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Medical Open Enrollment

Open enrollment forms and information

Open Enrollment Letter - 2021-22

Open Enrollment 2021-22 (Yellow Form)

2021-22 CalPERS Health Benefit Summary

CalPERS Health Program Guide

Glossary of Health Coverage and Medical Terms

2021-22 medical plan rate sheets

2021 - 2022 10-MONTH RATE SHEET

2021 - 2022 11-MONTH RATE SHEET

2021 - 2022 12-MONTH RATE SHEET

New Enrollments - Open Enrollment with a January 1, 2022 Start Date*

Other Information

*Pre-Tax Election & Waiver Form REQUIRED for New Medical Open Enrollments ONLY

Cash-in-Lieu Form REQUIRED - If Cancelling Medical Coverage

Benefit Contact Information

Eligibility Rules

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