Human Resources 

Open Enrollment SISC Flexible Benefit Programs November 2 - 20, 2009

• District Benefit Stipend Allotment
• Medical and Dental Plan Ratetable
• Blue Shield HMO Enrollment Form
• SISC Membership Change Form
• Delta Dental Enrollment Form
• Blue Shield HMO Provider Directory - Santa Cruz County
• BS of California Mental Health Service Administrator (MHSA) Provider Network - Santa Cruz County

 

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
• Blue Shield HMO Plans Comparison
• Blue Shield HMO High Option Plan (10-0)
  • Outpatient Prescription Drug Coverage
• Blue Shield HMO Low Option Plan (25-500)
• Outpatient Prescription Drug Coverage
• Blue Shield HMO Chiropractic Benefits
• Blue Shield HMO Substance Abuse Treatment Benefits

 

Benefit Changes to PPO Plans effective October 1, 2009:

• Physical Medicine:  This benefit will combine Physical Therapy, Occupational Therapy and Chiropractic care into one benefit with a 26 visit limit per calendar year.  This modification is not applicable to the PPO Low Option Plan (high deductible).
• Routine Physical Exam (Employee & Spouse/Domestic Partner) and Preventative Care (Dependent Children):  The in-network benefit will pay 100% on all PPO plans and the deductible will continue to be waived.
• Acupuncture:  The benefit will allow 12 visits per calendar year; up to $50 in-network and $25 out-of-network.  This modification is not applicable to the PPO Low Option Plan (high deductible).
• Hospice Care:  The $10,000 lifetime maximum will be removed.
• Hearing Aid:  This benefit will include audiological evaluation and hearing aid supplies; visits for fitting, counseling, adjustment and repair subject to a $700 maximum every 24 months.

 

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

 

Medical and Dental Benefit Information:

 

• Blue Shield (Preferred Provider Organization)
  • SISC Dedicated Customer Service Unit: (800) 642-6155
  • P.O. Box 272540, Chico, CA  95927-2540
  • Medco Prescription Drugs (Blue Shield Members Only)
    • Customer Service Telephone Number: (800) 987-5241
    • Mail Order Program: (800) 633-2662
  • Mental Health (PacificCare Behavior Health)
• Website Access Code:  SISC
• Customer Service Telephone Number:  (800) 999-9585
• Blue Shield Nurseline 24/7
• Telephone Number:  (877) 304-0504
• Blue Shield HMO
• Evidence of Coverage - HMO High Option Plan
• Evidence of Coverage - HMO Low Option Plan
• Customer Service Telephone Number: (800) 642-6155
• Chiropractor (American Specialty Health Plans of California)
• Mail Order Prescription Drug Program - PrimeMail
  • By Phone:  (866) 346-7200
• Mental Health
• Customer Service Telephone Number: (877) 263-9952
• 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
• Employee Assistance Program (EAP) (PacificCare Behavior Health)
  • Website Access Code:  SISC
  • Customer Service Telephone Number:  (800) 999-9585
• Hartford Life (Life and Disability Insurance)
  • Customer Service Telephone Number:  (800) 800-289-9140
• SISC Flex Program
  • Customer Service Telephone Number:  (800) 972-1727
  • Email:  siscflex@kern.org
• Envoy Plan Services (Third Party Administrator for TSA's)
• Customer Service Telephone Number:  (800) 248-8858
• Email:  info@envoyplanservices.com
• Mailing address:  901 Calle Amanecer, Suite 200, San Clemente, CA  92673
• Keenan & Associates - Elite Choice - 457(b) plan
  • Customer Service Telephone Number:  (800) 343-0694, ext. 4261
  • Email:  cdickason@keenan.com or www.keenan.com/elitechoice
• Workers' Compensation - Keenan & Associates
• PRIME Advantage Medical Provider Network (MPN):  (800) 654-8102
• Website:  www.keenan.com
• Website User ID:  special
• Website Password:  access
• Covered Employee Notification of Rights Materials

Health and Welfare Benefits Committee Minutes