City of Rohnert Park

HEALTH BENEFITS INFORMATION:
Medicare/Supplemental Medical Plans - United American or Kaiser Permanente Senior Advantage Benefit Summaries:

• Kaiser Permanente Senior Advantage Plan (CA) only
• United American Medical Plan

Supplemental Medical Plan Rates (United American and Kaiser Permanente Senior Advantage):

• Retired before 07.01.09 Supplemental Medical Plan (Medicare)
• Retired before 07.01.09 Formula is 50% of the Premium for Supplemental Medical Plan (Medicare)
• Retired before 07.01.09 - Formula is 50% of 100% of Lowest Cost Plan - Supplemental Medical Plan (Medicare)
• Retired after 06.30.09 Supplemental Medical Plan (Medicare)

Split Plan Rates - 1 member enrolled in a Supplemental Medical Plan + 1 member enrolled in a Retiree Medical Plan under age 65:

• Retired before 07.01.09 - Formula is 50% of Actual City Premium - Supplemental Medical Plan (Medicare) and Medical Plan
• Retired after 06.30.09 - Supplemental Medical Plan (Medicare) and Medical Plan

Medical Retiree Rate Plans (under age 65) - Kaiser, REMIF, Sutter.

• Retired before 07.01.09, retirees under age 65
• Retired before 07.01.09, retirees under age 65 - Formula is 50% of 100% of Lowest Cost Plan
• Retired after 6.30.09, retirees under age 65
• Retired after 06.30.09, retirees under age 65 with $500 Credit
• Retired after 06.30.09, retirees under age 65 - Frozen City Contribution Rates
• Retired after 60.30.09, retirees under age 65 - Formula is 50% of 80% of Lowest Cost Plan

Kaiser Health Plans:

HMO Plan - Understanding your costs; copay or coinsurance

• Benefits Summary $20 Health Plan HMO
• Summary of Benefits and Coverage $20 High Health Plan
• Benefits Summary $40 Health Plan HMO
• Summary of Benefits and Coverage $40 Health Plan

High Deductible Health Plan - Health Savings Account - Understanding your costs

• Benefits Summary HSA High Deductible Health Plan $1500 HMO
• Summary of Benefits and Coverage HSA High Deductible Health Plan $1500 HMO
• Benefits Summary HSA High Deductible Health Plan $2500 HMO
• Summary of Benefits and Coverage HSA High Deductible Health Plan $2500 HMO

REMIF (Anthem Blue Cross) Health Plans:
Anthem Blue Cross Network - Find a Doctor (Instructions)
Comparison of Plans (grid)

• Benefit Summary EPO $250 Health Plan
• Benefit Summary EPO $500 Health Plan
• Benefit Summary PPO $500 Health Plan
• Benefit Summary HSA High Deductible Health Plan $1500
• Express Scripts - Pharmacy Benefits

Sutter Health Plans:
Sutter Health Great Coverage Booklet
Member Portal Flyer

• Benefits Summary $25 Health Plan ML62 HMO
• Summary of Benefits and Coverage $25 Health Plan ML62 HMO
• Benefits Summary $500 Health Plan ML68 HMO
• Summary of Benefits and Coverage $500 Health Plan ML68 HMO
• Benefits Summary HSA High Deductible Health Plan HD20
• Summary of Benefits and Coverage HSA High Deductible Health Plan HD20

• Acupuncture and Chiropractic Benefits

• Delta Dental PPO 02654 Retirees post 8.1.2011
• Delta Dental PPO 02654 Benefit Summary - Retirees pre 8.1.2011
• Delta Dental PPO 02654 Benefits Summary - Management Retireed pre 8.1.2011.pdf
• Delta Dental - New Value Added Features

• VSP Member Benefit Summary Retirees post 8.1.2011
• VSP Member Benefit Summary (Retirees) pre 8.1.2011
• VSP Exclusive Member Extras