Benefits & Medical Information Home
2020 Open Enrollment
May 1 – June 10, 2020 for changes effective July 1, 2020.
Open enrollment for benefits will end on June 10, 2020 11:59 PM
Open enrollment is the annual opportunity for benefit-eligible employees/retirees to add or delete an eligible dependent and make plan changes effective July 1, 2020.
Visit the BenefitBridge Resource Center located under the “more” tab, top right of your screen after you login. When completing your online Open Enrollment changes you can check to ensure that your District paid life insurance beneficiaries are current. Please review your current benefits and the 2020-2021 Monthly Contribution Rate Matrix effective July 1, 2020.
Note: Part-time Faculty Open Enrollment is currently closed pending the Fall 2020 open enrollment announcement.
Virtual Health Fair Meetings
May 11 – May 15, 2020
In addition to live-hosted meetings by select vendors, employees can also view additional videos & materials .
Click here for the schedule with meeting links, videos & materials
Important Links
2020 Employee Open Enrollment Benefits Newsletter/Announcement
2020 Retiree Open Enrollment Benefits Newsletter/Announcement
2020 – 2021 PCCD Employee Benefits Guide with Monthly Contribution Rate Matrix
2020 – 20201 PCCD Retiree Benefits Guide
PCCD Required Documentation Matrix
Registration and login online instructions for BenefitBridge
BenefitBridge Secure Enrollment Portal
403 (b) & 457 (b) Plan Information
For BenefitBridge technical assistance only, please contact BenefitBridge Customer Care at 800.814.1862;
Mon – Fri, 8:00 AM – 5:00 PM, PST or email benefitberidge@keenan.com
For assistance with your benefits questions, please contact the District, Benefits office at 510.466.7229;
Mon – Fri, 8:30 AM – 5:00 PM, PST or email benefits@peralta.edu
Benefits Resource Libraries -Current & Previous Plan Years
*Located under the Navigation tab top left of webpage.
Upcoming Plan year ( July 1, 2020 – June 30, 2021 ) Resource Library Below
Medical Plans
Kaiser HMO Plans
2020-2021 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
2020-2021 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
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
Anthem PPO Traditional & PPO Lite Self-funded Plans Administered by Trustmark
2020-2021 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)
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.
Dental
Dental PPO
Delta Dental PPO Plan – Plan Summary
UHC Dental DHMO – Direct Compensation Dental Plan
UHC DHMO – Direct Compensation Dental Plan Evidence of Coverage
UHC DHMO – Direct Compensation (DC) Contributory CA250/covered dental services CA D1065
Vision (Bundled With Medical Plans)
Kaiser Vision Plan & UHC Vision Plans – Benefits Summary
Voluntary Vision
VSP (Voluntary Vision) – Benefits Summary
District-Paid Life Insurance
District-Paid Disability Insurance
Long Term Disability Certificate
Employee Assistance Program (EAP) Administered by MHN
Flexible Spending Medical and Dependent Day Care Expenses under IRS Code 125
*Open enrollment occurs annually November 1-30 for the following plan year (January – December).
Current year forms & Documents:
FSA Handbook with Enrollment Form- 2020
Flexible Spending SPD: 2014-spd-003
Pre-tax Commuter Expense under IRS Code 132
Contribution Limit Increase for 2020:
The maximum amount you may contribute to each account cannot exceed the maximum amount specified in Code Section 132(f).
The maximum amounts are:
Parking Expenses $270/month
Transportation Expenses $270/month (Public transportation/vanpool)
Pre-Tax Commuter Handbook with Enrollment Form – 2020
Pre-Tax Commuter SPD: peralta-132-doc
Medicare Downloads
Medicare A, B & D Premium Reimbursement Plan Summary Plan Description (SPD) 2015
Medicare-A-and-B-and-D-Premium-Claim-Form-Revised-11-28-18
Medicare Reimbursement Plan Policy Statement 10.2015
**************************************************************************
PDF files