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Special Voluntary Life & AD&D Open Enrollment – September 2 through September 30, 2021

Peralta CCD and Voya will have a Voluntary Life & AD&D Open Enrollment from September 2 through September 30, 2021. This is a great opportunity to sign up for additional Life & AD&D up to the guaranteed issue amounts with no medical questions for you, spouse, and child dependents.

Eligible employees and dependents can elect up to the following Guaranteed Issue amounts without going through the Evidence of Insurability (EOI) process:

Employee: $150,000 | Spouse: $50,000 | Dependent Child: $10,000

Coverage/s elected will be effective October 1, 2021.

Click here for the announcement with online instructions and rates.

Part-Time Hourly Faculty Benefits Open Enrollment Announcement Fall 2021

Part Time and Hourly Faculty and Save the Date Benefits OE Announcement Fall 2021

Plan Year July 1, 2021 – June 30, 2022

Important links

2021-2022 PCCD Employee Benefits Guide with Monthly Contribution Rate Matrix

Open Enrollment 2021-2022 Virtual Presentations, Videos & Materials

Registration and login online instructions for BenefitBridge

BenefitBridge Secure Enrollment Portal

PCCD Required Documentation Matrix

403 (b) & 457 (b) Plan Information

Voluntary Benefits

Medical Plans

Kaiser HMO Plans

2021-2022 Kaiser Traditional Plans Summary of Benefits & Coverage

Peralta-Community-College-Kaiser-HMO-10 SBC

Peralta-Community-College-Kaiser-HMO-15 SBC

Peralta-Community-College-Kaiser-HMO-0 SBC

Click here for additional information

2021-2022 Kaiser Senior Advantage Plans Summary of Benefits & Coverage

Peralta Community College 65 HMO $0 SR ADV Benefit Summary

Peralta Community College 65 HMO $10 SR ADV Benefit Summary

Peralta Community College 65 HMO $15 SR ADV Benefit Summary

Kaiser Permanente Senior Advantage (HMO) Enrollment Form

Click here for additional information

2021-2022 Kaiser Senior Advantage HMO Delta Dental Plan Summary of Benefits & Coverage

KPSA HMO Delta Dental Plan Summary

Universal Benefit Enrollment Form – Retiree & Exceptional Processing

*Retirees enrolling in a Kaiser Permanente Senior Advantage Plan must complete the Kaiser Permanente Senior Advantage Enrollment form (above) and mail to the address on the form. If you are changing your medical plan during open enrollment also complete the Universal Benefit Enrollment Form (above) and mail to the PCCD Benefits Office at the address on the form along with any required dependent documents if applicable. Remember to enclose a copy of the Kaiser Permanente Senior Advantage Form mailed directly to Kaiser.

PCCD Kaiser Permanente Reimbursement Form

Kaiser Reimbursement Form

Anthem PPO Traditional & PPO Lite Self-funded Plans Administered by Trustmark

2021-2022 Summary of Benefits & Coverage

Peralta Self Funded Traditional PPO SBC $15 Plan (Local 1021 & Confidentials)

Peralta Self Funded Traditional PPO SBC $10 Plan (PFT, Management & Trustees)

Peralta Self Funded Traditional PPO SBC $15 Plan (Local 39)

Peralta Self Funded Lite PPO SBC $15 Plan (Local 1021 & Confidentials)

Peralta Self Funded Lite PPO SBC $10 Plan (PFT, Management & Trustees)

Peralta Self Funded Lite PPO SBC $15 Plan (Local 39)

Click here for additional information

Universal Benefit Enrollment Form – Retiree & Exceptional Processing

*Retirees changing medical plans during open enrollment must complete the Universal Benefit Enrollment Form (above) and mail to the PCCD Benefits Office at the address on the form along with any required dependent documents if applicable.

CASH IN-LIEU OF MEDICAL & DENTAL BENEFITS FORM

If you are an active employee waiving medical and dental benefits please uploaded the completed form with all required insurance verifications during your BenefitBridge online enrollment.