Retirement
Retiree medical, dental and vision benefits contracts are administered by the County, Human Resources Division. SJCERA collects retiree payments for premiums and maintains retiree plan eligibility. You may contact them at (209) 468-2163 or visit their website at www.sjcera.org. For specific questions about your plan and the coverage it provides, please contact your plan provider directly.
2023 - 2024 Retiree Open Enrollment Mailer and Rates
Medical Plans
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2023/2024 Anthem-Blue-Cross-Medicare-Part-D-Prescription-Enrollment-Form103.9 KB • pdf • April 11, 2023 -
Anthem Blue Cross Summary of Benefits101 KB • pdf • May 3, 2022
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Anthem Blue Cross Medicare Prescription Enrollment Guide117.7 KB • pdf • May 3, 2022
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Anthem Blue Cross Mail Order Prescription Information1.7 MB • pdf • January 24, 2022
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Anthem Blue Cross Enrollment Form1.3 MB • pdf • January 24, 2022
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Anthem Blue Cross Medicare Part D Prescription Enrollment Form575.3 KB • pdf • January 24, 2022
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CMCP-Enrollment-Form 2023-202487.8 KB • pdf • April 12, 2023
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CMCP with Medicare Summary of Benefits311.2 KB • pdf • May 4, 2022
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CMCP without Medicare Summary of Benefits208.7 KB • pdf • May 4, 2022
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Blue Shield Prescription Drug Formulary1.8 MB • pdf • January 24, 2022
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CMCP Enrollment Form87.8 KB • pdf • January 24, 2022
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Blue Shield Prescription Enrollment Form107.7 KB • pdf • January 24, 2022
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HMO Medicare COB medical enrollment form 2023/2024820.7 KB • pdf • April 12, 2023
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Healthnet EOC 2022 Flex Med1.8 MB • pdf • May 3, 2022
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Healthnet EOC 2022 HMO1 MB • pdf • May 3, 2022
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2022 Healthnet Retiree SBC734.6 KB • pdf • May 3, 2022
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Health Net Medicare HMO COB Enrollment Form2.7 MB • pdf • January 24, 2022
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Health Net Flex Net Out-of-Area Enrollment Form1 MB • pdf • January 24, 2022
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Health Net Seniority Plus High Option Plan Brochure830 KB • pdf • January 24, 2022
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Health Net Seniority Plus High Option Summary of Benefits835.5 KB • pdf • May 3, 2022
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Health Net Flex Net Out-of-Area Summary of Benefits4.2 MB • pdf • May 3, 2022
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Health Net Seniority Plus Low Option Brochure830 KB • pdf • January 24, 2022
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Health Net Medicare HMO COB Summary of Benefits1.3 MB • pdf • January 24, 2022
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Health Net Medicare HMO COB Brochure976.8 KB • pdf • January 24, 2022
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Health Net COB Prescription Enrollment Form89.9 KB • pdf • January 24, 2022
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Health Net Seniority Plus Low Option Enrollment Form89.5 KB • pdf • January 24, 2022
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Health Net Seniority Plus Low Option Summary of Benefits795.9 KB • pdf • May 3, 2022
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Health Net Seniority Plus High Option Plan Enrollment Form89.3 KB • pdf • January 24, 2022
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Health Net Medicare COB Prescription Summary of Benefits98.7 KB • pdf • May 3, 2022
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County Of San Joaquin Northwest SSOB_KPSA_2022-2023 - Part D108.4 KB • pdf • May 3, 2022
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2022-2023_SJC_ Under 65 _Traditonal HMO_Benefit Summary - Disclosure92.7 KB • pdf • May 3, 2022
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Kaiser Permanente Guide to Medicare Booklet10.5 MB • pdf • January 24, 2022
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Kaiser Senior Advantage Over 65 High Option Summary of Benefits93.3 KB • pdf • May 3, 2022
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Kaiser Under 65 Traditional and Northwest Plan Summary of Benefits58.4 KB • pdf • May 3, 2022
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Kaiser NorthWest Enrollment Form250.4 KB • pdf • January 24, 2022
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Kaiser Senior Advantage Over 65 Low Option Enrollment Form664.2 KB • pdf • January 24, 2022
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Kaiser Under 65 Tradition Plan Enrollment Form349.5 KB • pdf • January 24, 2022
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Kaiser Senior Advantage Over 65 Low Option Summary of Benefits96.2 KB • pdf • May 3, 2022
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Kaiser Senior Advantage Over 65 High Option Enrollment Form672.2 KB • pdf • January 24, 2022
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Kaiser NorthWest Brochure1.3 MB • pdf • January 24, 2022
Dental Plans
Vision Plan
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County of San Joaquin_Actives (Retirees Updated)_MBS_20221.5 MB • pdf • May 3, 2022
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VSP Benefit Plan Summary1.5 MB • pdf • January 24, 2022
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VSP Enrollment Form120.3 KB • pdf • January 24, 2022
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VSP TruHearing Discount Offer515.2 KB • pdf • January 24, 2022
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VSP Coupon584.6 KB • pdf • January 24, 2022