benefits News

2012 OE Workshop Flyer Actives

*2012 Open Enrollment*
2012 OE Workshop Flyer Actives 2012 OE Workshop Flyer Retirees 2012 FHDA Benefits Guide 2012 CalPERS Plan Changes FAQs

2012 CalPERS and Health Partners Presentations

http://www.youtube.com/watch?v=13Gz0Sl0uBc&list=UUWHcVDsYvL_xcRjarkRlqoQ&index=17&feature=plcp

1) CalPERS Health Webinar Introduction:
http://www.youtube.com/watch?v=13Gz0Sl0uBc&list=UUWHcVDsYvL_xcRjarkRlqoQ&index=17&feature=plcp

http://www.youtube.com/watch?v=M1ykedJQRis&feature=relmfu

2) Anthem Blue Cross & CVS Caremark Presentation:
http://www.youtube.com/watch?v=M1ykedJQRis&feature=relmfu

http://www.youtube.com/watch?v=IbLESgLLSm8&feature=context&context=C41b8d1bVDvjVQa1PpcFObBtsQ3v-7GE7P6BrA_MQtUNi1uYEv8l4=

3) Blue Shield of CA Presentation:
http://www.youtube.com/watch?v=IbLESgLLSm8&feature=context&context=C41b8d1bVDvjVQa1PpcFObBtsQ3v-7GE7P6BrA_MQtUNi1uYEv8l4=

http://www.youtube.com/watch?v=5mIlPyl1N1o&feature=plcp&context=C41b8d1bVDvjVQa1PpcFObBtsQ3v-7GE7P6BrA_MQtUNi1uYEv8l4%3D

4) Kaiser Permanente Presentation:
http://www.youtube.com/watch?v=5mIlPyl1N1o&feature=plcp&context=C41b8d1bVDvjVQa1PpcFObBtsQ3v-7GE7P6BrA_MQtUNi1uYEv8l4%3D.

http://www.youtube.com/watch?v=ZNEq1hXPSME&feature=relmfu

5) CalPERS Health Webinar Conclusion:
http://www.youtube.com/watch?v=ZNEq1hXPSME&feature=relmfu

Benefits Enrollment Period is scheduled from April 15 through 5pm, May 15, 2012.

Mandatory Online Enrollment via iElect.com is necessary for those that are Full - Time Employees and currently enrolled Part - Time Faculty

Enrolling for CalPERS coverage for the first time
Adding/deleting dependents
Participating in the Section 125 Cafeteria Plan

Open Enrollment changes and their respective effective dates:

Enrolling in a CalPERS medical plan for the first time, July 1, 2012
Changes to existing health insurance, July 1, 2012
Adding dependents, July 1, 2012
Deleting dependents, June 30, 2012
Participating in the Section 125 Cafeteria Plan - Full Time Employees only, July 1, 2012

CalPERS Health Benefit Rates - Bay Area

2012 CalPERS Health Benefit Rates
CalPERS Health Benefit Rates - Bay Area

HMO Benefits Grid

2012 Benefit Comparison Grid
      HMO Benefits Grid
      PPO Benefits Grid - Active
      PPO Benefits Grid - Retiree

How to enroll for Benefits online via iElect.com (Only for FT Active and currently enrolled PTF)

1) Log on to www.iElect.com

2) Enter Employer: FHDA

3) Enter LOGIN: SSN#MMDDYYYY

4) Enter PIN: (as provided by Secova)

For Retirees and Survivors - All documentation must be submitted to SECOVA, not FHDA or CalPERS

Retirees Supporting Services - Administered by SECOVA

Authorization for Automated Debit and/or Credit Policy

Authorization for Automated Debit and/or Credit Policy

For deposit and/or Withdrawal of the Following Transactions:

1) Monthly Payment of Retiree Health Plan Contribution (Direct Bill or Balance Bill)

2) Quarterly Survivor Health Plan Payment

3) Monthly Reimbursement of Retiree Health Plan Contribution Overpayments

4) Quarterly Reimbursement of Medicare Part B Premium

Electronic Fund Transfer (EFT) Authorization Form

Electronic Fund Transfer (EFT) Authorization Form

Health Plan Information

Effective July 1, 2012, the District provides medical insurance through CalPERS and offers the following six plans:

HMO Plans

Blue Shield NetValue

www.kp.org/calpers

www.blueshieldca.com/bsc/calpers/member

Anthem Blue Cross

PPO Plans (Administered by Anthem Blue Cross )

PERS Care

PERS Care - Available in all 50 States
      Anthem Blue Cross Prudent Buyer Preferred Providers Network

PERS Choice - Available in all 50 States
      Anthem Blue Cross Prudent Buyer Preferred Providers Network

PERS Select - Restricted to CA residents only
      Anthem Blue Cross Select PPO Preferred Providers Network

http://www.anthem.com/ca/calpers/
http://www.anthem.com/ca/calpers/

CalPERS Health Booklets

2012 CalPERS Health Benefit Summary

Blue Shield Access+ HMO

Health Plan Directory

Should you have questions regarding your health plan, member ID cards, verification of provider participation, service area boundaries (covered zip codes), benefits, deductibles, limitations, exclusions, copayments, of if you have a concern that needs attention, please contact the following health plan providers:

HMO Plans

www.blueshieldca.com/bsc/calpers/member

     Blue Shield of California
     Member Services: (800) 334-5847
     www.blueshieldca.com/bsc/calpers/member

www.kp.org/calpers

     Kaiser Permanente
     Member Services: (800) 464-4000
     www.kp.org/calpers

PPO Plans

www.anthem.com/ca/calpers

      PERS Select, PERS Choice, and PERS Care (Administered by Anthem Blue Cross)
      Member Services: (877) PERS-PPO or (877) 737-7776
      www.anthem.com/ca/calpers

www.caremark.com/calpers

      Pharmacy Benefits (Administered by CVS Caremark)
      Member Services: (877) 542-0284
      www.caremark.com/calpers

Employees interested in changing their health enrollments, and/or participate in the Section 125 Cafeteria Plan, must do so during the Open Enrollment Period. The scheduled Open Enrollment Period will take place from April 15 - May 15, 2012. Employees may add/delete dependents to their existing health plan during the plan year if they experience a qualifying event. Proper documentation such as: birth/marriage certificate(s), State-registered domestic partnership, and social security card(s) for all dependents are required to enroll any new dependents.

CalPERS Health Benefits Insurance Forms

A. For Employees Only

CalPERS Health Plan Enrollment for Employees - Form HBD-12

B. For Retirees and Survivors Only

CalPERS Health Plan Enrollment for Retirees/Survivors - Form HBD-30

CalPERS Health Plan Enrollment for Retirees/Survivors - Form HBD-30

Agency Name: Foothill-De Anza Community College District
Agency Code: Agency ID #4628924879

CalPERS Medicare Certification of Status - Form PERS08M0021DMC

C. For COBRA Enrollees Only

CalPERS COBRA Election Form for Actives - Form PERS HBD-85

D. For Dependents Coverage Only

CalPERS Affidavit of Marriage and Domestic Partnership - Form PERS HBSD-1965

E. For Kaiser Senior Advantage

Kaiser Senior Advantage Group Election Request Form

Monthly Imputed Income Rates for Same-Sex Domestic Partners Coverage - July to December 2012

Active Employees

Prescriptions

Prescriptions provided for PERS Select/Choice/Care: CVS Caremark

PERS Select/Care/Choice PDL Drugs Formulary - April 2012

Prescriptions provided for Blue Shield Access+ and NetValue

Blue Shield Rx Formulary - April 2012

PayFlex FSA Forms

PayFlex FSA Flyer

CalPERS Medical Providers' Links

1) Blue Shield of CA: Access+, NetValue, and 65 PLUS HMOs

Link:https://www.blueshieldca.com/bsc/calpers/member/plan-benefits/index.jhtml

      Blue Shield
      Current Members
      Prospective Members
      Member Services:
      (800) 334-5847

To find Blue Shield of CA providers:
https://www.blueshieldca.com/fap/app/search.html

2) Prescriptions provided by Blue Shield HMOs: PrimeMail®

Link:https://www.blueshieldca.com/consumer/pharmacy/participatingpharmacies/mailserviceprescriptions/pharmacy_mail_service.sp.

3) Kaiser Permanente HMO

http://my.kaiserpermanente.org/ca/calpers/benefits.html

Link: http://my.kaiserpermanente.org/ca/calpers/benefits.html

      Kaiser Member Services:
      (800) 464-4000
      TTY: (800) 777-1370

4) Anthem Blue Cross - PERS Care/PERS Choice/PERS Select

http://www.anthem.com/ca/calpers/

Link: http://www.anthem.com/ca/calpers/

      Anthem Blue Cross
      Customer Service Numbers:
      (877) 737-7776
      (818) 234-5141 (outside the continental U.S.)
      1-818-234-3547(TDD)

24/7 NurseLine
1-800-700-9185

HMC (Disease Management)
1-800-522-5560

5) Prescriptions provided by Anthem Blue Cross PPOs: CVS Caremark

http://www2.caremark.com/calpers/

Link: http://www2.caremark.com/calpers/

CVS Caremark Mail Service Order Form:
https://www.caremark.com/portal/asset/mof_unauth.pdf

      CVS Caremark
      PO BOX 94467
      PALATINE, IL 60094-4467

Customer Service Representative
(800) 552-8159

here

The District provides excellent paid Health and Welfare Benefits for all employees and their eligible dependents.

This page is for active employees. Click here for Retiree Information.
*For items not listed below, please contact Personnel for assistance.

Medical

*ACTIVE EMPLOYEE SERVICES* *Links will open in a new window or tab.
Medical	Dental	Vision	Wellness
EAP/Counseling (Outpatient)	Prescription Drugs (Mail Order--EPO/PPO)	Flexible Spending Accounts (Dependent Care and Health Care)	Life Insurance (Hartford/AD&D)
Supplemental Life Insurance* *Optional insurance. Must be selected by employee during Open Enrollment, for a fee.	Long Term Disability (LTD)	Worker's Comp	COBRA/HIPAA USERRA/WHCRA
Quick Links links to the following provider websites: Kaiser, UHC, Delta Dental, VSP, and EAP/UBH		Contact Benefits Unit

www.kaiserpermanente.org

*QUICK LINKS* *Links will open in a new window or tab.
MEDICAL	Kaiser (HMO): www.kaiserpermanente.org find doctors, Kaiser facilities, register for health-realted classes and nutritional courses, get information on disease management, health and wellness UnitedHealthcare (EPO/PPO): www.myuhc.com find network doctors and facilities, manage health accounts, monitor medical records and office visits, diagnose common illnesses, access health calculators, get up-to-date information on disease management, health and wellness www.deltadental.com
DENTAL	Delta Dental (DPO): www.deltadental.com find dentists, track office visits and records, view invoices, get information on common tooth and gum diseases and procedures
VISION	Vision Services Providers (VSP): www.vsp.com find optometrists, track office visits and records, view invoices, find discounts on eyewear--when available
EAP/UBH	Employee Assistance Program/United Behavioral Health: www.liveandworkwell.com find counselors, life coaches, crisis intervention hotline, financial management help, information for work-life balance, and emotional and mental support for employees and family. Initial five (5) visits are free.

www.myuhc.com

***Please Note:

For EPO, you must access providers from UnitedHealthCare CHOICE Health Plan.

It is imperative that you obtain the provider's tax ID number and verify it with UnitedHealthcare Customer Service @ 1-800-510-4846, to ensure fully paid benefits.

For PPO, you can access providers from UnitedHealthcare CHOICE PLUS Health Plan, or any non-contracted provider.

When using www.myuhc.com, Please search under "FACILITY" for list of Ambulance Services, Ambulatory Surgical Center, Dialysis Center, Extended Care Facility, Home Health Agency, Home IV Therapy, Hospice Center, Labs, Medical Equipment Vendors, Medical Rehab Center, MRI, Nursing Home, Physical Therapy, Radiology Center, and Urgent Care Center.

*CONTACT BENEFITS UNIT*
For More Information:	MyBenefits@fhda.edu (650) 949-6224 (phone) (650) 949-2831 (fax) Foothill-De Anza Community College District ATTN: Benefits Unit 12345 El Monte Road Los Altos Hills, CA 94022 overall benefits questions and compliance Wellness program Medical claims Medicare Retiree Inquiries Enrollment Worker's Compensation Personnel
For items not listed above, please contact Personnel* for assistance.

benefits News

2012 OE Workshop Flyer Actives

http://www.youtube.com/watch?v=13Gz0Sl0uBc&list=UUWHcVDsYvL_xcRjarkRlqoQ&index=17&feature=plcp

http://www.youtube.com/watch?v=M1ykedJQRis&feature=relmfu

http://www.youtube.com/watch?v=IbLESgLLSm8&feature=context&context=C41b8d1bVDvjVQa1PpcFObBtsQ3v-7GE7P6BrA_MQtUNi1uYEv8l4=

http://www.youtube.com/watch?v=5mIlPyl1N1o&feature=plcp&context=C41b8d1bVDvjVQa1PpcFObBtsQ3v-7GE7P6BrA_MQtUNi1uYEv8l4%3D

http://www.youtube.com/watch?v=ZNEq1hXPSME&feature=relmfu

CalPERS Health Benefit Rates - Bay Area

HMO Benefits Grid

How to enroll for Benefits online via iElect.com (Only for FT Active and currently enrolled PTF)

Authorization for Automated Debit and/or Credit Policy

Electronic Fund Transfer (EFT) Authorization Form

Blue Shield NetValue

www.kp.org/calpers

www.blueshieldca.com/bsc/calpers/member

Anthem Blue Cross

PERS Care

http://www.anthem.com/ca/calpers/

2012 CalPERS Health Benefit Summary

Blue Shield Access+ HMO

www.blueshieldca.com/bsc/calpers/member

www.kp.org/calpers

www.anthem.com/ca/calpers

www.caremark.com/calpers

CalPERS Health Plan Enrollment for Employees - Form HBD-12

CalPERS Health Plan Enrollment for Retirees/Survivors - Form HBD-30

CalPERS COBRA Election Form for Actives - Form PERS HBD-85

CalPERS Affidavit of Marriage and Domestic Partnership - Form PERS HBSD-1965

Kaiser Senior Advantage Group Election Request Form

Active Employees

PERS Select/Care/Choice PDL Drugs Formulary - April 2012

Blue Shield Rx Formulary - April 2012

PayFlex FSA Flyer

http://my.kaiserpermanente.org/ca/calpers/benefits.html

http://www.anthem.com/ca/calpers/

http://www2.caremark.com/calpers/

here

Medical

www.kaiserpermanente.org

www.deltadental.com

www.myuhc.com

Personnel