As a retiree, you are now part of Foothill - De Anza Retirees Association (FODARA). For more information on FODARA, please visit their website: FODARA
The Health Officer of Santa Clara County has issued a shelter-in-place order, effective 12:01 a.m. Tuesday, March 17, 2020, to help prevent the spread of COVID-19. The District Office is closed effective March 17, 2020 in response with the County order. The 2020 retiree survey deadline will be extended to June 15, 2020 in order to better serve the retiree group. If you have any questions, please email to firstname.lastname@example.org.
2020 Annual Retiree Survey
- 2020 Annual Retiree Survey Cover Letter
- 2020 Annual Retiree Survey Form
- 2020 Medicare Part B Premium Rates
- ACH Authorization Form FHDA
- Discovery Benefits Notice
- How to Apply for Medicare Part B Premium Reimbursement
Benefits Operation Policy and Procedures
- Operational Policy - Definitions
- Operational Policy - Dependent Eligibility
- Operational Policy - Contributions, Payments and Reimbursements
- Operational Policy - Penalties and Loss of Coverage
- Operational Policy - Appeal Process
Important Information for Prospective Retirees
- 2018 Health Benefits Retirement Orientation
- Check Off List for "Pre-97 Retirees"
- Check Off List for "Post-97 Retirees" Bridge to Medicare Program
- Check Off List for "Post-97 Retirees" VEBA Trust
How to Seek Reimbursements
Note: Employer mandated share of cost increased from $47.60 to $55.60 effective January 1, 2020 for retirees whose date of retirement is prior to May 17, 2012.
Medical premium reimbursements will be directly deposited into your accounts as close to the 1st of the month as possible but may take up to five (5) business days.
MEDICARE premium reimbursements will be directly deposited into your accounts as close to the 15th of the month of the quarter which it is due : April, July, October, December/January. Please allow up to five (5) business days for processing.
Change of Address
BOTH forms below are required for change of address. Please note:A retiree must notify the District and CalPERS of a change of address within ten (10) calendar days of the new effective date.
Enrollment Change Form
- To CHANGE your medical plan or enrollment status, submit form HBD-30: CalPERS CHANGE Health Plan Enrollment Form for Retirees/Survivors
Retirees Supporting Services - Administered by SECOVA
- Authorization for Automated Debit and/or Credit Policy For deposit and/or Withdrawal of the Following Transactions:
- Monthly Payment of Retiree Health Plan Contribution (Direct Bill or Balance Bill)
- Monthly Survivor Health Plan Payment
- Monthly Reimbursement of Retiree Health Plan Contribution Overpayments
- Quarterly Reimbursement of Medicare Part B Premium
- Electronic Fund Transfer (EFT) Information
- Electronic Fund Transfer (EFT) Authorization Form
Pre July 1, 1997 Retirees: 20-year Retiree and non-Pensioners Program
Post July 1, 1997 Hired Retirees: Bridge to Medicare Program (Restricted to Retiree + Spouse/Domestic Partner, Age 55-64 only)
Post July 1, 1997 Hired Retirees: VEBA Trust Program (Restricted to Retiree only, Medicare-eligible and age 65 or older)
Qualified retirees will be contacted by United Adminstrative Services to fill out enrollment application to seek VEBA $100 monthly subsidy toward Medicare premium part B. If you have any questions, the contact information is below,
NOTE: You do not need to enroll in a CalPERS health plan in order to be eligible for the VEBA subsidy.
CREDITABLE COVERAGE DISCLOSURE NOTICE- MEDICARE PART D and Prescription Drugs Program
Medicare Part D is the new voluntary outpatient prescription drug benefit that was added to the CalPERS Medicare program beginning January 1, 2013.
Medicare Part D is intended to assist those in Medicare who do not have prescription drug coverage through an employer group. CalPERS Members enrolled in a CalPERS Medicare or Basic plan already have a prescription drug coverage that does not require the supplementation of Medicare Part D.
Therefore, CalPERS Medicare plan members should not enroll in a non-CalPERS Medicare Part D prescription plan. CalPERS members who enroll in a non-CalPERS prescription drug plan will lose their CalPERS health coverage.If you have additional questions regarding your enrollment in Medicare Part D, contact CalPERS Customer Contact Center at 1-888-225-7377.
Medicare Part D is the federal voluntary outpatient prescription drug benefit that was added to the Medicare program beginning January 1, 2006.
As a CalPERS Medicare health plan member, you already have prescription drug coverage, so you do not need to enroll in an external Medicare Part D plan. If you do enroll in a non-CalPERS Medicare Part D plan, you will lose your CalPERS health coverage. For most CalPERS health plans, CalPERS applies for a Retiree Drug Subsidy for each retiree enrolled in Medicare Part A and/or Part B. The Retiree Drug Subsidy helps CalPERS offset your prescription drug costs and provide prescription drug coverage that is, for most members, as good as or better than non-CalPERS Medicare Part D prescription drug coverage.
Note: CalPERS does not apply for a Retiree Drug Subsidy for members enrolled in Kaiser's Senior Advantage plan and its Medicare Advantage Prescription Drug plan. Since Kaiser is a Medicare Advantage plan, CalPERS Kaiser members sign one election form and receive all health care services, including prescription drug benefits, through CalPERS Kaiser Permanente Senior Advantage Plan. In order for CalPERS to receive the federal subsidy, and provide those drug benefits to Medicare enrollees, Medicare health plan members may not be enrolled externally in a Medicare Part D prescription drug plan.
Here are some important reminders about Medicare Part D:
- When you retire, if you or your spouse is covered by another health plan that includes Medicare Part D Prescription Drug Plan benefits, you must first cancel your non-CalPERS Medicare Part D plan to enroll in, or continue enrollment in, a CalPERS health plan.
- If you are eligible for other group health coverage that includes Medicare Part D, you must choose to be covered by only one health plan that includes Part D.
- If you enroll in a non-CalPERS Medicare Part D plan, you will lose your CalPERS health coverage.
- If you are retired and want to continue your CalPERS health coverage, you should not voluntarily enroll in a non-CalPERS Medicare Part D plan.
If you are already enrolled in a non-CalPERS Medicare Part D plan, but would like to continue your CalPERS health coverage, you should disenroll from your non-CalPERS group-, union-, or retirement-provided health coverage.
Examples of non-CalPERS plans that include Medicare Part D are:Tricare, Medicaid ("MediCal" in California), and the American Association of Retired Persons (AARP). Sources of other Medicare Part D coverage can include coverage from a spouse (past or present), or coverage from your or your spouse's retirement group or employer group health plan coverage.
CalPERS Health Premium Rates
CalPERS Health Programs Full-Premium Rates