Annual Enrollment Notice

Health Fair Schedule

Guild Letter to Retirees

CalPERS Retiree Health Insurance

• CalPERS 2012 Health Benefit Summary New!
  • A side-by-side comparison of all CalPERS health plans
• CalPERS 2012 Health Program Guide New!
  • A complete information guide to your
    CalPERS health benefits
• CalPERS 2012 Medicare Enrollment Guide New!
  • A practical guide to understanding how CalPERS and Medicare work together

• Frequently Asked Questions About Medicare (link will take you to Medicare.gov website) New!

• Hospitals Excluded From the 2012 Blue Shield CalPERS Provider Network

  (This links to the CalPERS website. All Blue Shield members are encouraged to read this information)

• Need to contact CalPERS regarding long-term care? New!
• CalPERS Prescription Drug Program Changes for Plan Year 2012 New!
• CalPERS Medical Benefits Changes for 2011 Please Read
• CalPERS 60/90 Rule Please Read
• Understanding your Health Plan Statement
• 2012 CalPERS Premium Rates - HMO and PPO New!
• 2012 CalPERS Medicare Combination Premium Rates New!
• 2012 Dental and Vision Premium Rates New!
• 2012 EOCs New!
  • PERS Choice Basic and Medicare
  • PERS Select Basic and Medicare
  • PERS Care Basic and Medicare
  • Access+ HMO
  • Blue Shield NetValue
• Kaiser HMO
• 2012 Prescription Drug Changes New!
  • Anthem Blue Cross
  • Blue Shield
  • Kaiser
• Dental Plan Overview
• SafeGuard Plan Comparison Summary
• Delta Dental PPO - Using Your Plan
• Benefit Highlights for Delta Dental PPO
• 2010 Dental Vision Plan Summary
• 2008 Retiree Cover Letter
• 2009 Retiree Election Form & Questionnaire

Health Benefits for New Retirees

• Checklist for New Retirees Updated!
• Classified Retirement Process
• Faculty Retirement Process
• Retiree Program Summary - PERS
• Retiree Program Summary - STRS
• Important Information About AB528
• 2010 Summary of Rights
• Medicare Board Rule (290 KB/2 pages)
• CalSTRS Medicare Enrollment
• CalSTRS Medicare Packet
• CasSTRS Mediare Payment Authorization
• 2008 Medicare Cost
• Social Security Administration (link opens new browser window)
  CalSTRS Medicare Program (link opens new browser window)

Forms and Information You May Need

General Forms

• 2012 Dental and Vision Enrollment/Change Form
• 2011 Application for Retiree Health Bnefits
• 2010 Enrollment/Change form for Retirees and Survivors
• 2010 Application for Retiree Health Benefits
• CalPERS Health Plan Enrollment/Change Form

• Please complete only the highlighted portions of the form. To add a new dependent, please put an "A" in the Action Code column (highlighted on the form) to the left of the new dependent's name.

  To delete a dependent from your medical plan, put a "D" in the Action Code column to the left of the name of the dependent you wish to delete from your plan.

• Enrollment/Change for 2009 Retirees/Survivors

• SafeGuard - Health Plans Change Form (Common Form 04)
• Kaiser Senior Advantage Application
• Blue Shield - Request for Continuity of Care
• Blue Shield - Declaration of Disability for Overage Dependent Child 
• Blue Shield - International Claims Form
• Blue Shield - Rx Claim Form
• Blue Shield - Statement of Claim Form
• Blue Shield - Disabled Dependent Form
• Kaiser - Claim for Emergency Services Form
• VSP Out of Network Reimbursement Form

Domestic Partner Forms and Brochure

• Affidavit (Common Form 07)
• Tax Form (Common Form 08)
• Terminating a California Registered Domestic Partnership (Brochure)
• Declaration of Termination of Domestic Partnership (Form)

Survivor Information

• Survivor Q&A
• Survivor Health Benefits Application