This news story is also available in Spanish.
Following last month’s announcement naming Blue Shield of California as the new administrator for its Preferred Provider Organization (PPO) plans, the California Public Employees’ Retirement System (CalPERS) has finalized updates to all of its health benefit offerings for 2025, with Blue Shield’s Health Maintenance Organization (HMO) plans, Access+ and Trio HMO remaining competitively priced.
In 2025, Blue Shield will expand its low cost, high-quality HMO plan, Trio HMO, into Contra Costa County and three large ZIP codes in Shasta County*. The expansion brings a more affordable option to two areas that previously did not have access to this type of plan.
Blue Shield currently serves more than 170,000 CalPERS members with its HMO and EPO (Exclusive Provider Organization) plans and now for 2025 will serve an additional 400,000 with the PPO offering.
With these changes, CalPERS and Blue Shield are demonstrating their shared commitment to improving the member experience by focusing on improved healthcare access, quality and affordability for its members.
Blue Shield is continuously making enhancements to create a better healthcare experience for its members. Below are a few highlights CalPERS members can look forward to in 2025.
- Transforming health record access for all members: Blue Shield’s new Member Health Record will be available for all members by the end of 2024. The Member Health Record will provide members easy access to their medical history, including claims information, lab results, visit history and more — all in one digital place.
- Leading the way for a better pharmacy experience: In 2023, Blue Shield announced its Pharmacy Care Reimagined initiative, which will begin on January 1, 2025. Members with a Blue Shield pharmacy benefit plan can look forward to an integrated, coordinated and holistic pharmacy experience.
- Providing seamless support for members with a Blue Shield PPO plan: CalPERS has contracted with Included Health to provide virtual care, navigation and population health management services for active employees and their families who select the PPO plan. Together, Blue Shield and Included Health will provide holistic and seamless support.
“We are entering a new era of health care for our members,” said Dan Prettyman, vice president of Blue Shield’s Select Markets team that supports CalPERS and its members. “We are in an industry that is ripe for change, and we hope the model we are building with CalPERS will influence the rest of the industry to expand access to high-quality, affordable health care.”
With the CalPERS Board approval of the 2025 health plan changes and premiums, CalPERS members can look forward to annual open enrollment, which is taking place between September 16 and October 11, 2024. At that time, CalPERS members will be able to view all their options, including Blue Shield of California’s offerings, and make their coverage choices.
CalPERS is the largest public-employer purchaser of health benefits in California and the second largest employer-purchaser in the nation after the federal government. CalPERS is Blue Shield’s largest client.
*Trio HMO expansion into Shasta County is pending approval by the California Department of Managed Health Care.