Health & Welfare Benefits

Human Resources Employee Benefit-Related Activities >>

• 2018/2019 Master Planning Calendar

• 2018/2019 Annual Notices for Employees

Employee Benefits Open Enrollment Period

Monday, August 12, 2019 through Friday, August 30, 2019

During this Open Enrollment window, employees currently enrolled in a Blue Shield PPO or HMO medical plan may:

• Re-enroll in a different medical plan – or –
• May enroll/disenroll dependents in a medical and/or dental plan – or –
• Enroll in a medical and/or dental plan if coverage has been previously waived
• Enroll/disenroll in a vision plan

If you do not wish to make any changes - YOU DO NOT NEED TO DO ANYTHING

Benefit Information for all eligible employees effective October 1, 2019:

• Medical, Dental and Vision Plan Ratetable
• Annual Stipend Information
• Blue Shield PPO/HMO Medical Plan Comparison (side by side)
• Benefit Booklet - Active Employees

Open Enrollment Forms

• SISC III Enrollment Form (medical)
• SISC Membership Change Form
• Plan Election Form
• Delta Dental Enrollment Form
• VSP Vision Enrollment Form

Medical Plan Benefit Comparisons Benefit Eligible Employees/Retirees:

• Blue Shield PPO Medical Plan Comparisons
• Blue Shield PPO (80-E) Plan Summary of Benefits and Coverage (SBC)
  • Benefit Summary
  • Benefit Booklet (80-E) Plan
  • Navitus Health Solutions Rx Program - $7 generic/$25 brand name
• Blue Shield PPO (80-J) Plan Summary of Benefits and Coverage (SBC)
  • Benefit Summary
  • Benefit Booklet (80-J) Plan
  • Navitus Health Solutions Rx Program - $9 generic/$25 brand name
• Blue Shield PPO (HDHP-B) Plan Summary (high deductible plan)
  • Benefit Summary
  • Benefit Booklet (HDHP-B) Plan
  • Navitus Health Solutions Rx Program - subject to the $3,000/$5,200 annual medical deductible.  Once the deductible is met - $9 generic/$35 brand name
  • Costco Mail Order after the deductible is met - $18 generic/$90 brand name

• Navitus Health Solutions Rx Program*
  • *Costco Pharmacy provides most generic drugs with no copay.  This does not apply to the Blue Shield PPO (HDHP-B) medical plan.
  • Costco Pharmacy provides the mail order drug program.
• Value Based Site of Care Benefit Change Effective October 1, 2018
  • PPO plans will limit the maximum benefit amount at an in-network outpatient hospital facility for the following procedures: Arthroscopy, Cataract surgery, Colonscopy, Upper GI Endoscopy with Biopsy, Upper GI Endoscopy without Biopsy
  • If an in-network outpatient hospital facility is used, the member will be responsible for the regular deductible and coinsurance PLUS any amount by which the hospital exceeds the maximum benefit.
  • If an in-network Ambulatory Surgery Center is used, then there is no benefit change.  You will only be responsible for the regular deductible and coinsurance.

• Blue Shield HMO Medical Plan Comparisons
• Blue Shield HMO Plan ($10-0) Summary of Benefits and Coverage (SBC)
  • Benefit Summary
  • Benefit Booklet - HMO ($10-0) Plan
  • Navitus Health Solutions Rx Program - $5 generic/$10 brand name
• Blue Shield HMO Plan ($25-500) Summary of Benefits and Coverage (SBC)
  • Benefit Summary
  • Benefit Booklet - HMO ($25-500) Plan

  • Navitus Health Solutions Rx Program - $9 generic/$35 brand name

• Blue Shield HMO Plan ($30-20%) Summary of Benefits and Coverage (SBC)
  • Benefit Summary
  • Benefit Booklet - HMO ($30-20%) Plan
  • Navitus Health Solutions Rx Program - $9 generic/$35 brand name
• Blue Shield HMO Chiropractic and Acupuncture Benefits

Medical and Dental Benefit Contact Information and Useful Web Links:

• Blue Shield of California PPO (Preferred Provider Organization)
  • SISC Dedicated Customer Service Unit: (855) 256-9404
  • P.O. Box 272540, Chico, CA  95927-2540
    • Click here to locate a Participating PPO Provider
    • Blue Shield MDLIVE
      • Telephone Number:  (800) 657-6169
      • Website:  www.MDLIVE.com/SISC
      • App availabe for iPhones and Adroid phones
    • Mental Health
      • Customer Service Telephone Number:  (855) 256-9404
    • Carrum Health (Scripps Hospital)
      • Enhanced Benefit for hip, knee, and spine surgeries for PPO members
      • Telephone Number:  (888) 855-7806
      • Website:  my.carrumhealth.com/sisc
      • FAQ's

     

• Blue Shield of California HMO (Health Maintenance Organization)
  • Customer Service Telephone Number: (855) 256-9404
  • Click here to locate a Participating HMO Provider (Access + HMO)
  • Chiropractor and Acupuncture Benefits (American Specialty Health Plans of California - ASH)
    • To locate a provider, contact ASH at (800) 678-9133
  • Blue Shield MDLIVE
    • Telephone Number:  (800) 657-6169
    • Website:  www.MDLIVE.com/SISC
    • App available for iPhones and Android phones
  • Mental Health (MHSA Network)
    • Customer Service Telephone Number: (877) 263-9952
• Advance Medical offers the following:
  • Assists patients with medical conditoins by providing answers to their healthcare questions and ensuring they are receiving the best possible care.
  • Patients' medical cases are reviewed by doctors identified as world-leading experts in the fields of specialty.
  • Members who access this service are able to speak directly with a specialit once their case is established.
  • Telephone Number:  (855)201-9925
  • Website:  www.advancemedical.net/sisc

Medical Plan Benefit Information for Non-Benefit Eligible Employees:

• Anchor Bronze Plan Summary of Benefits and Coverage (SBC)
  • Benefit Summary
  • Benefit Booklet

Forms

• SISC III Enrollment Form (medical)
• SISC Membership Change Form
• Delta Dental Enrollment Form
• SISC Flex Premium Only Plan (POP) Enrollment Form
• Vision Service Plan Enrollment Form