We have an instructional video on our web site that walks members through the online process that can be viewed here. We will be promoting through our communication channels.
Our health team is negotiating health rates for 2021 and they will provide the CalPERS Board an update in closed session this month. The team will provide an update on our progress at the regularly scheduled stakeholder briefing on April 16.
CalPERS Investment Portfolio
Our investment team continues to manage the portfolio through the ongoing market volatility. While our asset value has risen in the past few days, what’s most important is for us to keep focused on the long-term and assess our returns at June 30, the date that dictates any changes to employer and member contributions.
April Board Meetings
We plan to hold our April Board and committee meetings scheduled for April 20-22 through video conference, including our public webcast. We are also working on a process to ensure we have the ability for public comment and we will share that with you soon.
I hope you and your families are healthy and safe. Please don’t hesitate to contact me or our Stakeholder Relations team if you have any questions.
Chief Executive Officer
By declaration of the Governor, CalPERS has announced that the 960 annual hours restriction is waived during the Coronavirus emergency period. Annuitant workers can exceed the annual restriction on hours. The 180 day waiting period, after retirement, to begin annuitant work is also waived during the emergency period.
March 24, 2020
Subject: Update on CalPERS and COVID-19
Dear Valued Stakeholders,
We know this has been a time of uncertainty for you, your organizations and all Californians. I wanted to reach out personally to assure you that CalPERS is committed to serving our members, employers and stakeholders during this challenging time. We are also prepared to deliver the quality customer service that CalPERS is known for, and we will continue to protect the safety of the retirement and health care benefits of California’s public employees.
As we have previously shared, we are posting regular updates on our website about the status of our operations and any changes to our services due to the impacts of COVID-19. We encourage you to share this with your membership, particularly the Frequently Asked Questions that we added today.
We are closely monitoring the global economic uncertainty resulting from the COVID-19 pandemic, recognizing that all of you and local and state leaders have a great interest in the impact to the fund. Below are some important updates that I wanted to share.
All April 1 retirement checks to members, beneficiaries and survivors will be paid on time. Due to current limitations at the State Controller’s Office, direct deposit statements will not be printed and mailed this month. Statements are available on-line through myCalPERS accounts.
Although our Sacramento headquarters and regional offices are closed to protect the public and our team members, our Contact Center remains open and fully operationally. Wait times are a little longer than normal. You can also remind members to use their myCalPERS account to make important updates online or submit secure member inquiries.
Costs and fees for testing for COVID-19 are waived for all CalPERS health members. This includes all HMO, PPO, basic, and Medicare plans. All other plan design features and coverage remains the same. We do advise members to refrain from all non-essential hospital visits, for their safety and for the safety of our health care workers.
CalPERS Investment Portfolio
Our Chief Investment Officer Ben Meng and his team have been planning for a market drawdown for over a year. We are better prepared than during the financial crisis of 2008. We have a healthy liquidity position, a diverse portfolio and asset allocation, and a total fund perspective that allows us to maintain our discipline while also looking for appropriate investments. CalPERS is positioned to mitigate risks and capitalize on investment opportunities. Ben will be giving an update on the portfolio in his April report to the Investment Committee scheduled for April 20.
April Board Meetings
We are currently planning to hold our April Board and committee meetings scheduled for April 20-22. We are working on solutions for video conference and teleconference depending on the status of the stay-at-home order at that time. We will keep you posted as we develop our plans.
We will be scheduling a webinar for our employer partners in the next two weeks to help answer their questions about impacts to the fund. Please send any questions to our Chief Financial Officer Michael Cohen that you would like addressed at Michael.firstname.lastname@example.org.
Thank you for your patience and cooperation during this time. Despite the circumstances, CalPERS is here for you. Please don’t hesitate to contact me or our Stakeholder Relations team if you have any questions.
Chief Executive Officer
CalPERS has announced that the return on investment number for fiscal year 2018/19 is 6.7%. This is a shortfall of 0.3% from the discount rate objective of 7%. The struggle continues for CalPERS to reach the target rate of return. The new Chief Investment Officer (CIO), Ben Meng, is still searching for the right combination of global equities staff and outside investment managers. The CIO has the same issue with private equity investment staff and outside managers. A new private equities head, Greg Ruiz, is due to start in July. Private equity is considered to be a key element in the future investment performance of CalPERS. Hopefully, we will soon see a stabilization of CalPERS investment strategies that will achieve results closer to those of CalSTRS.
This year, through a partnership with CalHR and CSU, we began an ongoing effort to regularly verify dependent eligibility for enrollment in the CalPERS Health Program. This process is specific to state and CSU employees and retirees, not public agency or school members.
Only eligible dependents should be enrolled for health benefits. Sometimes members mistakenly add dependents who are ineligible, or forget to unenroll dependents who no longer qualify, for example, a spouse or domestic partner who is no longer eligible for health coverage.
The Dependent Eligibility Verification (DEV) process helps ensure everyone on a CalPERS health care plan should be. Dependents include:
- Registered domestic partners
- Natural born children
- Adopted children
- Children of registered domestic partners
Every three years, DEV requires members to submit verification of dependent eligibility, which might include copies of birth certificates, tax returns, etc. If you have at least one enrolled dependent, you will receive a series of three letters reminding you to verify. You have 90 days to submit documentation to your agency’s human resources office for continued dependent coverage.
The first round of verifications began February 2018: We sent notification letters to members with April birthdays. By April 30, we hope to verify approximately 35,000 dependents. In May, we will contact those with July birthdays, and so on, until we cover each birth month over a three-year period. CalPERS will begin notifying retirees later this year, following the same process. All told, 247,969 active and retired state and CSU subscribers with dependents enrolled in the CalPERS health benefits program will need to verify their dependents by 2021.
Members responded well to the DEV pilot program, which kicked off in spring 2015 before the state senate passed SB 98, requiring state and CSU employers to continually verify dependent eligibility. By removing ineligible dependents, the pilot saved an estimated $122 million in costs. The 2018-2021 phase will continue to improve the long-term affordability of member care.
For more information about Dependent Eligibility Verification, visit calpers.ca.gov or call the CalPERS Customer Contact Center at 888 CalPERS (or 888-225-7377).
This morning, CalPERS CEO Marcie Frost was interviewed on Capital Public Radio. In the 15-minute conversation, she discussed the funding and sustainability of the System, and our recent work in collaboration with stakeholders to secure the future of the fund.
Link to audio interview: http://www.capradio.org/news/insight/2018/04/12/insight-041218b/
Link to “A Solid Foundation for the Future” document outlining our recent work to strengthen the fund, which is discussed in the interview: https://www.calpers.ca.gov/docs/forms-publications/solid-foundation-for-the-future.pdf
David Teykaerts | Stakeholder Strategy Manager | CalPERS |