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Simi Valley, California 93065
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AMERICAN FIDELITY OPEN ENROLLMENT SCHEDULE CLICK BELOW FOR PDF

Benefits

Dear SVUSD retirees, 

 

Due to the upcoming changes to your health plans for 2018, it is important that you look for the enrollment information in the mail from CALPERS regarding your next year's insurance coverage. All new enrollment forms need to be completed and mail back to CALPERS directly. The Simi Valley Unified School District will no longer be handling your insurance after December 31, 2017.

 

Thank you for your attention on this urgent matter.

Health Insurance Plans

DEADLINE TO ENROLL: OCTOBER 31, 2017

As of January 1, 2018, we are contracting with CalPERS to provide medical coverage for our active employees and retirees through the Public Employees Medical and Hospital Care Act. CalPERS provides medical plans with similar levels of coverage at less cost. A significant portion on these savings are being used to reduce the amounts our members will contribute to their medical premiums.

CalPERS offers PPO, Kaiser and HMO plan options, which use all of the same physicians and hospitals we've been using. 

PPO Members

CalPERS offers two PPO plans that use the exact same Anthem Blue Cross Network (all of the same physicians and hospitals) that we currently have. Both plans have a $500 individual deductible and both cover all of the same medical conditions. The differences between the two plans are as follows:

  1. PersCARE PPO Plan: A 90/10 coinsurance PPO plan that has a $2,000 out-of-pocket annual maximum per individual or $4,000 for two-party or family and has an additional $250 deductible for any inpatient hospital stay.
  2. PersCHOICE PPO Plan: An 80/20 coinsurance PPO plan that has a $3,000 out-of-pocket annual maximum per individual or $6,000 for two-party or family, but does not have an additional inpatient deductible and will cost you significantly less than PersCARE each month. Full-time employees will pay half of your current cost for this plan.

Kaiser Permanente Members

CalPERS offers a $15 co-pay Kaiser plan, which is slightly better than our current Kaiser plan ($20 co-pay). Kaiser members who enroll in the CalPERS Kaiser plan will retain their same member identification numbers. Full-time employees will pay half your current cost for this plan.

HMO Members

CalPERS offers a $15 co-pay HMP plan through several carriers: Anthem Blue Cross, Blue Shield of California, United Healthcare and HealthNet. All of these HMO plans offer the exact same levels of coverage, however, not all of these carriers contract with all of the providers we've been using. 

The Blue Shield Access Plus HMO plan is the least expensive plan that has all of our current network of medical groups and hospitals with the exception of UCLA Medical Group. The costs of these HMO plans vary, so it makes sense to enroll in the least expensive plan that is contracted with your current attending physicians. Full-time employees who select this plan will not be paying any monthly premium.

Please see the rate sheet HERE, which outlines the costs of all of the available plans.

Primary Care Physicians: When you receive your medical card from CalPERS, the plan you choose will probably assign you a new primary care physician. PLEASE DON'T BE CONCERNED! Simply call your carrier and request the primary care physician you prefer and you will be reunited with your physician of choice. (You will need to do this for all of your family members.)

The Enrollment Process

YOU MUST ENROLL TO CONTINUE YOUR COVERAGE!

  • All members will need to fill out two enrollment forms, HBD12 and HBD12A. Click HERE for the instructions.
  • Documentation for dependents will be required to submit along with your enrollment form. A marriage certificate for spouses and birth certificates for dependent children must be submitted for all of your eligible dependents.
  • The completed enrollment form and the dependent documentation must be submitted to Stacey Shoff by October 31, 2017.