2015 Open Enrollment – COBRA & ED Code Participants

This year’s annual Open Enrollment for 2015 benefits occurs from October 1 to November 30, 2014. If you wish to make any changes to your existing coverage, you must complete the enclosed Enrollment Form and return it to the District Benefits Office no later than November 30, 2014. All changes will be effective January 1, 2015. Please review the following brief highlights to understand changes that may affect you in 2015.

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If you do not wish to make any changes to your existing coverage for the upcoming year, no action is required on your part during this Open Enrollment period. However, if you wish to make changes to your existing coverage (i.e. changes to your medical plan, vision/dental coverage, etc.) you must complete and return the Enrollment Form enclosed in this packet.[/togg]

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Anthem 24/7 NurseLine Service: The WellPATH Employee Wellness Program sponsors the Anthem Blue Cross 24/7 NurseLine for all Plan participants enrolled in the PPO plans. The 24/7 NurseLine is there for you (at no cost) whenever you need to consult a healthcare professional regarding your health concerns. At home, on vacation, or on a business trip, this service provides you with direct access to a registered nurse (English or Spanish) to answer questions about allergies, fevers, types of preventive care, or any other topic to help you along your path to better health. Call Anthem 24/7 NurseLine toll-free at (800) 700-9184 or review the Anthem 24/7 NurseLine Flyer. [/togg]

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You can only enroll in Kaiser Permanente Health Plan if you live or work in a zip code on the attached Kaiser zip code range list. Also, Kaiser Permanente Health Plan coverage is only available to participants not eligible for Medicare (under age 65). If you are a retiree eligible for Medicare, effective January 1, 2015, you have the option to enroll in the Kaiser Permanente Senior Advantage Plan. However, the enrollment period for the Kaiser Permanent Senior Advantage Plan ends on October 31, 2014. Please contact the District Benefits Office for more information on the Senior Advantage Plan.

To enroll in Kaiser, you must complete the Kaiser enrollment form along with the FUSD Enrollment Form. For more information about Kaiser Permanente plan benefits and service areas, review the supplemental information enclosed in this Open Enrollment packet.[/togg]

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If you would like to enroll in or make changes to your existing dental and/or vision coverage under Education Code 7000, please note the following applicable criteria for enrollment:

a. If you are a Certificated Retiree with a retirement date prior to January 1, 2009 – you qualify for dental coverage only.

b. If you are a Certificated or Classified Retiree with a retirement date of January 1, 2009 or after, you qualify for both dental and vision coverage.

c. If you were previously enrolled in dental or vision coverage, and subsequently terminated that coverage, you are not eligible to re-enroll.[/togg]

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To assist you in making the best decisions for you and your family, the following information is available for your review:

Summary of Benefits & Coverage (Plan A | Plan B | Plan C – Kaiser )

Summary of Medical, Dental, and Vision Rates

Benefits Enrollment Form – which must be completed and returned to the Benefits Office no later than November 30, 2014.

California Region Group Enrollment Change Form

Summary of Zip Code Ranges For Kaiser Permanente Service Areas

For additional plan information and/or provider contact information view the following pages:




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