Medical Plan Information

ACWA JPIA Retiree Enrollment Guidelines


The District is required to offer retiree medical coverage that meets the requirements and guidelines established by ACWA JPIA and the insurance carriers. Retiree Enrollment Guidelines

ACWA JPIA Retiree Medical Changes Allowed


The District is required to offer retiree medical coverage that meets the requirements and guidelines established by ACWA JPIA and the insurance carriers. This document explains when and what types of changes a retiree can make to their medical coverage.Retiree Medical Plan Changes Allowed 
 


Medicare Enrollment FAQs

Employee and retiree questions about Medicare enrollment as they turn 65 or retire. Medicare FAQS for ACWA JPIA Plans 

 

Summary of Benefits Coverage


What is the Summary of Benefits and Coverage?

Under the Affordable Care Act (ACA), health insurers and employer groups must provide a summary of benefits and coverage (SBC) to participants and beneficiaries (generally employees and dependents). SBCs must follow standards set forth by the federal agencies.  The SBC helps eligible employees and dependents understand their benefits and coverage by using simple language in a consistent format.  The SBC includes brief summaries of:
  • Covered services
  • Examples of coverage
  • Appeals and grievance rights
  • Exceptions and limitations
  • Cost-sharing provisions, including any deductible, coinsurance, and co-payments
  • Continuation coverage
The SBC also contains a phone number to call for questions and the website address where the uniform glossary can be found.

Kaiser Permanente

 

Anthem Blue Cross

 

Plan Summaries


Some find these plan summaries more reader friendly than the Summary of Benefits Coverage. These are provided for your reference:

Proof of Eligible Dependent Status


ACWA JPIA requires the District to guarantee every dependent enrolled in a medical plan is an eligible dependent. The District must show proof of eligibility for each dependent you enroll. Commonly submitted documents are marriage certificates (spouse); birth certificates (child) and court orders (child).

For every dependent you are enrolling, you must submit a copy of the verification document with your medical enrollment form. If you cannot locate the documents, request from the county registrar’s office for where each event occurred (marriage or birth).

Nationwide Access through Anthem Blue Cross PPO’s BlueCard Network

Employee Rates

Retiree Rates

If you or your spouse is enrolled in a Medicare plan and the other is enrolled in Non-Medicare, please refer to the Mixed Medicare rates.      
                    

Required Annual Notices