CalPERS FAQs
Sutter Health is a healthcare provider network that includes doctors, hospitals, care centers, and other services.
Sutter Health Plan is a new health insurance plan option for the 2027 Open Enrollment period from September 14 through October 9, 2026. This option will be available to certain CalPERS members based on eligibility criteria.
To be eligible to enroll in the Sutter Health Plan option as a CalPERS member, you must:
- Live or work in an eligible ZIP code within Placer*, Sacramento, San Joaquin, Solano, Stanislaus or Yolo County.
- Be eligible for a Basic (non-Medicare) plan.
*Excludes Placer County ZIP codes: 95701, 95714, 95715, 95717, 96140, 96141, 96143, 96145, 96146 and 96148.
Sutter Health Plan allows members access to comprehensive and convenient care from many of Sutter’s doctors, clinicians and hospitals in Northern California. You can use the Find a Provider or Find a Location tool to search for participating providers in your area.
To be eligible to enroll in the Sutter Health Plan option as a CalPERS member, you must:
- Live or work in an eligible ZIP code within Placer*, Sacramento, San Joaquin, Solano, Stanislaus or Yolo County.
- Be eligible for a Basic (non-Medicare) plan.
*Excludes Placer County ZIP codes: 95701, 95714, 95715, 95717, 96140, 96141, 96143, 96145, 96146 and 96148.
If you already have a Sutter PCP, you’ll keep them when you enroll.
Sutter Health Plan will automatically assign a PCP for you.
You can change your PCP anytime through your Member Portal account (registration required) or by calling Customer Service at 833-674-2334.
You can keep your current specialist if they’re in the Sutter Health Plan network. You’ll need to ask your new primary care physician (PCP) for a referral to the specialist.
You can use the Find a Provider tool to confirm that your specialist is in the Sutter Health Plan network.
The Sutter Health Plan option allows you to see non-participating providers only in certain situations, including but not limited to:
- You have a prior authorization from your medical group.
- You need emergency medical services.
- You need urgent care services and you are out of the service area.
The Evidence of Coverage and Disclosure Form (EOC) for the Sutter Health Plan option includes additional information about situations when you may see a non-participating provider.
Sutter Health Plan network providers commonly use the Sutter Health electronic health records (EHR). This EHR can typically access electronic copies of your medical records from other Sutter Health providers as well as providers from Kaiser Permanente, UC Davis Medical Group, UC San Francisco Health or Stanford Health. A fee may apply if you request these records for personal use.
If your previous provider was in the Sutter Independent Physicians medical group or another medical group that is not accessible through the EHR, you may need to submit a Medical Records Request Form to your former provider before they can release your medical records to your new provider.
Note: If you currently have an established Sutter Health primary care physician (PCP) and use My Health Online (MHO), the secure Sutter Health patient portal, you will continue to have access to your medical history.
Your dependent will be assigned a primary care physician (PCP) in the Sutter Health Plan network within your eligible enrollment county. They can change to another in-network PCP at any time. While urgent and emergency care are covered outside the service area, all follow-up care must be received from in-network providers.
Your Sutter Health Plan ID card will list your primary care physician (PCP), medical group, important contact information and more.
Sutter Health Plan mails member ID cards for each covered member (you and any dependents you have) prior to your effective date.
Sutter Health Plan partners with Carelon Behavioral Health of California, Inc. (Carelon) to provide behavioral health services, including mental health and substance use disorder treatment. Carelon manages the behavioral health provider network and member support services.
Members can visit the Carelon website to get more information.
You can ask your current provider if they participate in the Carelon network or you can use Carelon’s provider search tool to search for your provider.
Your outpatient prescription drug coverage is administered by CVS Caremark®.
For more information about prescription drug coverage, visit the Caremark website or call CVS Caremark Customer Care at 833-291-3649.
This website allows you to view plan documents, including your Evidence of Coverage and Disclosure Form (EOC) and Summary of Benefits and Coverage (SBC).
You can also access plan documents through your Sutter Health Plan Member Portal account (registration required). Your portal account will have copies of your plan documents.
Beginning September 1, 2026, members can call Sutter Health Plan Customer Service at 833-674-2334. Customer Service will be available from 8:00 am to 7:00 pm, Monday through Friday.
Note: Effective January 1, 2027, Customer Service will be available from 7:00 am to 8:00 pm, seven days a week.