CalPERS described changes to its Value-Based Insurance Design (VBID) that take effect in 2026 and reviewed the key differences between PERS Gold and PERS Platinum PPO plans. Vanessa Albritton and Rob Jarzombek said the changes aim to encourage preventive care and make it easier for members to earn inpatient-deductible credits.

VBID changes and credits: CalPERS said members can earn $100 per qualifying activity, up to $500 in credits per subscriber per year. Qualifying activities for 2026 include a short depression or anxiety screening self-reported through Included Health; preventive screenings and immunizations (generally tracked through claims); a self-attested flu or COVID-19 vaccine via the Included Health app; obtaining a second opinion from a preferred provider or Included Health before nonurgent elective surgery; participation in Included Health care management for chronic conditions after an intake; and engagement with a diabetes prevention program (credit awarded after attending two sessions or app engagement in the first two months). CalPERS noted that dependents other than a spouse or domestic partner automatically receive all five credits at the start of the year, but family credits will not exceed $1,000. “Subscribers, spouses and domestic partners must complete the activities themselves to receive credit,” Albritton said.

VBID note: CalPERS said the smoking attestation credit will no longer apply to the PERS Gold inpatient deductible starting in 2026.

PERS Gold vs. PERS Platinum: Jarzombek explained that PERS Gold’s service area is limited to California and generally has lower monthly premiums but higher out-of-pocket costs (coinsurance is 80/20 in network). PERS Platinum has broader national and international coverage, higher premiums and lower out-of-pocket costs (coinsurance is 90/10 in network). CalPERS advised members that in-network and out-of-network deductibles are tracked separately and out-of-network spending does not count toward in-network deductible or coinsurance limits.

Monterey County service-area change: CalPERS said Blue Shield Access+ will replace Blue Shield Trio in Monterey County for 2026. Members enrolled in Trio in Monterey County will be automatically enrolled in Blue Shield Access+ unless they make a different election during open enrollment.

How to track credits: CalPERS said members should track VBID credits using the Included Health website or mobile app’s deductible tracker; credits for some activities will be tracked via claims, and others require self-reporting or intake with a case manager.

Where to learn more: CalPERS directed members to calpers.ca.gov/vbid for the full list of qualifying activities and details.