CalPERS Open Enrollment 2026 Health Benefit Officer Resource Toolkit

Open enrollment 2026 information for health benefit officers.

 

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Get an overview of Included Health and the services we offer to support CalPERS members.

Encuentre atención médica utilizando la aplicación Included Health

CalPERS Resources

CalPERS resources available for download.

Su proveedor de atención primaria (PCP) se centra en su salud general y ofrece atención personalizada coordinada para apoyar su bienestar total.

Si se inscribe en el plan PERS PPO, tendrá la oportunidad de elegir a su médico de atención primaria. Este es su médico principal y, por lo general, su primer punto de contacto. Tener una conexión sólida con su proveedor de atención primaria le permite obtener un conocimiento profundo de su historial médico, lo que le permite brindarle el tratamiento y la orientación más adecuados.

Si no selecciona un proveedor de atención primaria, se le asignará uno. Puede cambiar de proveedor de atención primaria en cualquier momento.

Cómo encontrar su proveedor de atención primaria o seleccionar uno nuevo:
Para buscar un médico de atención primaria y otros proveedores, llame a Included Health o inicie sesión.

Para cambiar su PCP, llame a Included Health al 855-633-4436 o visite el portal para miembros de Blue Shield .

Inicie sesión para elegir su proveedor de atención primaria

Helping Members Considering a CalPERS PPO Plan for 2026
If a member is thinking about enrolling in a CalPERS PPO plan for 2026 and wants to check if their current provider is in-network, direct them to the Blue Shield of California Provider Search Tool. They can search by provider name, facility, medical group, or specialty—such as pediatrics or psychology. This tool is available to all CalPERS members and does not require a login.

Inicie sesión para buscar un proveedor

Included Health members can use the Provider Match tool to find high-quality primary care providers (PCPs) and specialists that are in network. To access this benefit, you must have an active Included Health account.

Pro Tip:
If a member has questions about their PCP assignment, like how to change a matched PCP or why a certain provider is listed on a member’s Medical ID card, refer members to the Included Health FAQ on the microsite. It’s a quick and helpful resource for clearing up their common questions.

Podemos ayudarlo a encontrar y programar atención local dentro de la red para necesidades complejas. Included Health identifica médicos de alta calidad dentro de la red y derivaciones que mejor se adaptan a sus necesidades específicas. Se brindan recomendaciones médicas personalizadas según sus requisitos y preferencias únicos. También podemos solicitar que sus registros de paciente se compartan entre los proveedores participantes y los especialistas derivados para garantizar una atención integral y coordinada. Envíe un mensaje a un coordinador de atención en la aplicación Included Health o llame al 855-633-4436 para obtener más información y comenzar hoy mismo.

Inicie sesión para obtener los servicios de referencia de conserjería

We provide you with 24/7 telephonic support from registered nurses who can help direct you to the next clinically appropriate step, whether it be home care, urgent in-person care, or other integrated health services and benefits. You can consult with a nurse at any time or speak with a staff clinician for personalized advice on the best course of action for your care. This service includes education and support on your condition, symptoms, and treatment next steps via live phone consultations with Included Health staff clinicians. If applicable, the staff clinician will share educational materials, such as weblinks to various resources, and provide a written after-call summary through the Member Portal. Log in or call 855-633-4436 to learn more and get started today.

Inicie sesión para recibir asesoramiento en vivo

Include Health ofrece una manera conveniente de acceder a atención médica en cualquier momento y en cualquier lugar.

Nuestros servicios incluyen:

Atención de urgencias
Cuando necesite atención urgente, recíbala desde la comodidad de su hogar o desde cualquier lugar. Tiene acceso las 24 horas, los 7 días de la semana a nuestra red de atención virtual de primera clase.

Atención primaria virtual
Obtenga atención primaria con médicos de atención primaria virtuales que escriben y renuevan recetas, solicitan pruebas y análisis de laboratorio y ofrecen apoyo dedicado sin importar dónde se encuentre en su recorrido de atención médica.

Atención de salud mental virtual
La salud mental es una parte importante de su bienestar general. Reserve una visita virtual con un terapeuta o psiquiatra para recibir atención compasiva.

Inicie sesión o llame al 855-633-4436 para obtener más información y comenzar hoy mismo.

Inicie sesión para recibir atención virtual
For routine labwork under the PERS Gold plan, the average allowed amount at an Outpatient Hospital is $354 and you pay a $71 coinsurance; at Quest or LabCorp, the allowed amount is $65 and you pay $0; and at an Other Free-standing Lab, the allowed amount is $80 and you pay a $16 coinsurance. For routine labwork under the PERS Platinum plan, the average allowed amount at an Outpatient Hospital is $354 and you pay a $35 coinsurance; at Quest or LabCorp, the allowed amount is $65 and you pay $0; and at an Other Free-standing Lab, the allowed amount is $80 and you pay an $8 coinsurance.

Save money on labs

CalPERS members receive full coverage for lab services through Quest Diagnostics and LabCorp. Encourage members to leverage in-network labs by printing or screenshotting this one-page lab request document, and asking their provider to send their lab orders directly to an appropriate location.

 

Download the lab request document

What our members are saying about Included Health

“Wendy never gave up on me or felt that I was ever a burden. She provided grace and empathy. She is a true asset to your company. No matter how frustrated or stressed I was she made the process much easier. Wendy was always so diligent and went above and beyond to get the issue resolved with my PA. I can not thank Wendy enough for never giving up.”

—Included Health member

A smiling young man with a beard and a dark beanie hat looks directly at the camera. He is wearing a dark jacket and scarf, with a blurred outdoor background.

“I have called for several reasons since the beginning of the year when our insurance changed from Blue Cross to Blue Shield and I have been, unexpectedly, very pleased with the customer service and the people who have gone to bat with me when providers were trying to charge more than they were supposed to, for instance.... I'm impressed! THANK YOU!!”

—Included Health member

A woman with red hair and bangs, wearing dark-rimmed glasses and a patterned shirt, smiles faintly at the camera. The background is a bright, blurred indoor setting.

“Both nurses I spoke with were so mindful, thoughtful and asked thorough questions. I will definitely use them again if needed!”

—Included Health member

A young Black woman with braided hair and round gold-rimmed glasses smiles broadly at the camera. She is wearing a white collared shirt, with a blurred urban background.
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