Welcome to Your Benefits Webpage!
- Contact Information for Benefit Plans and Retirement
Carriers Effective 10/1/2018 A printable list is available by clicking here.
Plan Website Customer Service Number SISC - Anthem Blue Cross
Navitus (Pharmacy)
MDLive
1-800-322-5709 (See # on ID Card)
SISC - Kaiser
Chiropractic & Acupuncture Benefits (ASH Network)
1-800-678-9133 (TTY 711)
SISC - Delta Dental www.deltadentalins.com 1-866-499-3001 SISC - VSP www.vsp.com 1-800-877-7195 SISC - EAP Company Code:
"SJECCD" (for Kaiser Senior Advantage Enrollees only)
"SISC" (for everyone else)
1-800-999-7222 Hartford Life & LTD www.thehartford.com 1-800-572-9047 IGOE-Flexible Spending Account Member ID: Your SSN
Employer ID: IGOSJCC
800- 633-8818, Opt# 1 PERS www.calpers.ca.gov 1-888-225-7377 STRS www.calstrs.com 1-800-228-5453 The TDS Group
(403b Administrators)
1-866- 446-1072, Option #4 457 Plans
VALIC
TIAA-CREF
CalPERS 457
1- 408-529-8846
1-800-842-2252
1-800-260-0659
2024 OPEN ENROLLMENT
September 27, 2024 through October 17, 2024
During Open Enrollment (OE), those of you wishing to make changes to your coverage in the District’s medical, dental and/or vision plan(s) can make those changes without a qualifying event (life status change). Eligible changes include switching from Kaiser to Anthem Blue Cross or from Anthem Blue Cross to Kaiser, adding an eligible dependent not currently enrolled in medical, dental, and/or vision, and/or removing a dependent from coverage from medical, dental, and/or vision. Other than upon a life status event(s), open enrollment is the only time you can make changes to your benefit plan(s). For a qualifying life event, such as marriage, birth, adoption, loss of other coverage, etc., you have up to 30 calendar days from the date of the qualifying event date to enroll any eligible dependents. No late changes will be accepted.
If you do not want to make any changes, no further action is required. Changes are only made to your coverage if you initiate them and submit all required documentation during the OE period.
If you plan to make a change, as long as you submit the proper enrollment or change form along with supporting documentation, if applicable, by 5:00pm on Thursday, October 17, 2024, your changes will retroactively take effect as of October 1, 2024. If you do not submit everything required by that time and date, you will have to wait until 2025 to make any changes (absent a qualifying event). Links to all forms are available below.
To add a dependent to your plan(s) or remove a dependent from coverage:
Adding a Dependent: to add a dependent that is not currently covered under your medical, dental and/or vision plan is complete SISC III Member Change Form and provide proof of their eligibility:
to add a spouse: a copy of your 2023 Federal Tax Return (only financial information may be redacted) or marriage certificate if married in 2024;
to add a domestic partner: a copy of your State Registration Certificate (applies to all couples);
to add your child
Biological - a copy of his/her certified birth certificate (can be covered to age 26);
Step – a copy of his/her certified birth certificate (may be covered to age 26);
Adopted, Foster or Court Appointed – a copy of the court order (can be covered to age 18)
Removing a Dependent: to remove a dependent from coverage under your medical, dental, and/or vision plan is complete SISC III Member Change Form and turn it in by the due date (10/17/2024).
As a reminder, it is the employee’s responsibility to notify the Benefits Coordinator in Human Resources within 30 days of the event if you have a covered dependent that ceases to be your dependent; for example:
- You get divorced.
- Your domestic partnership ends
- Your child or spouse becomes an active member of the military.
Failure to timely notify the District (by emailing HR.Benefits@sjeccd.edu or michelle.mckay@sjeccd.edu) will result in loss of continuation coverage rights under COBRA, and will include the carrier(s) billing you for services the ineligible dependent received, plus reimbursement of District paid premiums.
To switch plans:
To switch from the Health Waiver or Anthem Blue Cross to Kaiser: complete a Kaiser Permanente Enrollment Form and turn it in to Human Resources no later than 5:00pm, Thursday, October 17, 2024. Proof of your dependent’s eligibility is also required if the dependent is not already enrolled in your current plan(s). If you submit forms to switch, consider yourself switched as of October 1st. Do not use the District’s Anthem Plan after September 30, 2024. There is little to no out-of-network coverage on our plans and you will be financially responsible for any non-emergency services you or any covered dependent receives from a non-Kaiser provider/facility starting October 1st.
Kaiser Plan Summary & Plan Information
Switching to Anthem Blue Cross
To switch from the Health Waiver or Kaiser Permanente to Anthem Blue Cross: complete a SISC III Enrollment Form and turn it in to Human Resources no later than 5:00pm, Thursday, October 17, 2024. Proof of your dependent’s eligibility is also required if the dependent is not already enrolled in your current plan(s). If you submit forms to switch, consider yourself switched as of October 1st. Do not use the District’s Kaiser Plan after September 30, 2024. There is little to no out-of-network coverage on our plans and you will be financially responsible for any non-emergency services you or any covered dependent receives from a non-Anthem PPO provider/facility starting October 1st.
Anthem Blue Cross Plan Summary & Plan Information
SISC & THE CARRIERS WILL REJECT A TYPED SIGNATURE – therefore, it is your responsibility to assure your digital signature is recorded properly on the form. If the certificate is not included at your signature (the blue line under your name with the date stamp or the red squiggley mark next to your name), your request will be rejected. It is your responsibility to assure your signature is recorded properly and submitted before the due date or you will need to wait until the Open Enrollment 2025 to make any changes. To assure your request is processed, it is best to print the form, sign it with a pen and either send it to HR via the Pony, US Mail, Fax, or scanned and emailed (if you email, be sure you send via an encrypted email). You may also submit your forms at HR on Campus during this OE period.
Kids in College: for those of you enrolled in Kaiser Permanente:
If you are enrolled in Kaiser Permanente and you have a covered child going away to college out of state or outside of a Kaiser Service Area in California, you may want to consider switching to Anthem Blue Cross as our Kaiser plan will only cover them for emergencies when away at school/outside of the Kaiser Service Area.
Part-Time Faculty: The fall semester enrollment period for the Kaiser Plan ended September 16, 2024, with an effective date of September 1, 2024. If you missed the enrollment window, you may sign up during this Open Enrollment period (with an effective date of 10/1/2024). See the Associate Faculty webpage by clicking the link below Benefits along the left side of this page.
Submissions
All completed enrollment forms and supporting documentation must be receivedin Human Resources by 5:00pm, Thursday, October 17, 2024. You may scan and email your submission through an encrypted email to HR.Benefits@sjeccd.edu, or Fax them to the Benefits Fax line at 408.239.8804, or send them to Human Resources via the Pony.
Once your enrollment/change is processed by the carrier, Member ID Cards for Kaiser and Anthem will be mailed to adults by the carrier directly to your home in 10-14 business days. There are no ID cards for Delta and VSP.
Your email or fax receipt is your proof of HR’s receipt. A confirmation email will be sent out by your benefits team once all changes have been processed. If we have any questions, we will contact you directly. Due to the volume, we cannot respond to questions regarding receipt or completeness until after all have been processed, so again, Your email or fax receipt is your proof of HR’s receipt if you do not physically turn it in.
Benefits GuideInfo on all plans in one place! Introducing the SJECCD Benefits Guide Book! Please click the link below for information on the District’s health and welfare package. Feel free to download a copy (.pdf) or save the link onto your own computer, as well as share the link with your spouse or child away at college. Information on all plans and added benefits is now available in one source, right at your fingertips 24/7. Whether you are a new hire or you've been with the District for years, this book contains information on District plans all in one place! The 2024-2025 Benefits Guide will be available shortly. There are no changes to our benefits so the information in the 23/24 book is still correct. SJECCD 2023 - 2024 Benefits Guide |
- Opposite Sex Domestic Partners Now Eligible
Those of you with an opposite sex domestic partner that are registered with the State of California as Domestic Partners may now enroll your partner under the District’s plan(s). If you are not already registered, you may do so by clicking here https://www.sos.ca.gov/registries/domestic-partners-registry/. Simply provide a completed SISC III Member Change Form and a copy of your certificate of registry within 30 days of becoming registered or you may have to wait until the 2023 OE period unless they have a qualifying event.
- Sending Protected Information Through Email
If you have an enrollment form or change form to submit to the Benefits Office, please send it through Office 365 and "Encrypt" the email prior to sending it. This will ensure protected information like dates of birth and social security numbers are sent securely. It is very simple just a click of a link but if you do not have access to that function, simply email HR.Benefits@sjeccd.edu and request an encrypted email to reply to.
- Associate Faculty Benefits
See the Associate Faculty Benefits Page for more information.
- Adding Or Removing Dependents
- Completion and submission of the following form is required to add or remove a covered dependent from your medical, dental, and/or vision plan. Outside of Open Enrollment, supporting documentation is also required (ie., dissolution of marriage, birth certificate, etc.)
- Workspace Ergonomic Resources
Whether you are working remotely or in the workplace, make sure your workspace(s) is/are set up properly. The best way to reduce fatigue, burn out, and ultimately injury is for you to set up the tools/equipment you have, in the best way possible for you. The following flyers will help you do that.
Think Ergonomics (desktop) - Helpful tips to help you customize your workstation when using a desktop computer.
Think Ergonomics (laptop) - Helpful tips to help you customize your workstation when using a laptop computer.
Sit/Stand Workstation - Helpful tips to assure your sit/stand device is adjusted and used properly.
Easy Ergonomics - a helpful guide put out by Cal OSHA to help you learn how to work safely and reduce your risk of injury.
Please channel any requests you may have for special or different equipment through your immediate supervisor. If you need special assistance or require a formal ergonomic evaluation feel free to email Benefits Coordinator Michelle McKay at michelle.mckay@sjeccd.edu.
Welcome New Employees!!
For those of you eligible for health and welfare benefits, please review the Benefits Guide Book for information on all the benefit plans (including optional benefits) available to you. Enrollment forms will be sent to you prior to your benefit orientation. Additional details on each plan can be found by scrolling down this page and will be discussed during your New Employee Orientation.
Benefit Plans for Active Employees
- Medical Plans
Anthem Blue Cross
Anthem Blue Cross and Stanford have settled their contract retroactive to 9/1/2022 (no lapse). If you have questions, please call Anthem directly or your doctor's office at Stanford Health.
(Enrollment Packet for ALL benefit eligible Active employees)
- Active Employee's Plan Summary including Prescription Coverage (Anthem Blue Cross)
- Active Employee's Enrollment Guidebook (Anthem Blue Cross)
- Costco Mail Order Prescription Form (Anthem Blue Cross Enrollees Only)
- Anthem Mobile App Instructions
- Anthem Hip, Knee & Spine Surgeries (Blue Distinction REQUIREMENTS)
- SISC III Enrollment Form (Anthem Blue Cross) to print and sign
- SISC III Enrollment Form (Anthem Blue Cross) for digital signatures
- SISC III Membership Change Form (to add/terminate dependents, update address/name) to print and sign
- Anthem In-Network Labs (SISC)
- How to Print a Temporary ID Card (Anthem Blue Cross only)
Kaiser Permanente
(Enrollment Packet for ALL benefit eligible employees - including Plan A for associate faculty)
- Kaiser Enrollment Form (for digital signatures)
- Active Employee's Plan Summary (Kaiser)
- Chiropractic & Acupuncture Benefits
- Dental Plan
There is no annual cap for basic services and tiered. Basic Services are covered at 70% (first year), then each year you use the plan your coverage increases until you hit 100%. Orthodontia is covered at 100% up to a lifetime maximum of $3,000. Bridges and dentures however are covered at 50%. Below is a plan summary. Seeing a dentist that is part of Delta's PPO Network will provide you with the least out of pocket expense.
- Vision Plan
VSP is our vision plan. You get one comprehensive exam every 12 months, glasses or contact lenses every 24 months. There is little to no out of network coverage so be sure you find a provider at www.vsp.com
VSP Plan Summary VSP TruHearing Hearing Aid Discount Program - Employee Assistance Plan (EAP)
AnthemEAP plans offer confidential counseling services to all our benefit eligible employees and covered retirees, their dependents and anyone living in the employee/covered retiree's household. Telephonic, electronic (like Facetime or Skype), and in person counseling services are available, as are legal services, financial planning services, child care assistance, elder care assistance, discounted tickets for movies and attractions, etc., as are resources for tobacco, alcohol and drug dependency and our over all emotional health and mental wellness.
EAP Overview Identity Theft Flyer Child Care Resources Legal & Financial Services Flyer Elder Care Resources Substance Abuse Flyer Depression Resources Flyer Work-Life Flyer
Benefit Plans for Eligible Retirees
- Anthem Blue Cross
- Retiree Plan Summary (For all Covered Retirees eff 7/1/2018)
- EAP Plan (See EAP section above for more information on benefits/services available)
- Kaiser Permanente
Additional Information
- Address, Name, and Dependent Changes:
To change your address, name, add/remove a dependent please print, complete, sign and return the form below to HR.Benefits@sjeccd.edu, fax to 408.239.8804, or mail it via the Pony or US Mail to
Michelle McKay, Human Resources, 40 South Market Street San Jose, CA 95113.
- Adding/Removing Dependents
Adding Dependents:
Adding an eligible dependent that is not currently covered under your medical, dental and/or vision plan requires a completed original enrollment form and:
- To add a spouse: a copy of your previous year's Federal Tax Return (first page, redacted financial info)
- To add a domestic partner: a copy of your State Registration form (applies to same sex couples only unless one is 62 or older);
- To add your child (adopted, biological, or step): a copy of his/her certified birth certificate and:
- For all plans: SISC Member Change Form
YOU MUST ENROLL YOUR NEW DEPENDENT(S) WITHIN 30 DAYS OF THE EVENT (birth, marriage, adoption, etc.) or you may not be able to enroll them until the next regular Open Enrollment Period.
Removing Dependents:
As a reminder, it is the employee’s responsibility to notify the Benefits Coordinator in Human Resources within 60 days of the event if you have a covered dependent that ceases to be your dependent; for example:
- You get divorced.
- Your child between the ages of 19 – 25, gets married or is not a full time student at an accredited institution. (They can remain on Blue Cross or Kaiser, but not dental, vision, the EAP or life insurance). It is your responsibility to notify Human Resources timely.
- Your child becomes an active member of the military.
Failure to timely notify the District (by emailing the Benefits Coordinator in Human Resources) will result in loss of continuation coverage rights under COBRA and may include the carrier(s) billing you for services the ineligible dependent received and/or reimbursement of District paid premiums.
For specific eligibility questions contact the HR Benefits Office at extension 6713 or HR.Benefits@sjeccd.edu.
- For all plans: SISC Member Change Form
- Loss of Coverage/Qualifying Events
Health Insurance Portability & Accountability Act (HIPAA): For those eligible to decline enrollment for themselves, or any employee who elected to not enroll an eligible dependent (spouse, child, domestic partner) because of enrollment in another health insurance plan, you may be able to enroll yourself and your dependents in a District plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents' other coverage) IF you request enrollment within 30 days after your or your dependents' other coverage ends (or after the employer stops contributing toward the other coverage). Failure to notify the Benefits Coordinator timely means you will have to wait until the next regular open enrollment period.
In addition, if you have a new dependent as a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.
To request special enrollment or obtain more information, contact Michelle McKay, Benefits Coordinator at 408.223.6713 or HR.Benefits@sjeccd.edu.
Employees are no longer allowed to waive medical coverage for themselves (with the exception of those currently grandfathered in). All employees must at least enroll themselves in Kaiser or Anthem Blue Cross. Failure to submit your preferred plan enrollment form within your first 30 days of employment/becoming eligible for coverage will result in you (alone) being enrolled in Kaiser Permanente only. You will not have any other coverage (no dental, vision, life insurance, LTD coverage) and none of your eligible dependents will be enrolled in any district plan until there is a qualifying event or you enroll during a regular Open Enrollment period.
- Life Insurance Coverage for Adult Children
Beginning on their 21st birthday and each birth month after that until they turn 23, adult children must be a full-time student at an accredited institution to remain covered by the District's life insurance policy. Before the last day of their birth month, a copy of their current class schedule indicating their total units, or a letter from the school stating their full-time status, and the form below must be submitted to the Human Resources Department or their life insurance coverage will end.
- Disabled Children
If you have an adult child who is disabled, temporarily or permanently, please contact the Benefits staff in Human Resources at extension 6713 to discuss available options of keeping him/her covered UNDER ALL PLANS regardless of age and/or student status. Adult children who become disabled after age 26 and become dependent on you may be eligible for enrollment under the District's health and welfare plans. Please contact HR.Benefits@sjeccd.edu or call 408.223.6713 immediately for more information and required documentation.
- Keep Your beneficiaries Up to Date
- Update your beneficiary(s) for your District paid and/or supplemental life insurance (contact HR.Benefits@sjeccd.edu for supplemental coverage);
- Update your PERS or STRS beneficiary;
- Update your legal name (if you have legally changed it with Social Security)
- Update your home address or telephone number (if you have moved or changed your number recently)
- Update your Emergency Contact information
- Pre-Designate your personal physician to treat you for work related injuries/illnesses
Please note: due to the number of District employees, we are unable to verify the current emergency contact and/or the beneficiary(s) you have on file. If any time during the year you are unsure of who/what you listed, complete a new form(s) and submit the original(s) to Human Resources. All forms above are available all year long on this page and the Human Resources page.
- Flexible Spending Accounts:
Flexible Spending Account Enrollment/Change Form
Medical Care Reimbursement Account
- The 2024 annual medical care account maximum is $3,200.00 (the annual minimum is $240.00).
- You will automatically rollover of up to $610.00 of unused 2024 contributions to be available for you to use in 2025 (even if you do not open an account for 2025).
Dependent Care Reimbursement Account
- The annual maximum for 2024 remains at $5,000.00
This plan allows you to accumulate pre-tax dollars to reimburse yourself for childcare expenses, and/or day care expenses for a disabled dependent while you are employed. Among the eligible expenses are after-school care or extended day programs, babysitters, elder care expenses (if elder is your dependent), preschool and summer day camp. There is no rollover option for dependent care accounts.
Dependent Care Reimbursement Account FlyerTransportation Account
- The maximum MONTHLY election allowed is $315.00
This plan allows you to set pre-taxed dollars aside reimbursement of certain transportation expenses incurred as a direct result of your employment. If you take public transportation (CalTrain, Bart, VTA, etc.).
For more information about Flexible Spending Accounts including forms for additional cards, automatic deposit, and the Orthodontia Treatment Statement are available by scrolling down on this page to the Flexible Spending Account section.
IT IS THE PARTICIPANT'S RESPONSIBILITY TO ASSURE THE EXPENSES THEY USE THE PLAN FOR ARE ELIGIBLE EXPENSES AS EACH PLAN HAS STRICT LIMITATIONS ON WHEN ONE CAN CANCEL THE PLAN MID-YEAR.
- iGOE Orthodontia Treatment Statement - Required if the Medical Care Reimbursement Account will be used for orthodontia services for you and/or a dependent
- Form for Additional Card (for spouse)
- iGOE Direct Deposit Form
- Setting up your Website and iGOE App Account
Optional Forms (see below):
- Medical Care Worksheet (Broken link)
- Dependent Care Worksheet (Broken link)
- Retirement accounts (403B & 457 plans)
Please refer to Payroll's Public Folder in Outlook for the required forms to enroll in or make changes to a 457 Deferred Compensation Account and for inquires to 403b accounts.
All permanent employees, full and part-time, and adjunct faculty are eligible to enroll in either plan. It does not matter whether you are currently a member of PERS or STRS. It also does not matter what union or constituency group to which you belong.
Plans available to you through your employment with the District (if eligible) are with one of the carriers below:
- CalPERS 457 Plan
- TIAA CREF
- Valic
ALL ENROLLMENT FORMS ARE AVAILABLE THROUGH THE PAYROLL DEPARTMENT, PLEASE CALL THEM AT (408) 270-6412 OR GO TO THEIR PUBLIC FOLDER IN OUTLOOK.
- Pension Plans: CalPERS & CALSTRS
- Life Insurance & Long Term Disability
The Hartford:
Long Term Disability Insurance Life Insurance To view the PowerPoint presentation on beneficiary designations, purchasing additional life insurance to and other benefits/services The Hartford provides eligible employees (from presentations held onsite April 14, 2015) please click the link below:
Supplemental Life Insurance Workshop, April 2015 (Broken link)
- Claim Forms
VSP Out-of-Network Claim Form (Broken link)
iGOE Flexible Benefit Plan Reimbursement Request Form (Broken link)
- Summary of Benefits and Coverage (SBC's)
Anthem Blue Cross
- For Active Enrollees including COBRA (group numbers 40911A, 409112A, 409113A)
- For Early Retirees <65 years old (group numbers 40911J, 40911K)
Kaiser Permanente
- Regular Active Employees including Adjunct Faculty (groups: #606394-0030ACN (Faculty), 606394-0030ALN (CSEA), and 606394-0030AMN (MSC)
- Associate Faculty DHMO Plan B (group #606394-0134ACN (part-time faculty only)
- Early Retirees <65 years old (group #60634-0029RBN, and 606394-0029ROR
Delta Dental
- For All Enrollees (Active & Retired)
Summaries are not available for medical plans tied to Medicare
- Medicare
If you are an employee currently enrolled in the District's Kaiser Permanente or Anthem Blue Cross Plan and you are nearing your 65th birthday, please see the pamphlet below provided by Medicare to learn about the steps you should take to enroll in Medicare Parts A&B (and possibly D) and when.
The District recommends you (and/or your spouse) enroll in Part A upon turning 65 - it's free - but you are not required to enroll in Medicare Part B (or D) in order to continue your medical coverage as an active employee with SJECCD. However, if you have other medical coverage you should reach out to that employer to assure compliance with their plan(s).
The District's plan will remain your primary while actively employed, therefore, we do not require you to sign up and pay for Part B (or D) upon your 65th birthday. You should take steps with Medicare to assure Parts B & D (and A if not already enrolled) are effective the first of the month after your employment/coverage ends with SJECCD.
Please see the Medicare Brochures below:
Applying Online for Medicare - Even if you Are Not Ready to Retire 2017