Eligible retirees have five (5) Medicare plans available to choose from. Please
click on the following links to find the information you are looking for, or
contact the Retirement Services Department at (408) 794-1000 for additional
information.
Please note: You will need Adobe
Acrobat Reader in order to open PDF documents.
Summary Plan Information | Cost | Evidences
of Coverage
HIPAA Privacy Notices |
Authorization To Release Information Forms |
Contact
The Plan Providers
SUMMARY OF PLAN INFORMATION | top
of page |
 - 2012 Quick Reference Sheet (File Size: 77kb)
- 2011 Medicare Plan Comparison (File Size: 122kb) - 2012 Kaiser CA KPSA Benefits (File Size: 35kb) - 2012 Blue Shield HMO Summary (File Size: 61kb) - 2012 Blue Shield PPO Summary (File Size: 95kb) - 2012 UHC - Group Medicare Advantage (File Size: 70kb) - 2012 UHC PacifiCare Sr. Supplement Plan F (File Size: 174kb) - 2012 UHC Sr. Supp Vision Rider (1) (File Size: 125kb) - 2012 UHC Sr. Supp Vision Rider (2) (File Size: 125kb) - 2012 UHC Sr. Supp Neuromuscular Skeletal Rider (File Size: 129kb)
COST | top
of page |
- 2012 Medical Plan Rates (pg 2) (File Size: 149kb)
EVIDENCES OF COVERAGE | top
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- 2012 KPSA EOC (File Size: 7,969kb) - 2012 KP Medicare OOA EOC (File Size: 4,758kb) - 2011 BSC Medicare HMO EOC (File Size: 413kb) - 2011 BSC Medicare PPO EOC (File Size: 513kb) - 2011 PacifiCare Sr. Supplement EOC (File Size: 495kb) - 2011 Secure Horizons EOC (File Size: 1,327kb)
HIPAA PRIVACY NOTICES | top
of page |
- California Kaiser Permanente (File Size: 82kb) - Blue Shield of California (File Size: 76kb) - United Healthcare (PacifiCare/Secure Horizons) (File Size: 166kb) - Northwest Kaiser Permanente (File Size: 573kb)
AUTHORIZATION TO RELEASE INFORMATION FORMS | top
of page |
- Kaiser Senior Advantage (File Size: 68kb) - Blue Shield of California (File Size: 61kb) - United Healthcare (PacifiCare/Secure Horizons) (File Size: 166kb) - Northwest Kaiser Permanente (File Size: 822kb)
CONTACT THE PLAN PROVIDERS | top
of page |
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