Health & Welfare Benefits

Human Resources Benefit Related Activities >>

2012-2013 Master Planning Calendar

Medical & Dental

Benefit Information for all eligible employees effective October 1, 2012:

• Medical and Dental Plan Ratetable
• Annual Stipend Information
• SISC III Enrollment Form (medical)
• SISC III Membership Change Form
• Delta Dental Enrollment Form
• SISC Flex Premium Only Plan (POP) Enrollment Form
• SISC Blue Shield PPO Enrollment Guide
• SISC Blue Shield HMO Enrollment Guide

Medical Plan Benefit Comparisons:

• Blue Shield PPO Plans Comparison
• Blue Shield PPO High Option Summary
• Blue Shield PPO Medium Option Summary
• Blue Shield PPO Low Option Summary
• Medco Prescription Drug Program (PPO High and Medium Only)
• Blue Shield HMO Plans Comparison
• Blue Shield HMO High Option Plan (10-0)
  • Medco Rx Program - $5 generic/$10 brand name
• Blue Shield HMO Low Option Plan (25-500)
  • Medco Rx Program - $9 generic/$35 brand name
• Blue Shield HMO Chiropractic Benefits
• Blue Shield HMO Substance Abuse Treatment Benefits

Medical and Dental Benefit Contact Information and Useful Web Links:

• Blue Shield (Preferred Provider Organization)
  • SISC Dedicated Customer Service Unit: (800) 642-6155
  • P.O. Box 272540, Chico, CA  95927-2540
    • Blue Shield MDLIVE
      • Telephone Number:  (888) 632-2738
    • Mental Health
      • Customer Service Telephone Number:  (800) 263-9952
    • Anthem Blue Cross Employee Assistance Program (EAP)
      • Telephone Number:  (800) 999-7222
      • Website:  www.anthemEAP.com
      • Member Login:  SISC
      • EAP Articles:
        • Managing Traumatic Stress
        • Surviving a Traumatic Event
        • Traumatic Incidents
• Blue Shield HMO
  • Evidence of Coverage - HMO High Option Plan
  • Evidence of Coverage - HMO Low Option Plan
  • Amendment to Evidence of Coverage eff July 1, 2012
  • Customer Service Telephone Number: (800) 642-6155
  • Chiropractor (American Specialty Health Plans of California)
  • Mental Health (MHSA Network)
    • Customer Service Telephone Number: (877) 263-9952
  • Anthem Blue Cross Employee Assistance Program (EAP)
    • Telephone Number:  (800) 999-7222
    • Website:  www.anthemEAP.com
    • Member Login:  SISC
    • EAP Articles:
      • Managing Traumatic Stress
      • Surviving a Traumatic Event
      • Traumatic Incidents
• Express Scripts Program (PPO High & Medium Plans, HMO Plans Only)
  • Customer Service Telephone Number: (800) 987-5241
  • Mail Order Rx Program: (800) 633-2662
  • Employees can go to www.express-scripts.com to locate a pharmacy.  In order to use the website to locate a pharmacy, employees must register as a member.
  • Employees can also contact pharmacies or go to their individual websites (e.g. Rite-Aid, CVS) to find out whether or not they are open 24-hours.
  • According to SISC, if there is an urgent need after hours to get a prescription filled, emergency rooms will provide the needed medication until the individual can get to a pharmacy.
  • Express Scripts Participating Pharmacies (Santa Cruz County)

• Delta Dental (Dental Coverage)
  • Customer Service Telephone Number: (888) 335-8227
  • Claims: PO Box 7736, San Francisco, CA 94120
  • Delta Dental Evidence of Coverage (EOC) - Active Employees & Retirees
• Hartford Life (Life and Disability Insurance)
  • Customer Service Telephone Number:  (800) 800-289-9140
  • Website:  www.TheHartfordAtWork.com
  • Ability Assist Program
  • Life Conversations Program:
    • Beneficiary Assist
    • Express Pay Program
    • Travel Assist Program
• SISC Flex Program
  • Customer Service Telephone Number:  (800) 972-1727
  • Email:  siscflex@kern.org
  • Website:  http://sisc.kern.org
  • The SISC Flex Plan Brochure
  • SISC Flex Eligible Expenses for 2012
  • SISC Flex Card - Questions & Answers
• Envoy Plan Services, c/o MidAmerica (Third Party Administrator for TSA's)
  • 403(b)/457(b) contribution limitations for 2013 will increase from $17,000 to $17,500
  • The "catch-up" contribution limit, however, for those employees age 50 and over remains unchanged at $5,500.
  • Customer Service Telephone Number:  (800) 248-8858
  • Fax Number:  (877) 513-2272
  • Mailing Address:  211 E Main Street, Ste 100, Lakeland, FL  33801
  • Email:  info@envoyplanservices.com
  • 403(b) Plan Highlights
  • 457(b) Plan Highlights
  • 403(b) versus 457(b) Plans
  • Enrollment Procedures
  • 403(b) Salary Reduction Agreement*
  • 457(b) Salary Reduction Agreement*
  • Transaction Request Form*
  • *Salary Reduction Agreements and Transaction Request Forms are sent to Envoy Plan Services for processing.  Fax number is (877) 513-2272.
• RSG Securities c/o Zuk Financial Group - 457(b) plan
  • Jule Hilton, Ed. D., Financial Advisor:  (831) 421-9361
  • Email:  jhilton@zukfinancial.com or www.rsgsecurities.com
  • Address:  104 Walnut Avenue, Ste. 200, Santa Cruz, CA  95060

Forms

• SISC III Enrollment Form (medical)
• SISC Membership Change Form
• Delta Dental Enrollment Form
• SISC Flex Premium Only Plan (POP) Enrollment Form
• Life Insurance Beneficiary Form
• 403(b) Salary Reduction Agreement
• 457(b) Salary Reduction Agreement
• Workers' Compensation Incident Report Form

Rates & Stipends

• Medical and Dental Plan Ratetable
• District Benefit Stipend Allotment

Life & Disability Insurance

Hartford Disability Insurance:

• Disability coverage for Educational Administrators and Certificated employees with 5 or more years of District service
• Disability coverage for Educational Administrators and Certificated employees with less than 5 years of District service and Classified Administrative Managers
• Disability coverage for Classified and Confidential Employees
• Disability coverage for Classified employees, 20 hours per week, at least 9 months per year

Hartford Life Insurance:

• President
• Certificated, Classified and Confidential Employees
• Classified and Educational Administrators
• Classified Employees, 20 hours per week, at least 9 months per year
• Beneficiary Form

Worker's Comp

Workers' Compensation - Keenan & Associates

To report a work related injury and file a Workers' Compensation claim, please contact

Susan Torres, Benefits Analyst at (831) 479-6182 or via email at sutorres@cabrillo.edu.

• PRIME Advantage Medical Provider Network (MPN):  (800) 654-8102
• Website:  www.keenan.com
• Website User ID:  special
• Website Password:  access
• Workers' Compensation Incident Report
• Covered Employee Notification of Rights Materials
• Workers' Compensation Employer Designated Provider Listing

Health and Welfare Benefits Committee

• Benefits Overview Document

Next Benefits Committee Meeting: TBD

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