Hearing benefits for active employees are currently provided through the HMO in which you are enrolled. The Plan also provides hearing benefits on a self-funded basis to members enrolled in an HMO which does not cover hearing aids.

The Plan provides the following types of benefits, through the Plan service providers listed.

Medical, hospital, surgical and prescription drug benefits are currently provided through one of two health maintenance organizations ("HMOs") Kaiser Permanente Health Plan or Blue Shield of California. Members who enroll in the Plan on or after January 1, 2012, and all Residential Specialists, may enroll only in Kaiser.

Blue Shield of California
(800) 393-6130
https://www.blueshieldca.com

Summary of Benefits & Coverage: 

Blue Shield Active + HMO Facility Coinsurance 20-20%

Blue Shield Active + HMO Facility Deductible 30-30%/2000

Blue Shield Trio HMO Facility Coinsurance 20-20%

Blue Shield Trio HMO Facility Deductible 30-30%

Evidence of Coverage: 

Blue Shield Active + HMO Facility Coinsurance 20-20%

Blue Shield Active + HMO Facility Deductible 30-30%/2000

Blue Shield Full PPO Combined Deductible 35-500 80/60

Blue Shield Trio HMO Facility Coinsurance 20-20%

Kaiser Permanente (Group #31159)
(800) 464-4000
(800) 788-0616 (Spanish)
https://thrive.kaiserpermanente.org/

Summary of Benefits & Coverage: 

Kaiser Active DHMO SBC

Kaiser Early Retiree HMO SBC

For complete information about your medical benefits, refer to the SPD & Formal Plan Rules.

Life and Accidental Death & Dismemberment Insurance benefits are provided through CIGNA Group Insurance.

CIGNA Group Insurance

Life Policy #FLX961752

AD&D Policy #OK961836

(800) 362-4462

www.cigna.com

Vision benefits are provided on an insured basis through Vision Service Plan (VSP).

Vision Service Plan (Group #31159)

Customer Service: 1 800 877-7195

www.vsp.com