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CalPERS approves 2026 HMO and PPO premiums; Trio replaced by AccessPlus in Monterey and Harmony expansion postponed
Summary
CalPERS approved the 2026 HMO and PPO premium rates and accepted two staff recommendations: replacing Blue Shield’s Trio with AccessPlus in Monterey County and delaying UnitedHealthcare’s Harmony four‑county expansion for one year.
CalPERS staff presented recommended 2026 premiums for HMO and PPO basic plans and Medicare plans and the board approved them after discussion. Staff said the weighted average increases are 6.5% for HMO premiums and just over 12% for PPO premiums; Medicare Advantage averages rose about 7% and Medicare supplemental (med sup) about 13.67%. CalPERS reported an overall weighted average premium increase of 8.21% for 2026, a 2.6% improvement from last year’s increase.
Staff identified two product‑level decisions to protect low‑cost options and program stability. First, Blue Shield’s Trio narrow‑network product faces a concentration of members in Monterey County that would push Trio’s premiums toward a higher tier within two to three years; staff recommended replacing Trio with Blue Shield’s broader AccessPlus in Monterey to spread cost across a larger pool. Second, UnitedHealthcare’s Harmony plan had experienced higher-than‑expected membership growth and volatility; staff recommended postponing Harmony’s planned expansion into four additional northern California counties for one year to allow costs and membership to stabilize. Staff said approval of the recommendations authorizes the premium schedule, the Monterey county network change, and the Harmony expansion postponement. The board motion to adopt the premiums and the network recommendations passed on a roll‑call vote.
