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Medical Plan Information

ACWA JPIA Retiree Enrollment Guidelines

The District is required to offer retiree medical coverage that meets the requirements and guidelines established by ACWA JPIA and the insurance carriers.  
Retiree Enrollment Guidelines

Summary of Benefits Coverage
What is the Summary of Benefits and Coverage?

Under the Affordable Care Act (ACA), health insurers and employer groups must provide a summary of benefits and coverage (SBC) to participants and beneficiaries (generally employees and dependents). SBCs must follow standards set forth by the federal agencies.  The SBC helps eligible employees and dependents understand their benefits and coverage by using simple language in a consistent format. The SBC includes brief summaries of:
Covered services
Examples of coverage
Appeals and grievance rights
Exceptions and limitations
Cost-sharing provisions, including any deductible, coinsurance and copayments
Continuation coverage
The SBC also contains a phone number to call for questions and the website address where the uniform glossary can be found.

Kaiser Permanente    
Kaiser Traditional HMO

Anthem Blue Cross   
Advantage PPO
Classic PPO
CalCare HMO
Value HMO

Plan Summaries
Some find these more reader friendly than the Summary of Benefits Coverage.  These are provided for your reference:

Kaiser Traditional HMO
Kaiser Traditional HMO Retired w/Medicare
Anthem Advantage PPO
Anthem Advantage PPO Retired w/Medicare
Anthem Classic PPO
Anthem Classic PPO Retired w/Medicare
Anthem CalCare HMO
Anthem CalCare HMO Retired w/Medicare
Anthem Value HMO
Anthem Value HMO Retired w/Medicare

Proof of Eligible Dependent Status
ACWA JPIA requires the District to guarantee every dependent enrolled in a medical plan is an eligible dependent. The District must show proof of eligibility for each dependent you enroll. Commonly submitted documents are marriage certificates (spouse); birth certificates (child) and court orders (child).

For every dependent you are enrolling, you must submit a copy of the verification document with your medical enrollment form. If you cannot locate the documents, request from the county registrar’s office for where each event occurred (marriage or birth).


Nationwide Access through Anthem Blue Cross PPO’s BlueCard Network     
Blue Card Information

Employee Rates

2016 Employee Rates
2017 Employee Rates

Retiree Rates
2016 Retiree Rates
2017 Retiree Rates
If you or your spouse is enrolled in a Medicare plan and the other is enrolled in Non-Medicare, please refer to the Mixed Medicare rates.      
    
                
Required Annual Notices
2016 Required Annual Notice
2017 Required Annual Notice
 

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