Kaiser Permanente Plans

The plans offered by Kaiser Permanente include:

Type Name Category Actions
pdf Evidence of Coverage 2020-21 Plan Year KP Traditional HMO Email Subject: Evidence of Coverage 2020-21 Plan Year Email Body: Download Evidence of Coverage 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_HMO_EOC_20-21.pdf Link to download document: Evidence of Coverage 2020-21 Plan Year
pdf Evidence of Coverage 2019-20 Plan Year KP Traditional HMO Email Subject: Evidence of Coverage 2019-20 Plan Year Email Body: Download Evidence of Coverage 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_HMO_EOC_19-20.pdf Link to download document: Evidence of Coverage 2019-20 Plan Year
pdf Benefit Summary 2020-21 Plan Year KP Traditional HMO Email Subject: Benefit Summary 2020-21 Plan Year Email Body: Download Benefit Summary 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_HMO_BenSum_20-21.pdf Link to download document: Benefit Summary 2020-21 Plan Year
pdf Benefit Summary 2019-20 Plan Year KP Traditional HMO Email Subject: Benefit Summary 2019-20 Plan Year Email Body: Download Benefit Summary 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_HMO_BenSum_19-20.pdf Link to download document: Benefit Summary 2019-20 Plan Year
pdf Summary of Benefits & Coverage 2020 English KP Traditional HMO Email Subject: Summary of Benefits & Coverage 2020 English Email Body: Download Summary of Benefits & Coverage 2020 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_HMO_SumBenCvg20-21.pdf Link to download document: Summary of Benefits & Coverage 2020 English
pdf Summary of Benefits & Coverage 2020 Spanish KP Traditional HMO Email Subject: Summary of Benefits & Coverage 2020 Spanish Email Body: Download Summary of Benefits & Coverage 2020 Spanish here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_HMO_SumBenCvg20-21_Spanish.pdf Link to download document: Summary of Benefits & Coverage 2020 Spanish
pdf Summary of Benefits & Coverage 2019 English KP Traditional HMO Email Subject: Summary of Benefits & Coverage 2019 English Email Body: Download Summary of Benefits & Coverage 2019 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_HMO_SumBenCvg19-20.pdf Link to download document: Summary of Benefits & Coverage 2019 English
pdf Summary of Benefits & Coverage 2019 Spanish KP Traditional HMO Email Subject: Summary of Benefits & Coverage 2019 Spanish Email Body: Download Summary of Benefits & Coverage 2019 Spanish here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_HMO_SumBenCvg19-20_Spanish.pdf Link to download document: Summary of Benefits & Coverage 2019 Spanish
pdf Evidence of Coverage 2020-21 Plan Year KP Choice HMO Email Subject: Evidence of Coverage 2020-21 Plan Year Email Body: Download Evidence of Coverage 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_HMO_EOC_20-21.pdf Link to download document: Evidence of Coverage 2020-21 Plan Year
pdf Evidence of Coverage 2019-20 Plan Year KP Choice HMO Email Subject: Evidence of Coverage 2019-20 Plan Year Email Body: Download Evidence of Coverage 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_HMO_EOC_19-20.pdf Link to download document: Evidence of Coverage 2019-20 Plan Year
pdf Benefit Summary 2020-21 Plan Year KP Choice HMO Email Subject: Benefit Summary 2020-21 Plan Year Email Body: Download Benefit Summary 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_HMO_BenSum_20-21.pdf Link to download document: Benefit Summary 2020-21 Plan Year
pdf Benefit Summary 2019-20 Plan Year KP Choice HMO Email Subject: Benefit Summary 2019-20 Plan Year Email Body: Download Benefit Summary 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_HMO_BenSum_19-20.pdf Link to download document: Benefit Summary 2019-20 Plan Year
pdf Summary of Benefits & Coverage 2020 English KP Choice HMO Email Subject: Summary of Benefits & Coverage 2020 English Email Body: Download Summary of Benefits & Coverage 2020 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_HMO_SumBenCvg20-21.pdf Link to download document: Summary of Benefits & Coverage 2020 English
pdf Summary of Benefits & Coverage 2020 Spanish KP Choice HMO Email Subject: Summary of Benefits & Coverage 2020 Spanish Email Body: Download Summary of Benefits & Coverage 2020 Spanish here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_HMO_SumBenCvg20-21_Spanish.pdf Link to download document: Summary of Benefits & Coverage 2020 Spanish
pdf Summary of Benefits & Coverage 2019 English KP Choice HMO Email Subject: Summary of Benefits & Coverage 2019 English Email Body: Download Summary of Benefits & Coverage 2019 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_HMO_SumBenCvg19-20.pdf Link to download document: Summary of Benefits & Coverage 2019 English
pdf Summary of Benefits & Coverage 2019 Spanish KP Choice HMO Email Subject: Summary of Benefits & Coverage 2019 Spanish Email Body: Download Summary of Benefits & Coverage 2019 Spanish here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_HMO_SumBenCvg19-20_Spanish.pdf Link to download document: Summary of Benefits & Coverage 2019 Spanish
pdf Evidence of Coverage 2020-21 Plan Year KP Traditional COBRA HMO Email Subject: Evidence of Coverage 2020-21 Plan Year Email Body: Download Evidence of Coverage 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_COBRA_HMO_EOC_20-21.pdf Link to download document: Evidence of Coverage 2020-21 Plan Year
pdf Evidence of Coverage 2019-20 Plan Year KP Traditional COBRA HMO Email Subject: Evidence of Coverage 2019-20 Plan Year Email Body: Download Evidence of Coverage 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_COBRA_HMO_EOC_19-20.pdf Link to download document: Evidence of Coverage 2019-20 Plan Year
pdf Benefit Summary 2020-21 Plan Year KP Traditional COBRA HMO Email Subject: Benefit Summary 2020-21 Plan Year Email Body: Download Benefit Summary 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_COBRA_HMO_BenSum_20-21.pdf Link to download document: Benefit Summary 2020-21 Plan Year
pdf Benefit Summary 2019-20 Plan Year KP Traditional COBRA HMO Email Subject: Benefit Summary 2019-20 Plan Year Email Body: Download Benefit Summary 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_COBRA_HMO_BenSum_19-20.pdf Link to download document: Benefit Summary 2019-20 Plan Year
pdf Summary of Benefits & Coverage 2020 English KP Traditional COBRA HMO Email Subject: Summary of Benefits & Coverage 2020 English Email Body: Download Summary of Benefits & Coverage 2020 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_COBRA_HMO_SumBenCvg20-21.pdf Link to download document: Summary of Benefits & Coverage 2020 English
pdf Summary of Benefits & Coverage 2020 Spanish KP Traditional COBRA HMO Email Subject: Summary of Benefits & Coverage 2020 Spanish Email Body: Download Summary of Benefits & Coverage 2020 Spanish here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_COBRA_HMO_SumBenCvg20-21_Spanish.pdf Link to download document: Summary of Benefits & Coverage 2020 Spanish
pdf Summary of Benefits & Coverage 2019 English KP Traditional COBRA HMO Email Subject: Summary of Benefits & Coverage 2019 English Email Body: Download Summary of Benefits & Coverage 2019 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_COBRA_HMO_SumBenCvg19-20.pdf Link to download document: Summary of Benefits & Coverage 2019 English
pdf Summary of Benefits & Coverage 2019 Spanish KP Traditional COBRA HMO Email Subject: Summary of Benefits & Coverage 2019 Spanish Email Body: Download Summary of Benefits & Coverage 2019 Spanish here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_COBRA_HMO_SumBenCvg19-20_Spanish.pdf Link to download document: Summary of Benefits & Coverage 2019 Spanish
pdf Evidence of Coverage 2020-21 Plan Year KP Choice COBRA HMO Email Subject: Evidence of Coverage 2020-21 Plan Year Email Body: Download Evidence of Coverage 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_COBRA_HMO_EOC_20-21.pdf Link to download document: Evidence of Coverage 2020-21 Plan Year
pdf Evidence of Coverage 2019-20 Plan Year KP Choice COBRA HMO Email Subject: Evidence of Coverage 2019-20 Plan Year Email Body: Download Evidence of Coverage 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_COBRA_HMO_EOC_19-20.pdf Link to download document: Evidence of Coverage 2019-20 Plan Year
pdf Benefit Summary 2020-21 Plan Year KP Choice COBRA HMO Email Subject: Benefit Summary 2020-21 Plan Year Email Body: Download Benefit Summary 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_COBRA_HMO_BenSum_20-21.pdf Link to download document: Benefit Summary 2020-21 Plan Year
pdf Benefit Summary 2019-20 Plan Year KP Choice COBRA HMO Email Subject: Benefit Summary 2019-20 Plan Year Email Body: Download Benefit Summary 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_COBRA_HMO_BenSum_19-20.pdf Link to download document: Benefit Summary 2019-20 Plan Year
pdf Summary of Benefits & Coverage 2020 English KP Choice COBRA HMO Email Subject: Summary of Benefits & Coverage 2020 English Email Body: Download Summary of Benefits & Coverage 2020 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_COBRA_HMO_SumBenCvg20-21.pdf Link to download document: Summary of Benefits & Coverage 2020 English
pdf Summary of Benefits & Coverage 2020 Spanish KP Choice COBRA HMO Email Subject: Summary of Benefits & Coverage 2020 Spanish Email Body: Download Summary of Benefits & Coverage 2020 Spanish here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_COBRA_HMO_SumBenCvg20-21_Spanish.pdf Link to download document: Summary of Benefits & Coverage 2020 Spanish
pdf Summary of Benefits & Coverage 2019 English KP Choice COBRA HMO Email Subject: Summary of Benefits & Coverage 2019 English Email Body: Download Summary of Benefits & Coverage 2019 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_COBRA_HMO_SumBenCvg19-20.pdf Link to download document: Summary of Benefits & Coverage 2019 English
pdf Summary of Benefits & Coverage 2019 Spanish KP Choice COBRA HMO Email Subject: Summary of Benefits & Coverage 2019 Spanish Email Body: Download Summary of Benefits & Coverage 2019 Spanish here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Choice_COBRA_HMO_SumBenCvg19-20_Spanish.pdf Link to download document: Summary of Benefits & Coverage 2019 Spanish
pdf Senior Advantage (HMO) with Part D- Low Option Kaiser Retirees Email Subject: Senior Advantage (HMO) with Part D- Low Option Email Body: Download Senior Advantage (HMO) with Part D- Low Option here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/2021-10-KPSA-EOC-Post-65.pdf Link to download document: Senior Advantage (HMO) with Part D- Low Option
pdf Senior Advantage (HMO) with Part D – High Option Kaiser Retirees Email Subject: Senior Advantage (HMO) with Part D – High Option Email Body: Download Senior Advantage (HMO) with Part D – High Option here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/2021-25-KPSA-EOC-Post-65.pdf Link to download document: Senior Advantage (HMO) with Part D – High Option
Deductible Plan Summary of Benefits and Coverage Kaiser Retirees Email Subject: Deductible Plan Summary of Benefits and Coverage Email Body: Download Deductible Plan Summary of Benefits and Coverage here: Link to download document: Deductible Plan Summary of Benefits and Coverage
pdf Traditional HMO Plan – Low Option Kaiser Retirees Email Subject: Traditional HMO Plan – Low Option Email Body: Download Traditional HMO Plan – Low Option here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/2021-HMO-EOC-ER-Pre-65.pdf Link to download document: Traditional HMO Plan – Low Option
pdf Deductible HMO Plan – High Option Kaiser Retirees Email Subject: Deductible HMO Plan – High Option Email Body: Download Deductible HMO Plan – High Option here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/2021-DHMO-EOC-ER-Pre-65.pdf Link to download document: Deductible HMO Plan – High Option
pdf HSA-Qualified High Deductible Health Plan (HDHP) HMO Kaiser Retirees Email Subject: HSA-Qualified High Deductible Health Plan (HDHP) HMO Email Body: Download HSA-Qualified High Deductible Health Plan (HDHP) HMO here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/2021-DHMO-HSA-EOC-ER-Pre-65.pdf Link to download document: HSA-Qualified High Deductible Health Plan (HDHP) HMO
pdf Traditional Plan (HMO) – Summary of Benefits and Kaiser Retirees Email Subject: Traditional Plan (HMO) – Summary of Benefits and Email Body: Download Traditional Plan (HMO) – Summary of Benefits and here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/2021-HMO-SBC-ER-Pre-65.pdf Link to download document: Traditional Plan (HMO) – Summary of Benefits and
Deductible Plan Summary of Benefits and Coverage Kaiser Retirees Email Subject: Deductible Plan Summary of Benefits and Coverage Email Body: Download Deductible Plan Summary of Benefits and Coverage here: Link to download document: Deductible Plan Summary of Benefits and Coverage
pdf HSA-Qualified High Deductible Health Plan (HDHP) HMO Kaiser Retirees Email Subject: HSA-Qualified High Deductible Health Plan (HDHP) HMO Email Body: Download HSA-Qualified High Deductible Health Plan (HDHP) HMO here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/2021-DHMO-HSA-SBC-ER-Pre-65.pdf Link to download document: HSA-Qualified High Deductible Health Plan (HDHP) HMO

Blue Shield Plans

The plans offered by Blue Shield

Type Name Category Actions
pdf Evidence of Coverage 2020-21 Plan Year Shield Signature HMO Email Subject: Evidence of Coverage 2020-21 Plan Year Email Body: Download Evidence of Coverage 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Signature_HMO_EOC_20-21.pdf Link to download document: Evidence of Coverage 2020-21 Plan Year
pdf Evidence of Coverage 2019-20 Plan Year Shield Signature HMO Email Subject: Evidence of Coverage 2019-20 Plan Year Email Body: Download Evidence of Coverage 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Signature_HMO_EOC_19-20.pdf Link to download document: Evidence of Coverage 2019-20 Plan Year
pdf Benefit Summary 2020-21 Plan Year Shield Signature HMO Email Subject: Benefit Summary 2020-21 Plan Year Email Body: Download Benefit Summary 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Signature_HMO_BenSum_20-21.pdf Link to download document: Benefit Summary 2020-21 Plan Year
pdf Benefit Summary 2019-20 Plan Year Shield Signature HMO Email Subject: Benefit Summary 2019-20 Plan Year Email Body: Download Benefit Summary 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Signature_HMO_BenSum_19-20.pdf Link to download document: Benefit Summary 2019-20 Plan Year
pdf Summary of Benefits & Coverage 2020 English Shield Signature HMO Email Subject: Summary of Benefits & Coverage 2020 English Email Body: Download Summary of Benefits & Coverage 2020 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Signature_HMO_SumBenCvg20-21.pdf Link to download document: Summary of Benefits & Coverage 2020 English
pdf Summary of Benefits & Coverage 2019 English Shield Signature HMO Email Subject: Summary of Benefits & Coverage 2019 English Email Body: Download Summary of Benefits & Coverage 2019 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Signature_HMO_SumBenCvg19-20.pdf Link to download document: Summary of Benefits & Coverage 2019 English
pdf Evidence of Coverage 2020-21 Plan Year Shield Access+ HMO Email Subject: Evidence of Coverage 2020-21 Plan Year Email Body: Download Evidence of Coverage 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Access_HMO_EOC_20-21.pdf Link to download document: Evidence of Coverage 2020-21 Plan Year
pdf Evidence of Coverage 2019-20 Plan Year Shield Access+ HMO Email Subject: Evidence of Coverage 2019-20 Plan Year Email Body: Download Evidence of Coverage 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Access_HMO_EOC_19-20.pdf Link to download document: Evidence of Coverage 2019-20 Plan Year
pdf Benefit Summary 2020-21 Plan Year Shield Access+ HMO Email Subject: Benefit Summary 2020-21 Plan Year Email Body: Download Benefit Summary 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Access_HMO_BenSum_20-21.pdf Link to download document: Benefit Summary 2020-21 Plan Year
pdf Summary of Benefits & Coverage 2020 English Shield Access+ HMO Email Subject: Summary of Benefits & Coverage 2020 English Email Body: Download Summary of Benefits & Coverage 2020 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Access_HMO_SumBenCvg20-21.pdf Link to download document: Summary of Benefits & Coverage 2020 English
pdf Summary of Benefits & Coverage 2019 English Shield Access+ HMO Email Subject: Summary of Benefits & Coverage 2019 English Email Body: Download Summary of Benefits & Coverage 2019 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Access_HMO_SumBenCvg19-20.pdf Link to download document: Summary of Benefits & Coverage 2019 English
pdf Evidence of Coverage 2020-21 Plan Year Shield PPO Email Subject: Evidence of Coverage 2020-21 Plan Year Email Body: Download Evidence of Coverage 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_PPO_EOC_20-21.pdf Link to download document: Evidence of Coverage 2020-21 Plan Year
pdf Evidence of Coverage 2019-20 Plan Year Shield PPO Email Subject: Evidence of Coverage 2019-20 Plan Year Email Body: Download Evidence of Coverage 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_PPO_EOC_19-20.pdf Link to download document: Evidence of Coverage 2019-20 Plan Year
pdf Benefit Summary 2020-21 Plan Year Shield PPO Email Subject: Benefit Summary 2020-21 Plan Year Email Body: Download Benefit Summary 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_PPO_BenSum_20-21.pdf Link to download document: Benefit Summary 2020-21 Plan Year
pdf Summary of Benefits & Coverage 2020 English Shield PPO Email Subject: Summary of Benefits & Coverage 2020 English Email Body: Download Summary of Benefits & Coverage 2020 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_PPO_SumBenCvg20-21.pdf Link to download document: Summary of Benefits & Coverage 2020 English
pdf Summary of Benefits & Coverage 2019 English Shield PPO Email Subject: Summary of Benefits & Coverage 2019 English Email Body: Download Summary of Benefits & Coverage 2019 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_PPO_SumBenCvg19-20.pdf Link to download document: Summary of Benefits & Coverage 2019 English
pdf Evidence of Coverage 2020-21 Plan Year Shield Needles PPO Email Subject: Evidence of Coverage 2020-21 Plan Year Email Body: Download Evidence of Coverage 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Needles_PPO_EOC_20-21.pdf Link to download document: Evidence of Coverage 2020-21 Plan Year
pdf Evidence of Coverage 2019-20 Plan Year Shield Needles PPO Email Subject: Evidence of Coverage 2019-20 Plan Year Email Body: Download Evidence of Coverage 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Needles_PPO_EOC_19-20.pdf Link to download document: Evidence of Coverage 2019-20 Plan Year
pdf Benefit Summary 2020-21 Plan Year Shield Needles PPO Email Subject: Benefit Summary 2020-21 Plan Year Email Body: Download Benefit Summary 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Needles_PPO_BenSum_20-21.pdf Link to download document: Benefit Summary 2020-21 Plan Year
pdf Summary of Benefits & Coverage 2020 English Shield Needles PPO Email Subject: Summary of Benefits & Coverage 2020 English Email Body: Download Summary of Benefits & Coverage 2020 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Needles_PPO_SumBenCvg20-21.pdf Link to download document: Summary of Benefits & Coverage 2020 English
pdf Summary of Benefits & Coverage 2019 English Shield Needles PPO Email Subject: Summary of Benefits & Coverage 2019 English Email Body: Download Summary of Benefits & Coverage 2019 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Needles_PPO_SumBenCvg19-20.pdf Link to download document: Summary of Benefits & Coverage 2019 English
pdf Evidence of Coverage 2020-21 Plan Year Shield Bronze PPO Email Subject: Evidence of Coverage 2020-21 Plan Year Email Body: Download Evidence of Coverage 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Bronze_PPO_EOC_20-21.pdf Link to download document: Evidence of Coverage 2020-21 Plan Year
pdf Evidence of Coverage 2019-20 Plan Year Shield Bronze PPO Email Subject: Evidence of Coverage 2019-20 Plan Year Email Body: Download Evidence of Coverage 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Bronze_PPO_EOC_19-20.pdf Link to download document: Evidence of Coverage 2019-20 Plan Year
pdf Benefit Summary 2020-21 Plan Year Shield Bronze PPO Email Subject: Benefit Summary 2020-21 Plan Year Email Body: Download Benefit Summary 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Bronze_PPO_BenSum_20-21.pdf Link to download document: Benefit Summary 2020-21 Plan Year
pdf Summary of Benefits & Coverage 2020 English Shield Bronze PPO Email Subject: Summary of Benefits & Coverage 2020 English Email Body: Download Summary of Benefits & Coverage 2020 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Bronze_PPO_SumBenCvg20-21.pdf Link to download document: Summary of Benefits & Coverage 2020 English
pdf Summary of Benefits & Coverage 2019 English Shield Bronze PPO Email Subject: Summary of Benefits & Coverage 2019 English Email Body: Download Summary of Benefits & Coverage 2019 English here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Bronze_PPO_SumBenCvg19-20.pdf Link to download document: Summary of Benefits & Coverage 2019 English
pdf Blue Shield Signature HMO EOC 2018-2019 Email Subject: Blue Shield Signature HMO EOC 2018-2019 Email Body: Download Blue Shield Signature HMO EOC 2018-2019 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Signature_HMO_EOC_18-19.pdf Link to download document: Blue Shield Signature HMO EOC 2018-2019
pdf Blue Shield PPO EOC 2018-2019 Email Subject: Blue Shield PPO EOC 2018-2019 Email Body: Download Blue Shield PPO EOC 2018-2019 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_PPO_EOC_18-19.pdf Link to download document: Blue Shield PPO EOC 2018-2019
pdf Blue Shield Bronze PPO EOC 2018-2019 Email Subject: Blue Shield Bronze PPO EOC 2018-2019 Email Body: Download Blue Shield Bronze PPO EOC 2018-2019 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Bronze_PPO_EOC_18-19.pdf Link to download document: Blue Shield Bronze PPO EOC 2018-2019
pdf Blue Shield PPO Needles EOC 2018-2019 Email Subject: Blue Shield PPO Needles EOC 2018-2019 Email Body: Download Blue Shield PPO Needles EOC 2018-2019 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Shield_Needles_PPO_EOC_18-19.pdf Link to download document: Blue Shield PPO Needles EOC 2018-2019

Delta Dental Plans

The plans offered by Delta Dental include:

Type Name Category Actions
pdf Evidence of Coverage 2020-21 Plan Year DeltaCare USA DHMO Email Subject: Evidence of Coverage 2020-21 Plan Year Email Body: Download Evidence of Coverage 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/DHMO_EOC_20-21.pdf Link to download document: Evidence of Coverage 2020-21 Plan Year
pdf Evidence of Coverage 2019-20 Plan Year DeltaCare USA DHMO Email Subject: Evidence of Coverage 2019-20 Plan Year Email Body: Download Evidence of Coverage 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/DHMO_EOC_19-20.pdf Link to download document: Evidence of Coverage 2019-20 Plan Year
pdf Benefit Summary 2020-21 Plan Year DeltaCare USA DHMO Email Subject: Benefit Summary 2020-21 Plan Year Email Body: Download Benefit Summary 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/DHMO_BenSum_20-21.pdf Link to download document: Benefit Summary 2020-21 Plan Year
pdf Benefit Summary 2019-20 Plan Year DeltaCare USA DHMO Email Subject: Benefit Summary 2019-20 Plan Year Email Body: Download Benefit Summary 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/DHMO_BenSum_19-20.pdf Link to download document: Benefit Summary 2019-20 Plan Year
pdf Evidence of Coverage 2020-21 Plan Year Delta Dental DPPO Email Subject: Evidence of Coverage 2020-21 Plan Year Email Body: Download Evidence of Coverage 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/DPPO_EOC_20-21.pdf Link to download document: Evidence of Coverage 2020-21 Plan Year
pdf Evidence of Coverage 2019-20 Plan Year Delta Dental DPPO Email Subject: Evidence of Coverage 2019-20 Plan Year Email Body: Download Evidence of Coverage 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/DPPO_EOC_19-20.pdf Link to download document: Evidence of Coverage 2019-20 Plan Year
pdf Benefit Summary 2020-21 Plan Year Delta Dental DPPO Email Subject: Benefit Summary 2020-21 Plan Year Email Body: Download Benefit Summary 2020-21 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/DPPO_BenSum_20-21.pdf Link to download document: Benefit Summary 2020-21 Plan Year
pdf Benefit Summary 2019-20 Plan Year Delta Dental DPPO Email Subject: Benefit Summary 2019-20 Plan Year Email Body: Download Benefit Summary 2019-20 Plan Year here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/DPPO_BenSum_19-20.pdf Link to download document: Benefit Summary 2019-20 Plan Year
pdf EOC DeltaCare USA HMO Delta Dental Retirees Email Subject: EOC DeltaCare USA HMO Email Body: Download EOC DeltaCare USA HMO here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Retiree_Delta_DHMO_EOC_2018.pdf Link to download document: EOC DeltaCare USA HMO
pdf EOC Delta DPPO High & Low Option Delta Dental Retirees Email Subject: EOC Delta DPPO High & Low Option Email Body: Download EOC Delta DPPO High & Low Option here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Retiree_Delta_DPPO_EOC_2018.pdf Link to download document: EOC Delta DPPO High & Low Option
pdf EOC Delta DPPO High & Low Option (Texas Only) Delta Dental Retirees Email Subject: EOC Delta DPPO High & Low Option (Texas Only) Email Body: Download EOC Delta DPPO High & Low Option (Texas Only) here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Retiree_Delta_DPPO_EOC_Texas_2018.pdf Link to download document: EOC Delta DPPO High & Low Option (Texas Only)
pdf Delta Dental DHMO EOC 2018-2019 Email Subject: Delta Dental DHMO EOC 2018-2019 Email Body: Download Delta Dental DHMO EOC 2018-2019 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/DHMO_EOC_18-19.pdf Link to download document: Delta Dental DHMO EOC 2018-2019
pdf Delta Dental DPPO EOC 2017-2018 Email Subject: Delta Dental DPPO EOC 2017-2018 Email Body: Download Delta Dental DPPO EOC 2017-2018 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/DPPO_EOC_17-18.pdf Link to download document: Delta Dental DPPO EOC 2017-2018
pdf DD Self-Funded DPPO Notice of Privacy Practices 2018 Email Subject: DD Self-Funded DPPO Notice of Privacy Practices 2018 Email Body: Download DD Self-Funded DPPO Notice of Privacy Practices 2018 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/DD_Self_Funded_DPPO_Notice_of_Privacy_Practices_2018.pdf Link to download document: DD Self-Funded DPPO Notice of Privacy Practices 2018
pdf Patient Charge Schedule – Low Option Delta Dental Retirees Email Subject: Patient Charge Schedule – Low Option Email Body: Download Patient Charge Schedule – Low Option here: https://www.sbcounty.gov/uploads/hr/Documents/Benefits/MedicalDentalVision/DeltaDental/2018 Delta Actives/Delta_Retiree_DPPO_Low_PCS_01.01.18.pdf Link to download document: Patient Charge Schedule – Low Option
pdf Patient Charge Schedule – High Option Delta Dental Retirees Email Subject: Patient Charge Schedule – High Option Email Body: Download Patient Charge Schedule – High Option here: https://www.sbcounty.gov/uploads/hr/Documents/Benefits/MedicalDentalVision/DeltaDental/2018 Delta Actives/Delta_Retiree_DPPO_High_PCS_01.01.18.pdf Link to download document: Patient Charge Schedule – High Option
pdf Patient Charge Schedule – Low Option (Texas Only) Delta Dental Retirees Email Subject: Patient Charge Schedule – Low Option (Texas Only) Email Body: Download Patient Charge Schedule – Low Option (Texas Only) here: https://www.sbcounty.gov/uploads/hr/Documents/Benefits/MedicalDentalVision/DeltaDental/2018 Delta Actives/Delta_Retiree_DPPO_Low_PCS_TX_Only_01.01.18.pdf Link to download document: Patient Charge Schedule – Low Option (Texas Only)
pdf Patient Charge Schedule – High Option (Texas Only) Delta Dental Retirees Email Subject: Patient Charge Schedule – High Option (Texas Only) Email Body: Download Patient Charge Schedule – High Option (Texas Only) here: https://www.sbcounty.gov/uploads/hr/Documents/Benefits/MedicalDentalVision/DeltaDental/2018 Delta Actives/Delta_Retiree_DPPO_High_PCS_TX_Only_01.01.18.pdf Link to download document: Patient Charge Schedule – High Option (Texas Only)

Other Benefit Plan Documents

Type Name Actions
pdf 401 (a) Plan Document Email Subject: 401 (a) Plan Document Email Body: Download 401 (a) Plan Document here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/401_a_PD.pdf Link to download document: 401 (a) Plan Document
pdf 401 (k) Plan Document Email Subject: 401 (k) Plan Document Email Body: Download 401 (k) Plan Document here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/401_k_PD.pdf Link to download document: 401 (k) Plan Document
pdf 457 (b) Plan Document Email Subject: 457 (b) Plan Document Email Body: Download 457 (b) Plan Document here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/457_b_PD.pdf Link to download document: 457 (b) Plan Document
pdf Accidental Death & Dismemberment Certificate Email Subject: Accidental Death & Dismemberment Certificate Email Body: Download Accidental Death & Dismemberment Certificate here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Accident_Death_Dismemberment_Cert_2017.pdf Link to download document: Accidental Death & Dismemberment Certificate
pdf Dependent Care Assistance Plan (DCAP) Email Subject: Dependent Care Assistance Plan (DCAP) Email Body: Download Dependent Care Assistance Plan (DCAP) here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Dependent_Care_Assistance_Plan_DCAP.pdf Link to download document: Dependent Care Assistance Plan (DCAP)
pdf Investment Policy Statement 2015 Email Subject: Investment Policy Statement 2015 Email Body: Download Investment Policy Statement 2015 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Investment_Policy_Statement_2015.pdf Link to download document: Investment Policy Statement 2015
pdf Kaiser Permamente Traditional HMO EOC 2018-2019 Email Subject: Kaiser Permamente Traditional HMO EOC 2018-2019 Email Body: Download Kaiser Permamente Traditional HMO EOC 2018-2019 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/KP_Traditional_HMO_EOC_18-19.pdf Link to download document: Kaiser Permamente Traditional HMO EOC 2018-2019
pdf SB County Term-Life Insurance Certificate 2018 Email Subject: SB County Term-Life Insurance Certificate 2018 Email Body: Download SB County Term-Life Insurance Certificate 2018 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/SBCounty_Term-Life_Cert_2018.pdf Link to download document: SB County Term-Life Insurance Certificate 2018
pdf Long-Term Disability Plan 2015 Email Subject: Long-Term Disability Plan 2015 Email Body: Download Long-Term Disability Plan 2015 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Long-Term_Disability_Plan_2015.pdf Link to download document: Long-Term Disability Plan 2015
pdf Medical Expense Reimbursement Plan FSA 2015 Email Subject: Medical Expense Reimbursement Plan FSA 2015 Email Body: Download Medical Expense Reimbursement Plan FSA 2015 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Medical_Expense_Reimbursement_Plan_FSA_2015.pdf Link to download document: Medical Expense Reimbursement Plan FSA 2015
pdf Part-Time, Seasonal and Temp Deferred Compensation Plan Email Subject: Part-Time, Seasonal and Temp Deferred Compensation Plan Email Body: Download Part-Time, Seasonal and Temp Deferred Compensation Plan here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/PST_Pt_Seasonal_Temp_Deferred_Comp_Plan_2010.pdf Link to download document: Part-Time, Seasonal and Temp Deferred Compensation Plan
Retirement Benefits (SBCERA Compass) Email Subject: Retirement Benefits (SBCERA Compass) Email Body: Download Retirement Benefits (SBCERA Compass) here: https://www.mydigitalpublication.com/publication/?i=170695 Link to download document: Retirement Benefits (SBCERA Compass)
pdf Retirement Medical Trust Agreement Plan 2013 Email Subject: Retirement Medical Trust Agreement Plan 2013 Email Body: Download Retirement Medical Trust Agreement Plan 2013 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Retirement_Med_Trust_Agreement_Plan_2013.pdf Link to download document: Retirement Medical Trust Agreement Plan 2013
pdf Retirement Medical Trust Plan Document 2015 Email Subject: Retirement Medical Trust Plan Document 2015 Email Body: Download Retirement Medical Trust Plan Document 2015 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Retirement_Med_Trust_Plan_2015.pdf Link to download document: Retirement Medical Trust Plan Document 2015
pdf Section 125 Premium Coversion Plan 2015 Email Subject: Section 125 Premium Coversion Plan 2015 Email Body: Download Section 125 Premium Coversion Plan 2015 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Section_125_Premium_Conversion_Plan_2015.pdf Link to download document: Section 125 Premium Coversion Plan 2015
pdf Short-Term Disability-Exempt 2015 Email Subject: Short-Term Disability-Exempt 2015 Email Body: Download Short-Term Disability-Exempt 2015 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Short-Term_Disability-Exempt_2015.pdf Link to download document: Short-Term Disability-Exempt 2015
pdf Short-Term Disability-Represented 2015 Email Subject: Short-Term Disability-Represented 2015 Email Body: Download Short-Term Disability-Represented 2015 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Short-Term_Disability-Represented_2015.pdf Link to download document: Short-Term Disability-Represented 2015
pdf Short-Term Disability-Pre-School Services 9 Month 2015 Email Subject: Short-Term Disability-Pre-School Services 9 Month 2015 Email Body: Download Short-Term Disability-Pre-School Services 9 Month 2015 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Short-Term_Disability-Pre-School_Services_9Month_2015.pdf Link to download document: Short-Term Disability-Pre-School Services 9 Month 2015
pdf Short-Term Disability-Probation 2015 Email Subject: Short-Term Disability-Probation 2015 Email Body: Download Short-Term Disability-Probation 2015 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Short-Term_Disability-Probation_2015.pdf Link to download document: Short-Term Disability-Probation 2015
pdf Short-Term Disability- SPO/SPS 2015 Email Subject: Short-Term Disability- SPO/SPS 2015 Email Body: Download Short-Term Disability- SPO/SPS 2015 here: https://www.sbcounty.gov/uploads/hr/Documents/Evidence_of_Coverage/Short-Term_Disability-SPO_SPS_2015.pdf Link to download document: Short-Term Disability- SPO/SPS 2015
pdf Employee Group Term Life Certificate of Insurance Email Subject: Employee Group Term Life Certificate of Insurance Email Body: Download Employee Group Term Life Certificate of Insurance here: https://www.sbcounty.gov/uploads/hr/Documents/Benefits/LifeInsurance/San_Bernardino_Term_Life_Certificate_33772_Eff 5-12-20188545.pdf Link to download document: Employee Group Term Life Certificate of Insurance
pdf How Much Life Insurance Do I Need? Email Subject: How Much Life Insurance Do I Need? Email Body: Download How Much Life Insurance Do I Need? here: https://www.sbcounty.gov/uploads/hr/Documents/Benefits/LifeInsurance/How_much_insurance_review_9-2015.pdf Link to download document: How Much Life Insurance Do I Need?
pdf Portability and Conversion Information Email Subject: Portability and Conversion Information Email Body: Download Portability and Conversion Information here: https://www.sbcounty.gov/uploads/hr/Documents/Benefits/LifeInsurance/Port_conversion_chart_SBC.pdf Link to download document: Portability and Conversion Information
pdf Plan Summary of Dependent Supplemental Life Insurance Email Subject: Plan Summary of Dependent Supplemental Life Insurance Email Body: Download Plan Summary of Dependent Supplemental Life Insurance here: https://www.sbcounty.gov/uploads/hr/Documents/Benefits/LifeInsurance/F89105_County_of_San_Bernardino_Plan_Summary_Final7718.pdf Link to download document: Plan Summary of Dependent Supplemental Life Insurance