Blue Cross Transition
Here is the link to the District’s collection of information on Blue Cross and the current transition: http://www.4cd.edu/hr/benefits/default.aspx . Just click on the “Anthem Blue Cross” category.
Here is the enrollment form: Anthem Blue Cross – Enrollment Form. (There is also a 52-page “enrollment kit” on the District website: http://www.4cd.edu/hr/benefits/default.aspx).
Here too is the text of the letter sent by District HR to all employees. Below that, you’ll find lots of other information about the new plans.
CCCCD Employees:
We are pleased to announce Anthem Blue Cross will be the new medical provider for CCCCD effective August 1, 2013. This will replace the existing HealthNet plan, however, it will not replace the currently offered Kaiser Permanente plan. The decision to offer Anthem Blue Cross was made in conjunction our various employee groups in order to provide our employees with the best medical benefits at the lowest possible costs.
A special open enrollment will be held beginning Monday, June 3, 2013 through Monday, June 17, 2013 for medical changes only. The regularly scheduled open enrollment will be held October 15, 2013 through November 13, 2013 for the Dental, Vision, Medical and Section 125 plans.
HealthNet Members: Every employee who is a HealthNet member is required to complete a new enrollment form and turn it into the District Human Resources Department by 5:00 pm on Monday, June 17, 2013. If you do not turn in an enrollment form, your coverage with HealthNet will be terminated effective midnight of July 31, 2013 and you may no longer have medical coverage. HealthNet members have a choice to enroll into one of the newly offered Anthem Blue Cross Plans or the existing Kaiser Permanente Plan.
Kaiser Permanente Members: Employees who are currently enrolled in the Kaiser Permanente plan may choose to enroll in the newly offered Anthem Blue Cross Plan. If employees select this option then an enrollment form must be completed and submitted to the District Human Resources by June 17, 2013 for an effective date of August 1, 2013. If employees opt to remain in the Kaiser Permanente plan then no action is needed.
It is important that you are aware of your benefit options before you begin the open enrollment process. Please come to one of the scheduled special open enrollment meetings noted below to obtain more information from Anthem Blue Cross and Kaiser Permanente representatives. You may attend any of the following open enrollment meetings for assistance. You may view and access the Anthem Blue Cross enrollment form at www.4cd.eduby clicking on the “Human Resources” tab and then the “Benefits” tab to access the “Anthem” link. You may also view and access the Kaiser Permanente enrollment form at www.4cd.edu by clicking on the “Human Resources” tab and then the “Benefits” tab to access the “Kaiser” link.
Special enrollment meetings will be held on:
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Monday, June 3, 2013
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Diablo Valley College, Trophy Room, 10:00 am – 12:00 noon
District Office, Board Room, 2:00 pm – 4:00 pm
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Wednesday, June 5, 2013
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Contra Costa College, Room LA-100, 10:00 am – 12:00 noon
Diablo Valley College, Trophy Room, 2:00 pm – 4:00 pm
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Monday, June 10, 2013
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Los Medanos College, Room L109, 1:00 pm – 3:00 pm
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Thursday, June 13, 2013
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Contra Costa College, Room LA-100, 2:00 pm – 4:00 pm
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Monday, June 17, 2013
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District Office, Board Room, 10:00 am – 12:00 noon
Los Medanos College, Room L109, 2:00 pm – 4:00 pm
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Anthem Blue Cross
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Effective August 1, 2013 Anthem Blue Cross will be replacing HealthNet of California. Following are the new plans being offered through Anthem Blue Cross:
HMO (Health Maintenance Organization) Plan
Common copays include $15 for office visits; $5 for generic drugs; $15 for brand name drugs; $100 for Emergency Room visits; $0 for Hospital admission.
You will need to select a Primary Care Physician (PCP) and Medical Group (i.e. such as John Muir Group, Hills Physician, etc.) on your enrollment form. This plan covers physicians within California who take Anthem HMO and are accepting new patients. You cannot go outside of the HMO network of physicians. If you do not select a PCP and/or Medical Group then one will be assigned to you by Anthem Blue Cross. You will be required to obtain a referral from a PCP in order to see a specialist.
EPO (Exclusive Provider Organization) Plan
Common copays include $15 for office visits; $5 for generic drugs; $15 for brand name drugs; $50 for Emergency Room Visits; $0 for Hospital admission.
Anthem EPO uses the Anthem Preferred Provider Organization (PPO) network. There is no coverage outside of the Anthem PPO network of physicians. You will NOT be required to select a Primary Care Physician and NO medical groups exist under this plan. Since this is a national plan you may visit any physician in the country who takes Anthem Blue Cross PPO and who is accepting new patients. You do NOT need a referral from a Primary Care Physician to see a specialist.
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Kaiser Permanente
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We are pleased to continue to offer Kaiser Permanente as an optional medical carrier alongside Anthem Blue Cross. The following is a highlight of the currently offered Kaiser plan:
HMO (Health Maintenance Organization) Plan
Common copays include $15 for office visits; $5 for generic drugs; $15 for brand name drugs; $50 for Emergency Room visits; $100 for Hospital admission.
To view additional services and co-pays offered by Kaiser please visit the District’s home page at www.4cd.eduand click on the following: “Human Resources, “Benefits,” “Benefits Overview” and then “CCCCD Summary of Benefits” link.
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Important Notes
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· Please refer to the District website at www.4cd.eduunder “Human Resources,” “Benefits” and then “Anthem/Blue Cross” to view health plan rates for Anthem and Kaiser Permanente. These rates are subject to Governing Board approval for 2013-2014.
· Adding a New Dependent: The District Human Resources Department will need to verify all newly added insured dependents during open enrollment. You will need to provide state issued birth and or marriage certificates and legal guardianship or adoption papers which are acceptable forms of verification. If verification cannot be provided, dependents will not be enrolled for any coverage. Please make sure to bring the documentation when you turn in your enrollment form.
· Anthem will be able to grandfather those members who have already gone through pre-authorization or step-therapy with their prior carrier for prescriptions if the member can show that they were covered by one of the Explanation of Benefits (EOB) showing their insurance covered the prescription. They will also accept any prior carrier documentation showing it was approved or covered.
· Continuity of Care/Transitional Assistance: If eligible, the member would need to complete a “Transitional of Care Request Form.” This is completed immediately and in addition to their enrollment application during this special open enrollment time. This allows a member who is currently going through a course of treatment or in an acute phase of illness to continue treatment with their provider until completion or they can move to a participating network provider. It is only applicable if the provider you are seeing is not in Anthem’s network. The form itself outlines the criteria for being eligible and once it is completed it should be faxed to the number on the first page of the form. The form is received by the Anthem Care Management nurses who will reach out directly and confidentially to the new member and to their provider. You may locate this form at the District website at www.4cd.edu, under “Human Resources,” “Benefits” and then “Anthem Blue Cross.”
· Copies of the Anthem Blue Cross prescription formulary list is available online at the District website at www.4cd.edu under “Human Resources,” “Benefits,” and then “Anthem Blue Cross” (for Anthem).
· Additional Anthem Blue Cross and Kaiser Permanente plan designs are included in the enrollment packet and on the www.4cd.edu website. Again, all HealthNet members must complete an Anthem Blue Cross enrollment form or a Kaiser Permanente enrollment form to continue coverage. Deadline to complete the form is June 17, 2013.
You may obtain a hard copy of the Anthem or Kaiser Permanente enrollment packet from your local HR Department, the District Office Human Resources Department or at any of the special open enrollment meetings noted in this letter.
If you have any questions regarding the health plans described in this letter, please feel free to contact Reed Rawlinson at the District Human Resources Department at 925-229-6853 or myself at 925-229-6852.
Andrea Gonzalez-Lewis
HR Support Services Manager
500 Court Street, 4th floor Human Resources Department
Martinez, Ca. 94553
Phone: 925-229-6852
Fax: 925-229-2490
Here is a comparison of costs: premiums and copays for all the plans under consideration including those for retirees: Health Net vs Anthem Comparison 5_7_2013. Here is a more detailed comparison of premiums for all plans: Health Net vs Anthem Effective July 1 2013 Health Benefit Rate Matrix. Here is a new easy-to-read version with cost-to-faculty clearly presented: Premiums
Here are instructions for checking to see if your doctor or hospital takes Anthem Blue Cross: Guide for Searching for Doctors – Anthen Blue Cross(1).
Here are the lists of covered drugs for Health Net, Anthem Blue Cross, and the different lists for retirees. These lists may help you determine how medication you take would be covered if we switch providers, but remember that formulary lists can and do change at any time.
Formulary – Active Employee Health Net HMO and Elect
Anthem Blue Cross Prescription Program Drug List
Formulary Retiree Medicare Plan
Formulary Retiree Health Net PPO
There is more information available on the District web site under “Human Resources” and “Benefits.” Here is the link:
http://www.4cd.edu/hr/benefits/default.aspx
If you have questions about the Blue Cross Bid or how your medical care would be affected, please call Reed Rawlinson at the District Office: 925-229-6853 or Jeffrey Michels, United Faculty Executive Director: 925-330-2125 (or ufjeffmichels@gmail.com). If you have questions about the vote, you may call Jeff, Glenn or Terri at the UF Office: 925-680-1771.
