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CalPERS Cracking Down On Who Gets Health Care

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(Sacramento, CA)
Thursday, April 4, 2013

by Katie Orr

CalPERS provides health coverage to 1.3 million people, and 733 thousand of those are dependents. The pension system is auditing health plans to make sure those dependents are actually eligible for coverage. Subscribers have until the end of June to get ineligible people off their plans or risk losing their coverage retroactively.

Phillip Sherwood is with the advocacy group California State Retirees. He's concerned the audit method puts too big a burden on plan subscribers to prove eligibility.

"We're not against a reasonable way of checking the eligibility of beneficiaries," he said. "We're not against that all. We think they're going a little bit too far and invasive to prove long standing relationships that are there."

CalPERS research found 4 to 8 percent of dependents on employer sponsored health care plans in other states were actually ineligible. The average saving of removing those people was more than 13 hundred dollars each.  

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