Medical Program Information

Blue Shield Documents

Plan Comparisons

 

Blue Shield Forms

These matrixes are intended to be used to help you compare coverage benefits and is a summary only. The plan contract should be consulted for a detailed description of coverage benefits and limitations.

October 2022 to September 2023

80% PPO Benefit Summary (PDF)

90% PPO (Frozen) Benefit Summary (PDF)

100% PPO Benefit Summary (PDF)

H.S.A.- Plan A  Individual - Benefit Summary (PDF)

H.S.A - Plan A Family - Benefit Summary (PDF)

H.S.A.- Plan B - Benefit Summary (PDF)

Anchor Bronze Benefit Summary (PDF)

 

Blue Shield & Navitus Prescription
Summary of Benefits & Coverage

The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary.

October 2022 to September 2023

100-B PPO - $20 Office Visits, $7 to $25 Prescriptions (PDF)

90-E PPO (Frozen) - $20 Office Visits, $7 to $25 Prescriptions (PDF)

80-G PPO - $30 Office Visits, $9 to $35 Prescriptions (PDF)

HSA - Plan A PPO Family (PDF)

HSA - Plan B PPO Family (PDF)

Anchor Bronze (PDF)

2022-2023 Blue Shield Side-by-Side Comparison (PDF)

 

Kaiser Documents

Plan Comparisons

 

Kaiser Forms

 

Kaiser Benefit Summaries

These are summaries of the most frequently asked-about benefits. These charts do not explain benefits, Cost Share, out-of-pocket maximums, exclusions, or limitations, nor do they list all benefits and Cost Share amounts.

October 2022 to September 2023

 

 

Kaiser Summary of
Benefits & Coverage

The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary.

October 2022 to September 2023

 

 

COBRA Documents

COBRA Forms

COBRA/Retiree Notification Form (PDF)

 

2022-2023 Plan Comparisons

COBRA Blue Shield PPO Rates (PDF)

COBRA Kaiser Rates Without Vision(PDF)

COBRA Kaiser Rates With Vision (PDF)

 

 

Benefit Summaries &
Summary of Benefits and Coverage

Benefit Summaries & Summary of Benefits and Coverage can be found under the listing for each specific program: Medical, Dental, and Vision.

 

Notices & Rights

Annual Notices 2022 to 2023 (PDF)

RESIG Privacy Practices Notice (PDF)

Medical Program Overview

RESIG’s broker, Alliant Insurance Services, negotiates with health benefit program carriers on an annual basis. The current plan period is October 1, 2022, to September 30, 2023.

The Health Program includes Kaiser Permanente and Blue Shield plans sponsored through Self-Insured Schools of California (SISC). Kaiser Permanente includes HMO plans and High Deductible Health Plan (HDHP) compatible with a Health Savings Account (HSA). Blue Shield health plans include PPO plans including an HDHP compatible with an HSA. The HSA plans are administered by RESIG.

Two Kaiser Permanente Senior Advantage (KPSA), two Blue Shield PPO 65+ and an Anthem Blue Cross Medicare supplemental (CompanionCare) plans are available for retirees over age 65 with Medicare Parts A & B or retirees who are Medicare-eligible prior to age 65.  The Medicare 101 Seminar is scheduled for a 60-minute seminar on February 15, 2023, at a time to be determined later.