2021 EMPLOYEE BENEFITS OVERVIEW - Your Benefits, Your Choice.
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2021
EMPLOYEE BENEFITS OVERVIEW
Your Benefits, Your Choice.
TABLE OF CONTENTS
Welcome to the County of San Mateo! ............................................................................................................................. 3
Who You Can Cover .......................................................................................................................................................... 4
Dependent Eligibility Verification ...................................................................................................................................... 5
When You Can Make Changes to Your Benefits ................................................................................................................. 6
When Your Benefits Terminate ......................................................................................................................................... 7
What’s New in 2021? ........................................................................................................................................................ 8
Medical Benefits ............................................................................................................................................................... 9
Dental Benefits ................................................................................................................................................................12
Cost of Health and Dental Benefits ...................................................................................................................................13
2021 Semi-Monthly Cost of Medical Benefits ...................................................................................................................14
Making the Most of Your Benefits Program ......................................................................................................................16
Medical ...........................................................................................................................................................................17
Dental..............................................................................................................................................................................24
Vision ..............................................................................................................................................................................28
Getting Care When You Need It Now ...............................................................................................................................29
Enhanced Services ...........................................................................................................................................................32
Employee Assistance Program..........................................................................................................................................32
Health and Wellness ........................................................................................................................................................36
Life Insurance ..................................................................................................................................................................39
Supplemental (Additional) Life Insurance .........................................................................................................................41
Short Term Disability Insurance........................................................................................................................................42
Travel Assistance .............................................................................................................................................................43
Health Savings Account ....................................................................................................................................................44
Flexible Spending Account ...............................................................................................................................................45
Additional Benefits ..........................................................................................................................................................49
Additional Benefits ..........................................................................................................................................................55
New!
MyBenefits.LifeTM (Replacing Ben-IQ) ..........................................................................................................................59
Contact Numbers .............................................................................................................................................................60
Key Terms ........................................................................................................................................................................61
Important Plan Notices and Documents ...........................................................................................................................63
Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 2
Welcome to the County of San Mateo!
Welcome to the 2021 Employee Benefits Guide, your single source document for the information you need to
make informed decisions about your benefits for yourself and your family.
The 2021 Employee Benefits Guide is intended to be a summary of some of the benefits offered to you and
your family including:
• health insurance
• dental insurance
• vision insurance
• life and disability insurance
• flexible spending accounts
Health and wellness resources are also featured in this guide to help you create and achieve a more balanced,
healthier, and productive well-being.
Additional information and forms about these employee benefits and others are available online at
http://hr.smcgov.org/employee-benefits.
The benefits described herein are offered to eligible employees of the County of San Mateo. All benefits are
subject to change and there is no guarantee that these benefits will be continued indefinitely. The descriptions
are general and are not intended to provide complete details about any or all plans. Exact specifications for all
plans are provided in the official Plan Documents, copies of which are available at
http://hr.smcgov.org/employee-benefits.
For an overview of benefits by Bargaining Unit, go to the Employee Benefits website and click on Benefits at a
Glance.
Thank you,
The Benefits Team
Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 3
Who You Can Cover
WHO IS ELIGIBLE? WHEN CAN I ENROLL?
All regular and probationary employees working 20 or Coverage for new hire begins on the 1st of the month
more hours a week are eligible to enroll in the County’s following date of hire. New employees who do not make
Health, Dental and Vision programs. an election within 31 days of becoming eligible will
automatically be enrolled for employee only coverage
You may enroll the following family members in our
under the Kaiser Traditional HMO.
medical, dental and vision plans.
Open enrollment for next plan year is generally held in
• Your current spouse or domestic partner. October. Open enrollment is the one time each year
• Your natural children, stepchildren, domestic that employees can make changes to their benefit
partner’s children, foster and/or adopted elections without a qualifying life event.
children under 26 years of age
Make sure to submit a Workday event within 31 days if
• Your disabled children age 19 or older.
you have a qualifying life event and need to make a
• A tax-qualified dependent change (add or drop) to your coverage election. These
changes include (but are not limited to):
County employees who are married or a dependent of
another County employee must maintain dental and • Birth or adoption of a baby or child
vision coverage through the County but may elect to • Loss of other healthcare coverage
waive this coverage and enroll under the • Eligibility for new healthcare coverage
spouse/domestic partner’s during Open Enrollment. • Marriage
Please contact Benefits Division during the open
• Divorce
enrollment period if you have questions.
You have 31 days from the qualifying life event to make
This is a brief description of the eligibility requirements your change in Workday.
and is not intended to modify or supersede the
requirements of the plan documents. The plan
documents will govern in the event of any conflict ADDING OR REMOVING DEPENDENTS?
between this description and the plan documents.
You are responsible for updating your dependent status
via Workday during the plan year (marriage, birth,
WHO IS NOT ELIGIBLE? death, divorce, dissolution of domestic partnership,
ineligibility of dependent child due to age/school status,
Family members who are not eligible for coverage etc.). Such notification must be made within 31 days
include (but are not limited to): that the status change occurs. Failure to submit
notification in a timely manner may impact dependent
• Parents, grandparents, and siblings. eligibility for health care continuation under COBRA, and
• Any individual who is covered as an employee of may result in you incurring liability for medical expenses
County of San Mateo cannot also be covered as a for non-eligible dependents.
dependent.
• Employees who work less than 20 hours per week,
temporary employees, contract employees, or
employees residing outside the United States.
Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 4
Dependent Eligibility Verification
All employees adding dependents will be asked to upload documentation in Workday verifying eligibility of
their covered dependents. The following chart is an easy guide to which form and documents must be
submitted. Failure to submit appropriate documentation will result in dependent’s ineligibility for coverage.
Dependent Type Eligibility Definition Documents Required for
Verifying Eligibility
Spouse • Person to whom you are legally • Marriage Certificate
married
• Meet County Domestic Partner • County of San Mateo Affidavit of
Eligibility Requirements Domestic Partnership -or-
Domestic Partners
• Must be at least 6 months • Declaration of Partnership filed with the
At least 18 years old
between any domestic California Secretary of State
partnerships
Natural Child(ren) • Minor or Adult Child(ren) of • Birth Certificate
Employee who is under age 26yrs
Under Age 26
Step Child(ren) • Minor or Adult Child(ren) of • Birth Certificate –and-
Employee Spouse who is under • Marriage Certificate showing Spouse as
Under Age 26 age 26yrs Parent
• Minor or Adult Child(ren) legally • Court documentation (Must include
Children Legally adopted by Employee who is presiding Judge Signature & Court Seal)
Adopted/Wards married or unmarried under age
26yrs
Children of Domestic • Minor or Adult Child(ren) of • County of San Mateo Affidavit of
Partners Employee Domestic Partner who is Domestic Partnership –and-
under age 26yrs • Birth Certificate
Under Age 26
• Natural Child, Step Child or • Birth Certificate –and-
Disabled Children Adopted Child of Employee who is • Certification of Disability from Social
over age 26yrs and incapable of Security
No age limit self-care due to physical or mental • -or-
illness. • Document of Disability from Physician if
not SSA Certified
Other Qualifying • Meets Requirements of IRS Code. • Birth Certificate Showing Individual to be
Relatives Sec. 105(b) an Eligible Relative –and-
• under age 26yrs • County of San Mateo Affidavit of Tax
Under Age 26 Qualifying Dependent
Both the Affidavit of Tax Qualifying Dependent and the Affidavit for Domestic Partnership are available online
at http://hr.smcgov.org/employee-benefits; click on Benefits Forms.
Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 5
When You Can Make Changes to Your Benefits
Other than during the annual “open enrollment” period, you may not change your coverage unless you
experience a qualifying event. Qualifying events include:
• Change in legal marital status, including marriage, divorce, legal separation, annulment, registration
or dissolution of domestic partnership, and death of a spouse
• Change in number of dependents, including birth, adoption, placement for adoption, or death of a
dependent child
• Change in employment status, including the start or termination of employment by you, your spouse,
or your dependent child
• Permanent change in work schedule, including a significant increase or decrease in hours of
employment by you, your spouse, or your dependent child, including a switch between part-time and
full-time employment that affects eligibility for benefits
• Change in a child's dependent status, either newly satisfying the requirements for dependent child
status or ceasing to satisfy them
• Change in your health coverage or your spouse's coverage attributable to your spouse's employment
• Change in an individual's eligibility for Medicare or Medicaid
• A court order resulting from a divorce, legal separation, annulment, or change in legal custody
(including a Qualified Medical Child Support Order) requiring coverage for your child or dependent
foster child
• An event that is a special enrollment event under HIPAA (the Health Insurance Portability and
Accountability Act), including acquisition of a new dependent or spouse or loss of coverage under
another health insurance policy or plan if the coverage is terminated because of:
o Voluntary or involuntary termination of employment or reduction in hours of employment or
death, divorce, or legal separation;
o Termination of employer contributions toward the other coverage, OR if the other coverage
was COBRA Continuation Coverage, exhaustion of the coverage
Removing Dependents
• Dependents who gain other coverage elsewhere must be dropped within 31 days. Proof of other
group coverage will need to be uploaded in the Workday Event
Important!—Three rules apply to making changes to your benefits during the year:
1. Any changes you make must be consistent with the change in status,
2. You must make the changes within 31 days of the date the event (marriage, birth, etc.) occurs,
3. With the exception of births, life events take effect the first of the following month after the life event
effective date.
Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 6
When Your Benefits Terminate Your medical, dental and vision plan coverage ends on the last day of the month following your date of termination or loss of eligibility. For example: if termination date is March 14, benefits will end on March 31. If termination date is March 31, benefits will end on March 31. You may continue benefits during a family leave of absence according to federal guidelines and in conjunction with the County’s policy for a limited period of time after termination, or under your federal and state COBRA rights. Your coverage ends on the date of your termination for your Flexible Spending Accounts (FSA), Group Life/AD&D, Long Term Disability (LTD), and Employee Assistance Program (EAP). Upon termination of loss of eligibility, employees can port or convert their Life Insurance coverage. For more information, please refer to page 38. For more information on COBRA, please refer to page 67. BENEFITS DURING FAMILY AND MEDICAL LEAVE AND CALIFORNIA FAMILY RIGHTS ACT An employee taking family/medical leave will be allowed to continue participating in any health and welfare benefit plan in which he/she was enrolled before the first day of leave (for a maximum of 12 work-weeks) at the level and under the same conditions of coverage as if the employee had continued in employment for the duration of such leave. The County will continue to make the same premium contributions as if the employee had continued working. The continued participation in health benefits begins on the date leave first begins under the Family and Medical Leave Act (e.g. for pregnancy disability leaves) or under the Family and Medical Leave Act/CFRA (e.g. for all other family care and medical leaves). In some instances, the County may recover premiums it paid to maintain health coverage for you if you fail to return to work following pregnancy disability leave. Employees on family/medical leave who are not eligible for continued paid coverage may continue their group health insurance coverage at their own expense in conjunction with the federal COBRA guidelines. Employees should contact the Human Resources department for further information. Under most circumstances, upon return from family/medical leave, an employee will be reinstated to his or her original job or to an equivalent pay, benefits, and other employment terms and conditions. However, an employee has no greater right to reinstatement than if he or she had been continuously employed rather than on leave. For example, if an employee on family/medical leave would have been laid off or terminated had he or she not gone on leave, or if the employee’s job is eliminated during the leave and no equivalent or comparable job is available, then the employee would not be entitled to reinstatement. An employee’s use of family/medical leave will not result in the loss of any employment benefit that the employee earned before using family/medical leave. Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 7
What’s New in 2021?
·LIFEBALANCE
·From fitness clubs and family attractions to weight management and whitewater rafting,
LifeBalance offers discounts on purchases and activities that help County employees stay active,
reduce stress, and live life to the fullest at no cost to employees. More information about this
new program can be found on page 51
NEW HEALTH SAVINGS ACCOUNT (HSA) ADMINISTRATOR
Benefits Coordinator Corporation (BCC) will replace Optum as the HSA administrator
beginning 2021. Refer to page 43 to find more about HSA.
MYBENEFITS.LIFETM
Bye, Ben-IQ, welcome MyBenefits.Life!
The Ben-IQ app will be transitioning to this new and improved, MyBenefits.Life (MBL). MBL is a web portal
AND a mobile app that house all benefits-related information – information where and when you need it.
Please see page 58 for more information.
A NEW BLUE SHIELD MEDICARE PPO RETIREE PLAN!
If you are 65 or older and retiring soon, we wanted to let you know about our NEW Blue Shield Medicare PPO
Plan.
The County is excited to introduce a new Blue Shield Medicare PPO Advantage Plan with Prescription Drug
being offered to Retirees who are 65 years or older. This new Medicare Advantage PPO Plan provides
comprehensive medical coverage, at a significantly lower cost, with access to see any Medicare contracted
doctor or hospital with a defined predictable co-payment schedule – not only in California, but nationwide.
Plan ahead! Remember, the health plan you are enrolled in at the time of retirement is the Medicare health
plan you will be enrolled in on your retirement date or when you turn 65.
Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 8
Medical Benefits
The County’s medical plans are designed to help maintain wellness and protect you and your family from
major financial hardships in the event of illness or injury. The County offers a choice of medical plans
through Blue Shield and Kaiser Permanente.
• HMO – a Health Maintenance Organization (HMO) in which patients seek medical care from a doctor
participating in the plan’s network. If you join Blue Shield, you select a PCP within Blue Shield’s network
of doctors. Most services and medicines are covered with a small co-payment. Any specialty care you
need will be coordinated through your PCP and will require a referral or authorization. More
information about Blue Shield’s health plan benefits is available at http://hr.smcgov.org/employee-
benefits; click on Medical Plans.
• Trio ACO HMO – Trio is powered by a new innovation in healthcare: the accountable care organiza�on
(ACO). An ACO is a network of doctors and hospitals that share responsibility in providing high-quality
coordinated care when needed while lowering the cost of delivering care more efficiently.
Trio works similar to a traditional HMO plan.
• PPO – a Preferred Provider (PPO) plan allows members the choice and flexibility to receive medical
services from a PPO network doctor or out-of-network doctor.
o In Network (PPO): Medical services are provided through the Blue Shield PPO network. You
are responsible for paying an annual deductible and a percentage of the cost of the services
(generally 20% of Blue Shield’s allowable amount).
o Out-of-network: This allows you to access services through any licensed doctor or hospital.
You are responsible for paying a deductible and a higher annual percentage of the cost of care
(generally 40% of Blue Shield’s allowable amount).
• High Deductible Health Plan - This is a plan that works in conjunction with a Health Savings Account
(please see page 43). You use the same PPO Network that you would under the standard PPO plan. All
of your preventative services are covered in full. You pay for the entire cost of non-preventive services
until you satisfy your annual deductible. From that point, you pay 10% of the cost for non-preventive
services until you reach your Calendar Year Maximum. At that point, do not pay out of pocket for any
services the rest of the year.
Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 9
Medical Benefits
• Health Maintenance Organization (HMO) - a plan in which patients seek medical care within the plan’s
own facilities. Under this plan, most services and medicines are covered with a small co-payment. You
select your doctor, or Primary Care Provider (PCP), from the staff at a local Kaiser Permanente facility.
All of your care is provided at a Kaiser facility. Services outside of a Kaiser facility are not covered except
if it is a life-threatening emergency. More information about Kaiser’s health plan benefits is available at
http://hr.smcgov.org/employee-benefits ; click on Medical Plans.
• High Deductible Health Plan - This is a plan that works in conjunction with a Health Savings Account
(please see page 43). You use the same Kaiser facilities that you would under the standard Kaiser plan.
All of your Preventative services are covered in full. You pay for the entire cost of non-preventive
services until you satisfy your annual deductible. From that point, you pay 10% of the cost for non-
preventive services until you reach your Calendar Year Maximum. At that point, do not pay out of pocket
for any services the rest of the year. More information about Kaiser’s health plan benefits is available at
http://hr.smcgov.org/employee-benefits ; click on Medical Plans.
BUILDING AND CONSTRUCTION TRADES COUNCIL OPTION
Eligible employees who are members of the Building and Construction Trades Council also have the option of
choosing the Operating Engineer’s plan which includes health (either a PPO or a Kaiser HMO plan), dental and
vision benefits.
For more information about the Operating Engineers Plan, contact Benefits Division at 650-363-1919 or email
benefits@smcgov.org.
Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 10Medical Benefits
WHICH PLAN IS RIGHT FOR YOU?
Consider an HMO (Health Maintenance Organization) if:
• You want lower, predictable out-of-pocket costs Plans To Consider
• You like having one doctor manage your care • Blue Shield Access+ HMO
• You are happy with the selection of network providers • Blue Shield Trio ACO
• You don’t see any doctors that are out-of-network • Kaiser Traditional HMO
Consider a PPO (Preferred Provider Organization) if:
• You want to be able to see any provider, even a specialist, Plan To Consider
without a referral • Blue Shield Full PPO
• You want access to one of the largest national networks in
the Country, with the ability to see any licensed provider in
the nation, regardless of whether or not the provider is in
the network
Consider a High Deductible Health Plan (HDHP) if:
• You want to be able to see any provider, even a specialist, Plans To Consider
without a referral • Blue Shield High
• You are willing to pay more to see out-of-network providers Deductible Health Plan
• You want tax-free savings on your healthcare costs • Kaiser High Deductible
• You want to build a savings account for future healthcare Plan (HMO)
costs for you and your eligible family members
• You want an extra way to add to your re�rement savings
More information about our health plan benefits is available at http://hr.smcgov.org/employee-benefits ;
click on Medical Plans.
Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 11Dental Benefits
The County offers two dental plans for employees: Cigna PPO and DeltaCare DHMO. Employees are required
to enroll in one of these two plans.
Preferred Provider Organization (PPO) plan in which dental services are provided through Cigna’s PPO
network. However, you can choose any dentist in any location inside or outside of the Cigna network. How
much you pay for dental services depends on how long you have worked for the County, your represented
group, and whether you choose a participating Cigna dentist. If you choose a non-participating dentist, you
pay the difference between the amount the dentist receives from Cigna (the “allowable amount”) and the
dentist’s charges. Pre-authorization from Cigna is recommended for charges of $250 or more. Orthodontic
treatment is not a covered service. More information about the Cigna plan is available online at
http://hr.smcgov.org/employee-benefits; click on Dental Plans.
These 3 buy-up options are still available to represented employees with more than 1 year of service:
o Core Dental Plan Plus Option #1 with $4,000 Maximum
o Core Dental Plan Plus Option #2 with $4,000 Orthodontia Coverage
o Core Dental Plan Plus Option #3 with $4,000 Max and Ortho Coverage
The dental buy-up option with $4,000 orthodontia coverage is still available to Management, Confidential,
District Attorney/County Counsel, and Sheriff Sergeant.
Employees who are enrolled in any of the buy-up plans are required to stay in the plans for
a minimum of two (2) years.
DeltaCare – a Dental Health Maintenance Organization (DHMO) plan that is affiliated with Delta Dental.
Under this plan, you must select a DeltaCare USA dentist and you must visit your selected dentist for all of
your dental care. There are no claim forms to complete, no deductibles, and no co-pays for most services.
More information about the DeltaCare plan is available online at htp://hr.smcgov.org/employee-benefits;
click on Dental Plans.
Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 12Cost of Health and Dental Benefits What is the cost to enroll in the County’s health and dental plans? Both employees and the County share in the cost of your health coverage. The amount of the premium you are responsible for depends on your employment status (full-time, 3/4 time or 1/2 time), the number of your dependents (if any) covered, and the specific plan you choose. For purposes of determining health premium costs, a full time employee works 40 hours per week, a half-time employee works 20-29 hours per week, and a ¾ time employee works 30-39 hours per week. The employee portion of the premiums is automatically deducted from your paycheck on a semi-monthly pre- tax basis. The tables on the next page list each health plan’s monthly premium cost for both the employee and County. Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 13
2021 Semi-Monthly Cost of Medical Benefits
ALL EMPLOYEES
Full Time Employees 3/4 Time Employees 1/2 Time Employees Total Total
Employee County Employee County Employee County Semi-Monthly Monthly
Blue Shield HMO
Cost Cost Cost Cost Cost Cost Premium Premium
Employee Only 89.20 505.50 215.57 379.13 341.95 252.75 594.70 1189.40
Employee +1 178.41 1010.99 431.16 758.24 683.90 505.50 1189.40 2378.80
Employee + Family 252.45 1430.56 610.09 1072.92 967.73 715.28 1683.01 3366.02
Full Time Employees 3/4 Time Employees 1/2 Time Employees Total Total
Employee County Employee County Employee County Semi-Monthly Monthly
Blue Shield TRIO HMO
Cost Cost Cost Cost Cost Cost Premium Premium
Employee Only 69.77 395.35 168.61 296.51 267.44 197.68 465.12 930.24
Employee +1 139.54 790.70 337.21 593.03 534.89 395.35 930.24 1860.48
Employee + Family 197.44 1118.85 477.15 839.14 756.86 559.43 1316.29 2632.58
Full Time Employees 3/4 Time Employees 1/2 Time Employees Total Total
Employee County Employee County Employee County Semi-Monthly Monthly
Blue Shield PPO
Cost Cost Cost Cost Cost Cost Premium Premium
Employee Only 184.36 553.08 322.63 414.81 460.90 276.54 737.44 1474.88
Employee +1 382.91 1148.73 670.09 861.55 957.27 574.37 1531.64 3063.28
Employee + Family 557.18 1671.53 975.06 1253.65 1392.94 835.77 2228.71 4457.42
Full Time Employees 3/4 Time Employees 1/2 Time Employees Total Total
Employee County Employee County Employee County Semi-Monthly Monthly
Blue Shield HDHP
Cost Cost Cost Cost Cost Cost Premium Premium
Employee Only 71.70 406.32 173.28 304.74 274.86 203.16 478.02 956.04
Employee +1 143.41 812.63 346.57 609.47 549.72 406.32 956.04 1912.08
Employee + Family 202.92 1149.89 490.39 862.42 777.86 574.95 1352.81 2705.62
Full Time Employees 3/4 Time Employees 1/2 Time Employees Total Total
Employee County Employee County Employee County Semi-Monthly Monthly
Kaiser HMO
Cost Cost Cost Cost Cost Cost Premium Premium
Employee Only 52.40 297.89 52.40 297.89 200.84 149.45 350.29 700.58
Employee +1 104.79 594.78 253.23 446.34 401.68 297.89 699.57 1399.14
Employee + Family 148.27 841.21 358.32 631.16 568.38 421.10 989.48 1978.96
Full Time Employees 3/4 Time Employees 1/2 Time Employees Total Total
Employee County Employee County Employee County Semi-Monthly Monthly
Kaiser HDHP
Cost Cost Cost Cost Cost Cost Premium Premium
Employee Only 41.14 234.10 41.14 234.10 157.69 117.55 275.24 550.48
Employee +1 82.27 467.20 198.82 350.65 315.37 234.10 549.47 1098.94
Employee + Family 116.42 660.67 281.34 495.75 446.25 330.84 777.09 1554.18
OPERATING ENGINEERS
PPO, Dental & Vision Full Time Employees 3/4 Time Employees 1/2 Time Employees Total Total
Semi-Monthly Monthly
Employee cost County cost Employee cost County cost Employee cost County cost
Premium Premium
Employee Only 44.45 400.05 144.46 300.04 244.47 200.03 444.50 889.00
Employee +1 88.85 799.65 288.76 599.74 488.67 399.83 888.50 1777.00
Employee + Family 120.00 1080.00 390.00 810.00 660.00 540.00 1200.00 2400.00
Kaiser, Dental & Vision Full Time Employees 3/4 Time Employees 1/2 Time Employees Total Total
Semi-Monthly Monthly
Employee cost County cost Employee cost County cost Employee cost County cost
Premium Premium
Employee Only 45.10 405.90 146.57 304.43 248.05 202.95 451.00 902.00
Employee +1 90.15 811.35 292.99 608.51 495.82 405.68 901.50 1803.00
Employee + Family 117.60 1058.40 382.20 793.80 646.80 529.20 1176.00 2352.00
Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 142021 Semi-Monthly Cost of Medical Benefits
DENTAL AND VISION CONTRIBUTIONS
Management,
Confidential, District
Core Dental Plan (No max, no Management Buy up- Core plus
Attorney/County
ortho coverage) Buy-Up (4k Ortho Coverage)
Counsel, Sheriff
Sergeant
1 1
Employee Cost County Cost Employee Cost County Cost
Employee Only 23.17
Employee + 1 7.27 65.39 40.66 65.39
Employee + 2 ore more 53.38
Cigna Dental PPO
All other represented Year 2+ Actives - Core plus Year 2+ Actives - Core plus Year 2+ Actives - Core plus Buy-Up 3 (4k
Core Dental Plan (2.5k Max)
employee groups Buy-Up 1 (4k Max) Buy-Up 2 (4k Ortho Coverage) Max & 4k Ortho Coverage)
1 1 1 1
Employee Cost County Cost Employee Cost County Cost Employee Cost County Cost Employee Cost County Cost
Employee Only 12.22 17.53 23.89
Employee + 1 5.86 52.77 19.24 52.77 30.38 52.77 43.76 52.77
Employee + 2 ore more 24.35 39.72 58.19
Delta Care DHMO VSP Vision Care
Employee cost County cost Employee cost County cost
Management,
Confidential, District
Attorney/County 2.25 20.24
Counsel, Sheriff 0.00 8.26
Sergeant
All other represented
2.25 20.24
employee groups
VSP Vision Care Buy-Up
Employee cost County cost
Employee Only 2.66
Employee + 1 5.59 8.26
Employee + 2 ore more 7.99
Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 15Making the Most of Your Benefits Program
Helping you and your family members stay healthy and making sure you use your benefits program to its best
advantage is our goal in offering this program. Here are a few things to keep in mind.
STAY WELL!
Harder than it sounds, of course, but many health
problems are avoidable. Take action—from eating
well, to getting enough exercise and sleep. Taking
care of yourself takes care of a lot of potential
problems.
ASK QUESTIONS AND STAY INFORMED
AN APPLE A DAY
Know and understand your options before you
decide on a course of treatment. Informed patients Eating moderately and well really does help keep
get better care. Ask for a second opinion if you're the doctor away. Stay away from fat-heavy,
at all concerned. processed foods and instead focus on whole grains,
vegetables, and lean meats to be the healthiest
you can be.
GET A PRIMARY CARE PROVIDER
Having a relationship with a PCP gives you a USING THE EMERGENCY ROOM
trusted person who knows your unique situation
when you're having a health issue. Visit your PCP Did you know most ER visits are unnecessary? Use
or clinic for non-emergency healthcare. them only in a true emergency—like any situation
where life, limb, and vision are threatened.
Otherwise, call your doctor, your nurse line, or go
GOING TO THE DOCTOR? to an Urgent Care clinic. You'll save a lot of money
To get the most out of your doctor visit, being and time.
organized and having a plan helps. Bring the
following with you: BE MED WISE!
• Your plan ID card Always follow your doctor's and pharmacist's
• A list of your current medications instructions when taking medications. You can
• A list of what you want to talk about with your worsen your condition(s) by not taking your
doctor medication or by skipping doses. If your medication
is making you feel worse, contact your doctor.
If you need a medication, you could save money by
asking your doctor if there are generics or generic
alternatives for your specific medication.
Questions? Contact Benefits Division: 650-363-1919 or benefits@smcgov.org 16Medical
HMO PLANS
Medical coverage provides you with benefits that help keep you healthy, like preventive care screenings and
access to urgent care. It also provides important financial protection if you have a serious medical condition.
Blue Shield Blue Shield TRIO Kaiser Traditional Kaiser
HMO HMO Plan HMO HDHP
In-Network In-Network In-Network In-Network
Annual Deductible $0 per individual $0 per individual $0 per individual $1,500 per individual
$0 family limit $0 family limit $0 family limit $3,000 family limit
Annual Out-of-Pocket Max
Individual $1,000 $1,000 $1,500 $3,000
Family $3,000 $3,000 $3,000 $6,000
Physician/Professional Services
Office Visits
Physician & Specialist $15 copay $15 copay $15 copay Plan pays 90% after
deductible
Access+ Specialist
(Allows you to seek care from
a specialist without a referral
$30 copay $30 copay Not allowed Not allowed
from your PCP)
Telemedicine $5 per consultation No charge No Charge No Charge
Preventive Services Plan pays 100% Plan pays 100% Plan pays 100% Plan pays 100%
Chiropractic and $10 copay $10 copay $15 copay Not covered
Acupuncture Care (up to 30 visits per year) (up to 30 visits per year) (up to 20 visits per year)
Lab and X-ray Plan pays 100% Plan pays 100% $5 copay then plan pays Plan pays 90% after
100% deductible
Infertility
Testing and Treatment 50% of allowable 50% of allowable 50% of allowable 50% of allowable
Charge Charge Charge Charge after deductible
Assisted Reproductive
Technology (ART) Services Not Covered Not Covered 50% of allowable 50% of allowable
GIFT, In Vitro Fertilization (IVF), ZIFT,
Transfer of cryopreserved embryos
Charge Charge after deductible
Artificial Insemination Not Covered Not Covered 50% of allowable 50% of allowable
Charge Charge after deductible
Family Planning
Physicians Family Planning
Plan pays 100% Plan pays 100% Plan pays 100% Plan pays 100%
Services
$50 per procedure Plan pays 90% after
Vasectomy $75/surgery $75/surgery
deductible
Plan pays 100% Plan pays 100% $50 per procedure Plan pays 90% after
Tubal Ligation
deductible
Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 17Medical
HMO PLANS
Kaiser
Blue Shield Blue Shield TRIO Kaiser Permanente Permanente
HMO HMO Plan Traditional HMO HDHP
In-Network In-Network In-Network In-Network
Hospital Benefits
Inpatient Hospitalization $100 admission $100 admission $100 admission copay Plan pays 90% after
copay copay deductible
Outpatient Surgery $50 copay $50 copay $50 copay Plan pays 90% after
deductible
Urgent Care $15 copay $15 copay $15 copay Plan pays 90% after
deductible
Emergency Room $100 copay $100 copay $100 copay Plan pays 90% after
(waived if admitted) (waived if admitted) (waived if admitted) deductible
Mental Health Services
Plan pays 90% after
Inpatient Hospital $100 per admission $100 per admission $100 per admission
deductible
Plan pays 90% after
Outpatient $15 copay $15 copay $15 copay; $7 group
deductible
Substance Abuse Services
Plan pays 90% after
Inpatient Hospital $100 per admission $100 per admission $100 per admission
deductible
Plan pays 90% after
Residential Care $100 per admission $100 per admission $100 per admission
deductible
Plan pays 90% after
Outpatient $15 copay $15 copay $15 copay; $5 group
deductible
Other Services
Transgender Covered Covered Covered Covered
(see plan document for (see plan document for (see plan document for (see plan document for
limitations) limitations) limitations) limitations)
Durable Medical Equipment Plan pays 90% after
No charge No charge 20% coinsurance
deductible
Orthotic and Prosthetic No charge after
No charge No charge No charge
Devices deductible
Skilled Nursing Facility
Plan pays 90% after
Up to 100 days per Member, per No charge No charge No charge
deductible
Benefit Period
Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 18Medical
PRESCRIPTION COVERAGE
Prescription drug coverage provides a benefit that is important to your overall health, whether you need a
prescription for a short-term health issue like bronchitis or an ongoing condition like high blood pressure. Here
are the prescription drug benefits that are included with our medical plans.
Blue Shield of CA Kaiser Permanente
HMO TRIO Traditional HMO HDHP
In-Network In-Network In-Network In-Network
(After Plan Deductible)
Pharmacy
Generic $15 per prescription $15 per prescription $10 per prescription $10 per prescription
Preferred Brand $25 per prescription $25 per prescription $20 per prescription $30 per prescription
Non-preferred $40 per prescription $40 per prescription $20 per prescription $30 per prescription
Brand
Specialty Drugs 20% up to $100 max $20 per prescription $30 per prescription
per prescription (30 day supply)
Supply Limit 30 days 30 days 100 days 30 days
Mail Order
Generic $30 per prescription $30 per prescription $10 per prescription $20 per prescription
Preferred Brand $50 per prescription $50 per prescription $20 per prescription $60 per prescription
Non-preferred $80 per prescription $80 per prescription $20 per prescription $60 per prescription
Brand
Specialty Drugs Not Covered Not Covered $20 per prescription Not Covered
(30 day supply)
Supply Limit 90 days 90 days 100 days 100 days
This summary is intended as a quick reference not a comprehensive description. For more plan information, please go to
Benefits Employee’s website at www.smcgov.org
Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 19Medical
PPO PLANS
Blue Shield Blue Shield of CA
PPO Plan HDHP
In-Network Out-Of-Network In-Network Out-Of-Network
Annual Deductible
Individual $200 $500 $1,500
Family $600 $1,000 $3,000
Annual Out-of-
Pocket Max $2,000 $4,000 $3,000 $6,000
Individual
$4,000 $8,000 $6,000 $12,000
Family
Lifetime Max Unlimited Unlimited Unlimited Unlimited
Physician/Professional Services
Office Visits
PCP & Specialist Plan pays 80% Plan pays 60% after Plan pays 90% after Plan pays 60% after
deductible deductible deductible
Telemedicine $5 per consultation Not Covered $5 per consultation Not Covered
Preventive Plan pays 60% after
Plan pays 100% Plan pays 100% Not covered
Services deductible
Chiropractic and Plan pays 90% after Plan pays 50% after
Acupuncture Care Plan pays 80% after Plan pays 60% after deductible (up to 20 visits deductible (in-network
deductible deductible (in-network per year) limitations apply)
(up to 30 visits per year) limitations apply)
Acupuncture: Not Covered Acupuncture: Not Covered
Lab and X-ray Plan pays 80% after Plan pays 60% after Plan pays 90% after Plan pays 60% after
deductible deductible (up to $350 deductible deductible
per day)
Infertility
Testing and Not Covered Not Covered Not Covered Not Covered
Treatment
Assisted Not Covered Not Covered Not Covered Not Covered
Reproductive
Technology (ART)
Services
GIFT, In Vitro Fertilization
(IVF), ZIFT, Transfer of
cryopreserved embryos
Artificial Not Covered Not Covered Not Covered Not Covered
Insemination
This summary is intended as a quick reference not a comprehensive description. For more plan information, please go to
Benefits Employee’s website at www.smcgov.org
Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 20Medical
PPO PLANS
Blue Shield Blue Shield of CA
PPO Plan HDHP
In-Network Out-Of-Network In-Network Out-Of-Network
Family Planning
Physicians Family Plan pays 100% Plan pays 60% after Plan pays 100% Not covered
Planning Services deductible
Plan pays 80% after Not covered Plan pays 90% after Not covered
Vasectomy
deductible deductible
Plan pays 100% Plan pays 60% after Plan pays 100% Not covered
Tubal Ligation
deductible
Hospital Services
Inpatient Plan pays 80% after Plan pays 60% after $100 copay then plan Plan pays 60% after
Hospitalization deductible deductible pays 90% after deductible (up to $600 per day)
(up to $600 per day) deductible
Outpatient Plan pays 80% after Plan pays 60% after Plan pays 90% after Plan pays 60% after
Surgery deductible deductible deductible deductible (up to $350 per day)
(up to $350 per day)
Urgent Care Plan pays 80% Plan pays 60% after Plan pays 90% after Plan pays 60% after
deductible deductible deductible
Emergency Room $100 copay $100 copay then plan pays 90% after deductible
(waived if admitted) (copay waived if admitted)
Mental Health Services
Inpatient Hospital Plan pays 60% after $100 copay then plan Plan pays 60% after
Plan pays 80% after
deductible pays 90% after deductible (up to $600 per
deductible
(up to $600 per day) deductible day)
Outpatient Plan pays 60% after Plan pays 90% after Plan pays 60% after
Plan pays 80% deductible deductible deductible (up to $350 per
(up to $350 per day) day)
Substance Abuse Services
Inpatient Hospital Plan pays 60% after $100 copay then plan Plan pays 60% after
Plan pays 80% after
deductible pays 90% after deductible
deductible
(up to $600 per day) deductible (up to $600 per day)
Residential Care Plan pays 80% after Plan pays 60% after Plan pays 90% after Plan pays 60% after
deductible deductible deductible deductible
(up to $600 per day) (up to $600 per day)
Outpatient Plan pays 60% after Plan pays 90% after Plan pays 60% after
Plan pays 80% deductible deductible
deductible
(up to $350 per day) (up to $350 per day)
This summary is intended as a quick reference not a comprehensive description. For more plan information, please go to
Benefits Employee’s website at www.smcgov.org
Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 21Medical
PPO PLANS
Blue Shield Blue Shield of CA
PPO Plan HDHP
In-Network Out-Of-Network In-Network Out-Of-Network
Other Services
Covered Covered Covered Covered
Transgender (see plan document for (see plan document for (see plan document for (see plan document for
limitations) limitations) limitations) limitations)
Durable Medical Plan pays 80% after Plan pays 60% after Plan pays 90% after Plan pays 60% after
Equipment deductible deductible deductible deductible
Orthotic and Plan pays 80% after Plan pays 60% after Plan pays 90% after Plan pays 60% after
Prosthetic Devices deductible deductible deductible deductible
Skilled Nursing Plan pays 80% after Freestanding SNF: Plan pays 90% after Freestanding SNF:
Facility deductible Plan pays 80% after deductible Plan pays 90% after
Up to 100 days per deductible deductible
Member, per Benefit
Period
Hospital-based: Hospital-based:
Plan pays 60% after Plan pays 60% after
deductible deductible
(up to $600 per day) (up to $600 per day)
This summary is intended as a quick reference not a comprehensive description. For more plan information, please go to
Benefits Employee’s website at www.smcgov.org
Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 22Medical
PPO PRESCRIPTION COVERAGE
Blue Shield of CA
PPO Plan HDHP
In-Network Out-Of-Network In-Network Out-Of-Network
Pharmacy
Tier 1 $15 per 25% + $15 per $10 per prescription 25% + $10 per
prescription prescription prescription
Tier 2 $30 per 25% + $30 per $25 per prescription 25% + $25 per
prescription prescription prescription
Tier 3 $45 per 25% + $45 per $40 per prescription 25% + $40 per
prescription prescription prescription
Tier 4 (excluding 20% up to 25% up to $200 per 30% up to $200 per 25% up to $200 per
Specialty) $100/prescription prescription PLUS prescription prescription PLUS 25%
25% of purchase of purchase price
price
Supply Limit 30 days 30 days 30 days 30 days
Mail Order
Tier 1 $30 per Not covered $20 per prescription Not covered
prescription
Tier 2 $60 per Not covered $50 per prescription Not covered
prescription
Tier 3 $90 per Not covered $80 per prescription Not covered
prescription
Tier 4 (excluding 20% up to Not covered 30% up to Not covered
Specialty) $200/prescription $200/prescription
Supply Limit 90 days Not applicable 90 days Not applicable
Specialty Drugs
Specialty Drugs 20% up to $100 Not covered 30% up to $200 per Not Covered
per prescription prescription
This summary is intended as a quick reference not a comprehensive description. For more plan information, please go to
Benefits Employee’s website at www.smcgov.org
Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 23Dental
FOR REPRESENTED ACTIVES WITH LESS THAN 1 YEAR OF SERVICE
Cigna
Dental PPO
DeltaCare DHMO
Dental Benefits Represented - Actives
Less Than 1 Year
PPO OON1
Calendar Year Maximum
None $2,500 $2,500
Calendar Year Deductible
Individual None $100 $100
Diagnostic and Preventive
Oral Exams
Routine Cleanings
Full Mouth X-rays Plan Pays 60% Plan Pays 60%
No Charge
Bitewing X-rays No deductible No deductible
Panoramic X-ray
Fluoride Application
Basic Services
Amalgam/Composite Fillings
Periodontics (Gum disease) Plan Pays 60% Plan Pays 60%
No Charge
Endodontics (Root Canal) After deductible After deductible
Extractions & Other Oral Surgery
Major Services
Crown Repair
Restorative - Inlays and Crowns Plan Pays 60% Plan Pays 60%
No Charge
Prosthodontics After deductible After deductible
Complex Oral Surgery
Implants
Plan Pays 60%
Plan Pays 60%
Calendar Year Maximum None After deductible up
to $1,000
Orthodontics
Child: $1,600 copay
Child to Age 19 and Adult Not Covered
Adult: $1,800 copay
1 Based on maximum allowable charge (In-Network fee level)
Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 24Dental
FOR REPRESENTED ACTIVES WITH MORE THAN 1 YEAR OF SERVICE
Cigna
Cigna
Cigna Dental PPO
Cigna Dental PPO
Dental PPO Year 2+ Actives -
DeltaCare Dental PPO Year 2+ Actives -
Dental Benefits Core Dental Plan - Core plus Buy Up
DHMO Represented
Year 2+ Actives - Core plus Buy Up
Option #3 with $4K
Core plus Buy Up Option #2 with $4K
Actives Max & $4K Ortho
Option #1 with $4K Ortho Coverage
Coverage
Max
Calendar Year Maximum PPO OON1 PPO OON1 PPO OON1 PPO OON1
None $2,500 $2,500 $4,000 $4,000 $2,500 $2,500 $4,000 $4,000
Calendar Year Deductible
Individual None None None None None None None None None
Diagnostic and Preventive
Oral Exams
Routine Cleanings
Full Mouth X-rays Plan Plan Plan Plan Plan Plan Plan Plan
No Charge pays pays pays pays pays pays pays pays
Bitewing X-rays 85% 85% 85% 85% 85% 85% 85% 85%
Panoramic X-ray
Fluoride Application
Basic Services
Amalgam/Composite Fillings
Periodontics (Gum disease) Plan Plan Plan Plan Plan Plan Plan Plan
No Charge pays pays pays pays pays pays pays pays
Endodontics (Root Canal)
85% 85% 85% 85% 85% 85% 85% 85%
Extractions & Other Oral
Surgery
Major Services
Crown Repair
Restorative - Inlays and Crowns Plan Plan Plan Plan Plan Plan Plan Plan
No Charge pays pays pays pays pays pays pays pays
Prosthodontics 85% 85% 85% 85% 85% 85% 85% 85%
Complex Oral Surgery
Implants
Plan Plan Plan Plan
pays 85% Plan pays 85% Plan pays 85% Plan pays 85% Plan
Calendar Year Maximum None
up to pays 85% up to pays 85% up to pays 85% up to pays 85%
$1,000 $1,000 $1,000 $1,000
Orthodontics
Child to 19:
Lifetime Maximum
$1,600 Child/Adult Child/Adult
Not covered Not covered
Adult: $4,000 $4,000
$1,800
1 Out Of Network Coinsurance Based on Maximum Allowable Charge (In Network Fee Level).
Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 25Dental
FOR MANAGEMENT, CONFIDENTIAL, DISTRICT ATTORNEY/COUNTY COUNSEL, SHERRIFF SERGEANT
Cigna
Cigna
Dental PPO
Dental PPO
Dental Benefits DeltaCare DHMO Management Buy Up - Core
Core Dental Plan -
plus Buy Up Option with
Management
$4K Ortho Coverage
PPO OON1 PPO OON1
Calendar Year Maximum
None None None None None
Calendar Year Deductible
Individual None None None None None
Diagnostic and Preventive
Oral Exam
X-Rays
Teeth Cleaning
Plan Pays Plan Pays Plan Pays Plan Pays
Fluoride Treatment No Charge
100% 100% 100% 100%
Space Maintainers
Bitewings
Sealants
Basic Services
Amalgam/Composite Fillings
Periodontics (Gum disease) Plan Pays Plan Pays Plan Pays Plan Pays
No Charge
Endodontics (Root Canal) 100% 100% 100% 100%
Extractions & Other Oral Surgery
Major Services
Crown Repair
Restorative - Inlays and Crowns Plan Pays Plan Pays Plan Pays Plan Pays
No Charge
Prosthodontics 100% 100% 100% 100%
Complex Oral Surgery
Implants
Calendar Year Maximum None None
Orthodontics
Eligible for Benefit Child to 19: $1,600 Child/Adult
Not Covered
Lifetime Maximum Adult: $1,800 $4,000
1 Out Of Network payment based on maximum allowable amount (In-Network level).
Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 26Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 27
Vision
All regular employees working full-time or part-time (over 20 hours per week) must enroll in the County’s
vision insurance plan. This benefit is fully paid for by the County. More information about the VSP plan is
available online at http://hr.smcgov.org/employee-benefits; click on Vision Plan.
CORE PLAN BUY-UP PLAN
(Premium Paid for by the County) (Employee Paid)
Benefits In-Network Non-Network In-Network Non-Network
Frequency
Exam Every 12 months Every 12 months
Lenses/Contacts Every 12 months Every 12 months
Frames Every 24 months Every 12months
Copayment
Subject to out of Subject to out of
Exam/Prescription Glasses $10 / $10 $10 / $10
network allowance network allowance
15% off contact fitting and evaluation 15% off contact fitting and evaluation exam,
Contacts
exam, not to exceed $60 not to exceed $60
Exam Copay Plan Pays up to: Copay Plan Pays up to:
Exam Covered in full $50 Covered in full $50
Lenses
Anti-reflective coating Not covered $35 copay
Single Lenses Covered in full $50 Covered in full $50
Bifocal Lenses Covered in full $75 Covered in full $75
Trifocal Lenses Covered in full $100 Covered in full $100
Lenticular Lenses Covered in full $125 Covered in full $125
Ultraviolet (UV) Coating Not Covered Covered in full Not covered
Frames
$130 $200
$150 for featured $220 for featured
Frame Allowance $70 $70
frame brands frame brands
$70 Costco frames $110 Costco frames
Suncare Option Not Covered Covered in full Not covered
Contacts
$150 Allowance; $200 Allowance;
Elective in lieu of lens and $105** in lieu of lens and $105**
frame* frame*
Medically Necessary Covered in full $210 Covered in full $210
* Progressive bifocals may be purchased for the difference in cost
** Contact lenses are in lieu of spectacle lenses and frames
Looking for the Perfect Pair? Visit eyeconic.com!
VSP’s online store lets you use apply your benefits directly to your purchase.
Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 28Getting Care When You Need It Now
TYPE APPROPRIATE FOR EXAMPLES ACCESS & CONTACT INFO
Nurseline Quick answers from • Identifying symptoms 24/7
a trained nurse • Decide if immediate care is
needed Kaiser:
• Home treatment options (800) 464-4000
and advice Blue Shield:
(877) 304-0504
Online visit Minor illnesses and • Common cold, flu, fever 24/7
conditions • Headache, migraine
• Skin conditions Kaiser:
• Allergies www.kp.org
Blue Shield:
www.teladoc.com/bsc
Office visit Routine medical • Preventive care Office Hours
care • Illnesses, injuries
and overall health • Managing existing To locate a provider:
management conditions • Kaiser Permanente
• Blue Shield of CA
Urgent care, Non-life-threatening • Stitches Vary, up to 24/7
Walk-in conditions requiring • Sprains
clinic prompt attention • Animal bites To locate a facility:
• Ear-nose-throat infections • Kaiser Permanente
• Blue Shield of CA
Emergency Life-threatening • Suspected heart attack or 24/7
room conditions requiring • stroke
immediate medical • Major bone breaks To locate a facility:
expertise • Excessive bleeding • Kaiser Permanente
• Severe pain • Blue Shield of CA
• Difficulty breathing
Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 29Enhanced Services
MOBILE APP MICROSITE
The Blue Shield of California app provides BSC members Access all the information you need in one
enhanced 24/7 service and ease-of-access to the convenient place – paper-free and online. Get the
information that matters most. As a member of Blue best out of your benefits – visit
Shield of California, with the app you can: www.blueshieldca.com/cosm
View your benefits, including information on Review your plan information 24/7
custom benefits, general exclusions and benefit View or download your latest health plan
maximums documents at any time.
Search for doctors and facilities by doctor Find doctors, hospitals, specialists, and more
specialty by location or by name Search for providers in our extensive networks by
using our simple tool.
Display your Blue Shield of California ID card Explore programs and services customized for
you
Review your health care team, including your Discover how healthy you can be with a variety of
doctor's credentials, locations and contact care options, health programs, and wellness
information discounts.
Find urgent care
Learn about our benefit discount programs, like
dental, vision and pharmacy
LIFEREFERRALS 24/7
Experts to help you handle life
Everyone can use a hand sometimes, and LifeReferrals 24/7SM offers convenient support to help you meet life’s
challenges. A simple phone call connects you with a team of experienced professionals ready to assist you with a wide
range of personal, family, and work issues. All of these services, including referrals to community resources, are
confidential and available for no copayment or extra cost.* When you call, you’ll be guided to the appropriate expert,
depending on your needs:
PERSONAL ISSUES FINANCIAL, LEGAL, AND MEDIATION REFERRALS TO COMMUNITY
For matters like relationship QUESTIONS RESOURCES
problems, stress, and grief, you can Request referrals for 30-minute A specialist can provide useful
talk by phone to trained counselors consultations with professionals information and referrals to a wide
and request face-to-face sessions about legal matters such as wills, and range of resources such as child and
with licensed therapists. lord/tenant issues, and alternatives elder care, meal programs &
to litigation; and financial matters transportation assistance.
such as retirement planning and tax
preparation.
You can call LifeReferrals 24/7 toll free, any time, at (800) 985-2405. You’ll also find
more information on our Web site, blueshieldca.com.
Questions? EContact Benefits Division: 650-363-1919 or benefits@smcgov.org 30You can also read
