SJDC Health Benefit SJDC Health Benefit OverviewOverviewRetiree Coverage – Group II

March 7, 2012Suzanne Franco

Employee Benefits Specialist

OverviewOverviewRetiree health insurance coverage will be

subject to the annual defined contribution as set by the District.

If the combined total of your premium is above the defined contribution, you will be responsible for the amount over. This amount cannot be elected on a “pre-tax” basis.

If the combined total of your premium is below the defined contribution, you will not have any cost for your coverage. You will not receive the difference as taxable income.

Level of coverage cannot exceed the active employee coverage.

Medical PlansMedical Plans

You can select from any of the medical plans currently offered to your bargaining unit not to exceed Blue Cross 4A or Kaiser 1.

Anthem Blue CrossKaiser Permanente

Delta Dental – Incentive Delta Dental – Incentive PlanPlan

70/80/90/100% Coverage$1000.00 Annual MaximumAdditional $200.00 if DPO/PPO dental provider is used.

NO implant coverage

Vision Service Plan – Plan Vision Service Plan – Plan BB

Lenses once per yearFrames once every two years$10 Office Visit co-pay

Retiree Life Insurance Retiree Life Insurance ScheduleScheduleGROUP TERM LIFE

RETIRED MEMBERS LESS THAN AGE 60 Benefits$8,000 benefit

RETIRED MEMBERS BETWEEN AGE 60-64 Benefits

$6,000 benefit RETIRED MEMBERS BETWEEN AGE 65-69

Benefits$3,000 benefit

RETIRED MEMBERS BETWEEN AGE 70-74 Benefits

$2,000 benefit RETIRED MEMBERS AGE 75 OR OLDER Benefits

$1,000 benefit

CALCULATION CALCULATION Two Party Rate under 65Two Party Rate under 65

BX 4A, Dental, Vision

Blue Cross $1618.00Dental $ 93.30Vision $ 16.94 Subtotal $1728.24Less D Cont $1324.38Your Cost $ 403.86

Kaiser 1, Dental, Vision

Kaiser $1647.00Dental $ 93.30Vision $ 16.94 Subtotal $1757.24Less D Cont $1324.38Your Cost $ 432.86

I’m 65!! I’m 65!! What happens What happens

now?now?

You must enroll in Part A and Part B.

CVT will enroll you in Part D

A copy of your card must be provided to CVT and to the District.

Medicare OverviewMedicare OverviewMedicare Part A – Hospital

Use when hospitalized

Medicare Part B – MedicalDoctor’s appointments

Medicare Part D – PrescriptionCoordinated with CVT coverage

Medicare Part A and BMedicare Part A and BIf you will receive a Social Security check

you will automatically qualify for Part A.If you do not automatically qualify Part A

or B, you may qualify through your current spouse or previous spouse. Please check with the SSA for additional information.

Ineligible Faculty members will receive information from STRS regarding automatic payment of Part A. You will need to enroll in the program offered by STRS.

Medicare Part DMedicare Part DCalifornia’s Valued Trust will enroll you in

Medicare Part D. Prescription plan name: SILVERSCRIPTPlan is coordinated with regular

prescription plan. If you have a prescription that is not

covered by SilverScript then CVT covers the prescription if previously allowed.

Coordination is automatic.Some prescriptions may require pre-

authorization or an override. CVT processes the override for our retired members.

Separate cards will be issued for medical and prescription coverage.

CALCULATION - Two Party CALCULATION - Two Party Rate Retiree under Rate Retiree under 65/Spouse over 6565/Spouse over 65BX 4A, Dental, Vision

Blue Cross $1062.00Dental $ 93.30Vision $ 16.94 Subtotal $1172.24Less D Cont $1324.38Your Cost $ 0.00

Kaiser 1, Dental, Vision

Kaiser $1047.00Dental $ 93.30Vision $ 16.94 Subtotal $1157.24Less D Cont $1324.38Your Cost $ 0.00

General General InformationInformation

Payment InformationPayment InformationPayments are due on the first of each month

for that month’s coverage. Payments not received by the 15th of the

month are subject to termination. Once coverage is terminated, you cannot reactivate your plan.

The District will be implementing a new billing system to invoice you for your premium. However, you are still responsible for your payment even if you do not receive an invoice.

Payments will be made to San Joaquin Delta College (aka: SJDC or Delta College)

Can I change my plan to Can I change my plan to save $?save $?Plans can be changed if you experience a qualifying event.

Qualifying events:◦ Change in work status (active to retired)◦ Reached Medicare age◦ Open Enrollment◦ Eligible for other coverage◦ Change in dependent status

Married/Divorced Guardianship

Miscellaneous QuestionsMiscellaneous Questions What happens to my spouse’s coverage if I should pre-decease my spouse?

Coverage is terminated at the end of the month in which our retiree deceases. Your spouse will be provided the option of continuing to purchase coverage. The plan will not be the same but is similar. The approximate cost for the medical, dental and vision coverage is $425/mo with Medicare Parts A and B activated.

I’m over 65 but my spouse is not. What medical cards does my spouse use? Your spouse will continue to use the regular Blue Cross medical card. You will receive a separate medical and prescription card with your name on it. If your spouse will be 65 before you then your spouse will receive individual personalized cards.

Now that I have Medicare, what do I give/tell my doctor? You will need to give the provider both your Medicare card and your Blue Cross card. Medicare will become your primary coverage and Blue Cross will be your secondary.

Do I keep my dental and vision coverage now that I am eligible for Medicare? Yes. These coverage’s do not change.

What happens if the active employee group eliminates the plan I have elected?

Group II retiree benefits are limited to the active employee group coverage. If a plan is eliminated then you will no longer be able to select that plan. (ex: Blue Cross 4A is changed to 6A for the active employees. The Group II retirees who are covered under Blue Cross 4A will be automatically changed to Blue Cross 6A.

Miscellaneous QuestionsMiscellaneous Questions I am under 65. Will my group number change on my Medical plan now

that I have retired? Yes, you will receive new medical cards with a new group number. Please continue to use your regular card until you receive the new card.

Can I use my coverage if I decide to reside outside of California or the United States? Blue Cross provides regular coverage for those residing within the United States. There will be minimal coverage for those residing internationally. If either circumstance applies, you will need to contact Blue Cross Blue Card for the proper billing procedures.

If I marry after I retire, can I add my spouse and dependents?Yes. Documentation will be required.

What happens when I reach my Medicare Part D “coverage gap”?CVT will pick up the cost of the prescriptions when you fall into the coverage gap between $2930 and $4700. You will not experience any interruption in coverage.

When does the annual defined contribution start? Each October the new defined contribution will begin. You will receive notification of the new rate in August during our open enrollment. You will also receive your new premium rates during this time.

Can I drop my spouse when I retire and add them back on at a later time? Yes, as long as your spouse experiences a qualifying event such as loss of coverage or becoming Medicare eligible.

Important Contact Important Contact NumbersNumbersCalifornia’s Valued Trust – Rep:

Tracy P(800) 288-9870

Blue Cross Blue Card(800) 810-2583

Medicare(800) 633-4227

SilverScript Pre-authorization(800) 294-5979

Medicare and You – publicationwww.medicare.gov/publications