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.

Find care using the Included Health app

CalPERS Resources

CalPERS resources available for download.

Your primary care provider (PCP) focuses on your overall health and offers coordinated personalized care to support your total well-being.

If you enroll in the PERS PPO plan, you will have the opportunity to choose your primary care physician. This is your main doctor and usually your first point of contact. Having a strong connection with your primary care provider allows them to gain a deep understanding of your medical history, enabling them to deliver the most appropriate treatment and guidance.

If you do not select a primary care provider, one will be matched to you. You can change your primary care provider at any time.

How to find your primary care provider or select a new one:
To search for a primary care physician and other providers, call Included Health or log in.

To change your PCP, call Included Health at 855-633-4436 or visit the Blue Shield member portal.

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.

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.

We can help find and schedule in-network, local care for complex needs. Included Health identifies high-quality, in-network physicians and referrals best matched to your specific needs. Personalized physician recommendations are provided based on your unique requirements and preferences. We can also request that your patient records are shared between participating providers and referred specialists to ensure comprehensive and coordinated care. Message a Care Coordinator in the Included Health app in or call 855-633-4436 to learn more and get started today. 

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.

Include Health offers a convenient way to access care anytime anywhere. 

Our services include:

Urgent care
When you need urgent care, get it from the convenience of your home or wherever you may be. You have 24/7 access to our best-in-class virtual care network.

Virtual primary care
Get primary care with virtual PCPs who write and refill prescriptions, order tests and labs, and offer dedicated support no matter where you are in your healthcare journey.

Virtual mental health care
Mental health is an important part of your overall well-being. Book a virtual visit with a therapist or psychiatrist for compassionate care.

Log in or call 855-633-4436 to learn more and get started today. 

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.

 

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

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

—Included Health member

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