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2018 Benefit Highlights
NEW WESTERN HEALTH ADVANTAGE HMO PLAN
Western Health Advantage HMO, a new plan partner for 2018, will provide coverage in the
counties of Colusa, El Dorado, Marin, Napa, Placer, Sacramento, Solano, Sonoma, and Yolo.
RATE CHANGES FOR 2018
Medical
The CalPERS medical plan rates all experienced changes for 2018. Within the Bay Area Region,
rates for the PERS Select (-2.5%), Choice (-3.6%) and Care (-5.3%) PPO plans all decreased. Rates
for the HMO plans were mixed, with the following plans receiving an increase: UnitedHealthcare
(29%), Health Net SmartCare (17.7%), Anthem HMO Select (9.3%) and Kaiser (6.3%). The
remaining HMO plans saw a decrease: Blue Shield Access+ (-13.2%), and Anthem HMO
Traditional (-6.5%).
Dental
The Delta Dental PPO and Buy-up plan rates decreased by 5.2%, while the Deltacare USA DHMO
plan received a 3% increase.
Vision
The VSP Core and Buy-up plan rates are not changing and are guaranteed through 12/31/2020.
Life Insurance
In July 2017, the City received a 10% decrease to our Basic and Supplemental Life insurance
rates. These rates are guaranteed through 6/30/2020.
PPO PLAN BENEFIT CHANGES
CalPERS introduced plan benefit changes for the PERS Select, PERS Choice, and PERSCare PPO
plans, including:
Expanding the use of Ambulatory Surgery Centers to include 12 new outpatient medical
procedures, including sigmoidoscopies, tonsillectomies, and kidney stone treatments. A
full list of the procedures will be listed in each health plan’s Evidence of Coverage.
Adding a site of care program to guide members who need certain prescription drug
infusions to lower-cost sites than hospitals (e.g., doctor’s office, ambulatory infusion
center, or home infusion).
A mobile application called Quick Care to help members quickly identify nearby clinics
and doctors’ walk-in offices, avoiding the need to use more expensive emergency room
care for their urgent care needs.