Health Plan Schedules of Benefits
Important Notice for Blue Shield Members
The network relationship between Blue Shield and Sutter Health has been terminated effective January 1, 2015. This applies to all Sutter physicians, medical groups and facilities. Blue Shield is continuing their discussions with Sutter Health in the hopes that a new agreement can still be reached.
Below you will find a Fact Sheet from Blue Shield with very valuable information on what members can expect should no new agreement be met. Please review carefully. Some of the important highlights are:
- There is a 6 month transition period (January 1, 2015 – June 30, 2015) where Blue Shield will continue to offer in-network benefits to members who receive care from Sutter Health providers. However, Sutter Health’s charges will be higher, and members should be aware that this will result in higher out-of-pocket expense for services received from Sutter Health. For example, if your co-insurance prior to 1/1/15 was 10% of $100 you would pay $10. Post 1/1/15, the $100 may now be $120, so the member would be paying 10% of $120 ($12).
- A letter will be going out to all PPO members in the next few days (sample letter attached).
- From January 1, 2015 – March 31, 2015, HMO members can continue to access care through their current Sutter providers at In Network levels.
- HMO members will be given a 60 day notice advising them of the change of network and will be reassigned a new provider group effective April 1, 2015 (please refer to attached Fact Sheet for table showing where members will be transitioned if auto assigned a provider).
- A letter to members will be going out mid-January to members. It is currently pending DMCH approval
Important information ALL members
If you are in a course of treatment, you will be granted “continuity of care” meaning you will be allowed to complete a current treatment with your Sutter provider. Please note the following requirements:
- The Member must have a Serious Disease and began active treatment prior to becoming enrolled
- The Member must be in an active course of treatment defined as treatment that is:
- Delivered following an inpatient stay or outpatient procedure and designed to assure recovery/rehabilitation; or
- Continuity of care for a Serious Disease that requires periodic diagnostic studies or adjustment of medications or treatments no less frequently than every six months.
- The Member’s health care provider is providing the Member with an active course of treatment that is not available from another provider in the Provider Network of the Member’s Health Plan Benefit.
- Disruption in the course of treatment would pose an undue hardship.
Important Notice for Kaiser Members
Chiropractic Care Benefit - New!
Beginning February 1, 2015 a chiropractic benefit has been added to both the Kaiser Traditional HMO and the Kaiser Deductible HMO plans.
Autism Services Amendment Added to Your Group Agreement
In October 2011, Governor Jerry Brown signed into law Senate Bill 946, which requires California health plans to cover “behavioral health treatment” for autism or pervasive developmental disorders when medically necessary. In response, Kaiser Foundation Health Plan, Inc .has added Senate Bill 946 amendments to their group health plans, effective July 1, 2012 and August 1, 2012, respectively.
Employee Benefit Plans
Updated information on Worker's Compensation Program:
- Worker's compensation third party administrator information
- Required forms to pre-designate a treating physician in the event of a work-related injury
- How to manage your dental plan online with Delta Dental’s easy to use tools and services
- Delta Dental Online Access
Benefit Enrollment Forms
403(b) Retirement Plan
As an employee of Marin Community College District, we are pleased to inform you that you are eligible to participate in our 403(b) retirement plan. Our 403(b) plan allows you to contribute pre-tax dollars into an investment provider of your choice. Participation in the plan not only helps you prepare for a more financially secure future, it provides significant tax advantages today.
To learn more, order the booklet A Guide to Your California Retirement Benefits, available at no charge from our plan administrator, Tax Deferred Solutions (TDS), California’s largest independent provider of 403(b) and 457(b) plan administration services. In addition, you may also request a FREE estimate of your projected retirement benefits. Visit Tax Deferred Solutions (TDS) web site to request your FREE information.
For additional information about 403(b) vendors and the products they offer, please visit 403bCompare web site.
403(b) Plan Setup or Plan Change Instructions - including a link to the Salary Redirection Agreement form.
Important Notice regarding 403(b) Administration Fees
Healthcare Reform Information
Content Responsible: Peggy Isozaki, Director of Fiscal Services, 415.883.2211 ext. 8160
Technical Contact: Melinda Molloy, Administrative Assistant to the Vice President of College Operations, 415.883.2211 ext. 8101