Eligible retirees have four (4) Non-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 |
 - 2010 Quick Reference Sheet (File Size: 80kb)
- Medical Plan Comparison (File Size: 128kb) - Kaiser CA 2010 Benefits (File Size: 37kb) - Blue Shield HMO/PPO/POS 2009 Benefits (File Size: 389kb) - Blue Shield Traveling Benefits - FAQs (File Size: 65kb) - Kaiser Northwest 2010 Benefits (File Size: 140kb) - Kaiser Hawaii 2010 Benefits (File Size: 107kb)
COST | top
of page |
- 2010 Medical Plan Rates (pg1) (File Size: 97kb)
EVIDENCES OF COVERAGE | top
of page |
- Kaiser CA 2010 EOC (File Size: 488kb) - Blue Shield HMO 2009 EOC (File Size: 3,392kb) - Blue Shield POS 2009 EOC (File Size: 3,640kb) - Blue Shield PPO 2009 EOC (File Size: 3,557kb) - Kaiser Northwest 2010 EOC (File Size: 883kb) - Kaiser Hawaii 2010 EOC (File Size: 2,631kb)
HIPAA PRIVACY NOTICES | top
of page |
- California Kaiser Permanente (File Size: 573kb) - Blue Shield of California (File Size: 76kb) - Northwest Kaiser Permanente (File Size: 44kb)
AUTHORIZATION TO RELEASE INFORMATION FORMS | top
of page |
- California Kaiser Permanente (File Size: 103kb) - Blue Shield of California (File Size: 61kb) - Northwest Kaiser Permanente (File Size: 360kb)
CONTACT THE PLAN PROVIDERS | top
of page |
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