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CalPERS Health Program Guide

Health Program GuideAn informational Guide to your CalPERS Health benefitsInformation as of August 2019 About This Publication The Health Program Guide describes CalPERS Basic Health plan eligibility, enrollment , and choices. It provides an overview of CalPERS Health plan types and tells you how and when you can make changes to your plan (including what forms and documentation you will need). It also describes how life changes or changes in your employ-ment status can affect your benefits and publication is one resource CalPERS offers to help you choose and use your Health plan.

Health Benefits Plan Enrollment for Active Employees (HBD-12) coverage form during your initial eligibility period, whether you elect to enroll or decline health coverage. If you or your eligible family members decline to enroll during the initial enrollment period, enrollment can occur at a later date. (See “Split Enrollments” on page 6 and

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  Health, Programs, Guide, Enrollment, Calpers, Calpers health program guide

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