Retiree Health Insurance Information

  • Please see below sections for retiree health insurance forms, rates, and plan summaries. If you will be a new retiree this year and you are eligible for the Bridge program, please remember that there is a deadline to turn in your retiree bridge form to Risk Mgmt and your retirement form to HRD. Please refer to your classifications bargaining unit language for applicable deadlines. Open enrollment for retirees is in the month of July each year. Please make sure you keep your email address up to date with Risk Mgmt as this is how the open enrollment (and all communication) will be sent to you.

Benefits Summaries and Changes Effective 10/1/2021

Benefits Summaries for 2020-21


    Click here for a side by side comparison of the plans (NOT ACCURATE PRICING - SEE THE LINK BELOW FOR THE PREMIUM SHEET)

    Certificated Premium Sheet

    Click here to view plan summaries for the following plans:

    • PPO Plan A
      Group #: 40464L (55-64 retiree)
    • Group #: 40464R (65+ retiree)
    • PPO Plan B
      Group #: 40464M (55-64 retiree)
    • Group#: 40464S (65+ retiree)
    • PPO Plan C
      Group #: 40464N (55-64 retiree)
    • Group#: 40464T (65+ retiree)
    • PPO Plan D
      Group #: 40464P (55-64 retiree)
    • Group#: 40464W (65+ retiree)
    • HMO Classic
      Group #: 57AHCC (55-64 retiree), 57AHCD (65+ retiree)
    • Kaiser
      Group #: 231876-0111 (55-64 retiree)
      Group #: 231876-0111 $10 Senior Advantage Plan (65+ retiree)
    • VSP (Vision)
      Group # 2338128A
    • Delta Dental
      Group # 7079-7147 (Standard Dental)
      Group # 7079-2150 (With Ortho)

Retiree Health Insurance Forms