Retiree Benefits

HMO Medical Plans and Enrollment Forms

• Blue Shield Trio Benefits Summary
• SISC III Enrollment Form for Blue Shield
• Blue Shield Full Network Benefits Summary
• SISC III Enrollment Form for Blue Shield
• Kaiser Permanente $0; Rx $5-20 (30 Day) Benefits Summary
• Kaiser Permanente Enrollment Form
• Kaiser Permanente $15; Rx $5-20 (30 Day) Benefits Summary
• Kaiser Permanente Enrollment Form

 

PPO Medical Plans and Enrollment Forms

• Blue Shield 90G $20; Rx $5-20 (30 Day) Benefits Summary
• Blue Shield 100A $10; Rx $5-20 (30 Day) Benefits Summary
• Blue Shield 2-Tier Anchor Bronze Benefits Summary
• SISC III Enrollment Form for Blue Shield
• Companion Care Benefits Summary

 

Prescription Coverage

• Navitus Medicare Rx Information

 

Additional Information

• HIPAA Notice of Privacy Practices

HMO Dental Plan

• Delta Care HMO Benefits Summary

 

PPO Dental Plans

• • • Delta Dental PPO 1500 Benefits Summary
    • Delta Dental PPO Unlimited Benefits Summary

• • • VSP - Vision Care