Benefits

1-888-225-7377          www.calpers.ca.gov

Contact your individual health plan for the following items, questions or requests:

• Evidence of Coverage (EOC) Books
• Identification Cards
• Benefits, Deductibles, Limitations & Exclusions
• Service Area Boundaries
• Individual Conversion Policy
• Change primary care physicians or medical group
• Certificate of Creditable Coverage

2023 Summary of Benefits and Coverage Notice
Choosing your health plan is an important decision. To assist you with this process, each health plan available through the California Public Employees’ Retirement System has produced a Summary of Benefits and Coverage (SBC). In addition, the federal government has compiled a glossary of common health insurance terms. Together, these documents provide important information to help you better understand your health benefit coverage and more easily compare health plan options.

• Anthem Blue Cross HMO & EPO
  • (855) 839-4524
  • www.anthem.com/ca/calpers

• Blue Shield of California
  • (800) 334-5847
  • www.blueshieldca.com/calpers

• Health Net of California
  • (888) 926-4921
  • www.healthnet.com/calpers

• Kaiser Permanente
  • (800) 464-4000
  • www.kp.org/calpers

• PERS Gold and PERS Platinum
  • (877) 737-7776
  • www.anthem.com/ca/calpers

• UnitedHealthcare
  • (877) 359-3714
  • www.uhc.com/calpers

• Western Health Advantage
  • (888) 942-7377
  • www.westernhealth.com/calpers

Delta Dental of California 
Delta Dental Customer Service
P.O. Box 997330
Sacramento, CA 95899-7330
1-800-765-6003

There are no membership cards for Delta Dental.  Give your provider your SSN & DOB.

 

Spouses/Domestic Partners and IRS Dependent children up to age 25 are eligible to enroll in Delta Dental.

 

PPO Plan Summaries:

VISION SERVICE PLAN (VSP)

For certificated employees: CalSTRS 1-800-228-5453 CalSTRS

For classified employees: CalPERS 1-888-CalPERS or 1-888-225-7377 CalPERS

To inquire about your Dependent Day Care or Medical Reimbursement accounts or claims contact:
American Fidelity Assurance Company
ATTN: AFES Flex Account Administration
P O Box 25510
Oklahoma City, Oklahoma 73106
Voice: 800-325-0654
Fax: 1-800-543-3539

To access reimbursement forms, click on the link below:

Flex Accounts Reimbursement Forms

Frequently Asked Flex Plan Questions (below)

Information on other voluntary plans call 1-800-662-1113

San Lorenzo Unified School District is pleased to announce that enhancements have been made to the 403(b) Salary Reduction and 457(b) Participant Agreement (SRA) process. Effective January 1, 2022 election requests will be submitted through an online system.  This system is provided by our 403(b) and 457(b) Plan Administrator, Envoy Plan Services, Inc. The online process allows 24-hour access for employees. All approved representatives of the District’s authorized investment provider companies will be able to assist employees with this online process.

 

There are many benefits to the new SRA process:

 

• Employees simply visit Online SRA System (tsacg.com) to access the online system.
• The system can be accessed 24 hours a day, 7 days a week.
• Employees can start, change, or stop a 403(b) and/or 457(b) SRA at their convenience.
• Employees receive immediate online confirmation that their request has been submitted.
• Authorized Investment Provider Agents/Representatives can assist employees.
• A list of authorized Investment Providers is available at www.envoyplanservices.com.

 

Employees should utilize the below instructions to successfully utilize the online Salary Reduction Agreement process:

1. Before completing the online Salary Reduction Agreement process, you MUST have an account established with the authorized Investment Provider of your choice.
2. Navigate to the secure website Online SRA System (tsacg.com).Note that the SRA information entered via the online system will supersede and replace all prior 403(b) and/or 457(b) elections including the amounts, investment providers, and effective dates. Any election(s) you want to continue must be reflected or the election will be stopped.
3. Employee Certification – You must confirm that you are eligible to participate in your employer’s plan. You will also be confirming that you have established your account under your employer’s plan with one of the Authorized Investment Providers. Click “Confirm” and then click “Submit”.

 

Employer and Participant Information – If you have previously entered SRA information or Envoy Plan Services has your demographic information archived in their system, most of your personal information will pre-populate.  If your information is not currently in Envoy Plan Services’ system, you will be able to add your record. Depending on the information displayed, be prepared to enter the following information:

 

• • Employer’s State
  • Employer’s Name
  • Employee’s Social Security Number
  • Employee’s Date of Birth
  • Employee’s Name, Address, and Telephone Number

 

• • Effective Date of the contribution(s)
  • The total dollar amount per pay period for all contributions
  • The investment provider(s) to whom you would like to contribute
  • The Plan type
  • The amount of a previous contribution, if any – not required to submit
    • This information can be found on your pay check stub, you can also call Envoy Plan Services (contact information provided at the bottom of this communication), or by checking with your investment provider directly
  • The new amount of your contribution

 

 

 

Should you have any questions regarding the process, please contact Envoy Plan Services SRA Department at 800-248-8858, option 1.

 

Accidents occur everywhere, in airlines, in trains, in automobiles, on the job, in the home and in sports activities.  In the fact of such tolls, the prudent person finds that Accidental Death and Dismemberment insurance is of prime importance in a well-rounded financial program. It provides one’s family a financial bridge over the gap that occurs when a breadwinner meets accidental death, or an accident occurs, resulting in the loss of sight or dismemberment. In addition, it provides a sum that may be needed to train one for a new career.

 

Accidental death often finds the deceased’s estate in an unprepared condition. Assets may be less liquid than desired. Accidental Death and Dismemberment Insurance may be used to provide the additional sum needed to counter these conditions. We are pleased to offer this program of Accidental Death and Dismemberment insurance. We urge each of you to examine your own individual or family needs and consider this program.

 

ELIGIBILITY
All full-time employees under age 70 are eligible to participate. An employee who works an average of at least 20 hours per week is considered full-time.

 

Under the Family Plan, you may insure your family members as follows:

Your spouse if under age 70 and your unmarried dependent children (including step, foster, or legally adopted children) under age 19 years of age — or until age 23 if the child is a full-time student at school and primarily dependent on your for support and maintenance.

NOTE: If you are covered as an employee, you cannot be covered as a dependent.

DESCRIPTION OF COVERAGE
Under this plan, you are covered 24 hours a day anywhere in the world, whether you are at home or on the job. You are also covered when traveling on business or for pleasure, including when you are flying as a passenger (but not as a pilot or crew member) in any civilian, public or military transport aircraft, except those owned, operated or leased by or on behalf of the policyholder. The benefits provided under this plan are payable in addition to any other insurance which may be in force at the time of loss.

 

Ask the Benefits Department for more information including rates for this plan.