Choosing the right health insurance plan in California can be a complex decision. With numerous options available, understanding the costs and coverage is crucial, especially for state employees and those considering COBRA. This guide breaks down the 2024 health premiums approved by the California Public Employees’ Retirement System (CalPERS), offering a clear comparison to help you make informed choices.
For many Californians, particularly state and California State University (CSU) employees, CalPERS provides access to a variety of health insurance plans. Understanding the employer contributions and individual costs is the first step in selecting a plan that meets your needs and budget. This article will delve into the different contribution formulas and premium amounts for active state and CSU members, as well as those utilizing COBRA.
Understanding CalPERS Health Premiums for Active State Employees
The contribution rates for active state members are determined by different formulas, primarily the 80/80 and 85/80 formulas. Your out-of-pocket cost will be any amount exceeding the employer’s contribution. It’s important for active subscribers to contact their employer to determine which formula applies to their specific bargaining unit.
The CalPERS Health Program offers various contribution structures under these formulas, further categorized under State Employer Health Benefit Contributions and State Employer Consolidated Benefits (CoBen). CoBen is a benefit allowance provided to employees in specific bargaining units to help offset the costs of health, dental, and vision benefits.
Below is a breakdown of the State Employer Health Benefit Contributions:
| Formula | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| 80/80 Formula (Bargaining Units 1, 3, 4, 11, 14, 15, 20 and 21)* | $912 | $1,657 | $2,101 |
| 80/80 Formula (Bargaining Units 6, 10, 12 and 13) | $747 | $1,492 | $1,936 |
| 85/80 Formula (Bargaining Units 5 and 9) | $794 | $1,538 | $1,982 |
*The health contributions include an additional $165 health care supplemental contribution for SEIU-represented employees.
This table, “State Employer Health Benefit Contributions,” outlines the monthly amounts contributed by the state government towards health benefits for its employees. The contributions vary based on the bargaining unit and coverage level (single, two-party, or family). For instance, employees under the 80/80 formula in Bargaining Units 1, 3, 4, 11, 14, 15, 20, and 21 receive a higher contribution compared to those in Bargaining Units 6, 10, 12, and 13. The 85/80 formula, applicable to Bargaining Units 5 and 9, has its own set of contribution rates.
The State Employer Consolidated Benefits (CoBen) have different contribution amounts:
| Formula | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| 80/80 CoBen (Bargaining Units 2, 7, 16, 18 and 19) | $793 | $1,567 | $2,040 |
| 80/80 CoBen (Bargaining Unit 17)*** | $958 | $1,732 | $2,205 |
| 85/80 CoBen (Bargaining Unit 8) | $840 | $1,613 | $2,086 |
| 85/80 CoBen (Excluded) | $842 | $1,624 | $2,100 |
**CoBen is the employer-provided benefit allowance for employees in bargaining units 2, 7, 8, 16, 17, 18, 19, and excluded employees to offset health, dental, and vision costs.
***CoBen contributions include an additional $165 health care supplemental contribution for SEIU-represented employees.
This second table, “State Employer Consolidated Benefits (CoBen),” illustrates the CoBen contribution amounts for different bargaining units and excluded employees. CoBen is designed to provide a consolidated benefit allowance, helping employees cover a broader range of benefits including dental and vision, in addition to health. Again, the 80/80 and 85/80 formulas dictate different contribution levels, and Bargaining Unit 17 under the 80/80 CoBen formula receives a distinct, higher contribution rate.
For detailed information specific to your situation, it’s recommended to refer to the applicable Memorandum of Understanding or utilize the Benefits Calculator available on the CalHR website. These resources provide personalized insights based on your bargaining unit and specific needs.
CalPERS Health Premiums for Active CSU Members
Active CSU members have a different contribution rate structure. Here are the monthly contribution rates for active CSU employees:
| Group | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| All Employees (Except Unit 6) | $983 | $1,890 | $2,366 |
| Unit 6 | $988 | $1,900 | $2,386 |
The “Active CSU Members Contribution Rates” table shows a simplified contribution structure compared to state employees. There are primarily two categories: Unit 6 employees and all other employees. While the difference is slight, Unit 6 employees have marginally higher contribution rates across all coverage levels (single, two-party, and family). CSU employees can quickly reference this table to understand their employer’s contribution towards their health insurance premiums.
Understanding 2024 Statewide COBRA Health Premiums
For individuals in California who are no longer employed by the state or CSU but wish to continue their health coverage, COBRA (Consolidated Omnibus Budget Reconciliation Act) provides an option. COBRA premiums are typically more expensive as they include the full premium plus an additional administrative fee. For CalPERS, COBRA premiums are calculated at 102% of the basic premiums.
Below are the 2024 Statewide COBRA Health Premiums effective January 1, 2024:
| Plan Name | Single (1) | Two-Party (2) | Family (3+) |
|---|---|---|---|
| Anthem Blue Cross Del Norte EPO | $1,240.19 | $2,480.37 | $3,224.49 |
| Anthem Blue Cross Select HMO | $944.08 | $1,888.16 | $2,454.61 |
| Anthem Blue Cross Traditional HMO | $1,221.90 | $2,443.80 | $3,176.93 |
| Blue Shield Access+ EPO | $910.34 | $1,820.68 | $2,366.88 |
| Blue Shield Access+ HMO | $910.34 | $1,820.68 | $2,366.88 |
| Blue Shield Trio HMO | $826.44 | $1,652.89 | $2,148.75 |
| CAHP | $862.45 | $1,674.31 | $2,189.84 |
| CCPOA – North | $1,012.42 | $2,030.14 | $2,741.18 |
| CCPOA – South | $834.67 | $1,674.56 | $2,263.07 |
| Health Net Salud y Más | $670.10 | $1,340.20 | $1,742.26 |
| Kaiser Permanente (CA) | $983.43 | $1,966.87 | $2,556.93 |
| Kaiser Permanente (Out-of-State) 1 | $1,338.70 | $2,677.40 | $3,480.62 |
| PERS Gold | $876.50 | $1,752.99 | $2,278.89 |
| PERS Platinum | $1,240.19 | $2,480.37 | $3,224.49 |
| PORAC | $870.06 | $1,742.16 | $2,264.40 |
| Sharp Performance Plus | $849.90 | $1,699.81 | $2,209.75 |
| UnitedHealthcare SignatureValue Alliance | $900.64 | $1,801.28 | $2,341.67 |
| UnitedHealthcare SignatureValue Harmony | $778.97 | $1,557.95 | $2,025.33 |
| Western Health Advantage HMO | $823.37 | $1,646.75 | $2,140.78 |
1 These premiums cover all Kaiser out-of-state areas.
This detailed table, “CalPERS 2024 Statewide COBRA Health Premiums,” provides a comprehensive overview of the monthly costs for various health plans under COBRA. It includes popular providers like Anthem Blue Cross, Blue Shield, Kaiser Permanente, and UnitedHealthcare, among others. The premiums are listed for single, two-party, and family coverage, allowing individuals to compare the costs across different plans and choose one that fits their healthcare needs and financial situation during a period of job transition or other qualifying events. Note that while COBRA premiums are generally 102% of the basic premium, some carriers may charge less.
Making Informed Decisions About Your Health Insurance
Understanding these premium breakdowns is essential when you compare health insurance plans in California. Whether you are an active state or CSU employee or considering COBRA coverage, reviewing these figures will help you estimate your healthcare costs for 2024. Remember to consider not only the premiums but also the coverage benefits, provider networks, and your individual health needs when making your final decision. Always consult official CalPERS and CalHR resources for the most up-to-date and personalized information.
