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1. I am adopting a baby / child and want to add him / her to my health insurance plans. What do I need to do?

You must begin the process of adding your new baby/child to your health insurance plan(s) as soon as possible after completing the adoption process. All forms required can be obtained from Human Resources.


Submit the following completed forms to Human Resources.

• Personal Information Change form: Submit to Human Resources to begin the process.


• Anthem Blue Cross Change form: To add your new dependent to your medical insurance plan.


• REMIF Enrollment form: To add your new dependent to your dental, vision, and EAP plans.

Note the following:

• Changes to your health insurance plan(s) must be submitted to the insurance agencies within 30 days of the date of adoption. If you do not add your new dependent within 30 days of the date of adoption, you will not be able to add him/her until our next Health Insurance Open Enrollment period.


• A copy of the official adoption paperwork must be submitted to Human Resources when the adoption is final. If you do not provide the official documents within three months, your new dependent will be removed from your health insurance plan(s) and cannot be added again until the next Health Insurance Open Enrollment period.


• You should also check the beneficiaries listed for your life insurance, CalPERS, and 457/deferred compensation, if applicable, and make any changes you might want. You may also want to change your Power of Attorney for PERS.

2. I just got divorced and want to remove my former spouse from my health insurance plans. What do I need to do?

You must begin the process of removing your former spouse and any step-children (unless you adopted them) from your health insurance plan(s) as soon as possible after your divorce. All forms required can be obtained from Human Resources.

Submit the following completed forms to Human Resources.

• Personal Information Change form: Submit to Human Resources to begin the process.

• Anthem Blue Cross Change form: to remove/terminate your spouse and any step-children (unless you adopted them) from your medical insurance plan.

• REMIF Enrollment form: to remove/terminate your spouse and any step-children (unless you adopted them) from your dental, vision, and EAP plans.
Note the following:
• Changes to your health insurance plan(s) must be submitted to the insurance agencies within 30 days of the date of your divorce.

• A copy of your divorce decree must be submitted to Human Resources within 30 days of the date of your divorce.

3. I just got married and want to add my spouse to my health insurance plan(s). What do I need to do?

You must begin the process of adding your spouse and any other new dependents to your health insurance plan(s) as soon as possible after your marriage. All forms required can be obtained from Human Resources.


Submit the following completed forms to Human Resources.

• Personal Information Change form: Submit to Human Resources to begin the process.


• Anthem Blue Cross Change form: To add your new dependent(s) to your medical insurance plan.


• REMIF Enrollment form: To add your new dependent(s) to your dental, vision, and EAP plans.

Note the following:

• Changes to your health insurance plan(s) must be submitted to the insurance agencies within 30 days of the date of your marriage. If you do not add your new dependents within 30 days of your marriage, you will not be able to add them until our next Health Insurance Open Enrollment period.


• You will have three months to provide official documentation for your new dependents. If you do not provide the official documents within three months, your spouse and any other new dependents will be removed from your health insurance plan(s) and cannot be added again until the next Health Insurance Open Enrollment period.


• You should also check the beneficiaries listed for your life insurance, CalPERS, and 457/deferred compensation, if applicable, and make any changes you might want. You may also want to change your Power of Attorney for PERS.

4. I just had a baby and want to add him/her to my health insurance plans. What do I need to do?

You must begin the process of adding your new baby to your health insurance plan(s) as soon as possible after the date of birth. All forms required can be obtained from Human Resources.


Submit the following completed forms to Human Resources.

• Personal Information Change form: Submit to Human Resources to begin the process.


• Anthem Blue Cross Change form: To add your new dependent to your medical insurance plan.


• REMIF Enrollment form: To add your new dependent to your dental, vision, and EAP plans.

Note the following:

• Changes to your health insurance plan(s) must be submitted to the insurance agencies within 30 days of the date of birth. If you do not add your new dependent within 30 days of the date of birth, you will not be able to add him/her until our next Health Insurance Open Enrollment period.


• You will have three months to provide official documentation for your new dependent. If you do not provide the official documents within three months, your new dependent will be removed from your health insurance plan(s) and cannot be added again until the next Health Insurance Open Enrollment period.


• You should also check the beneficiaries listed for your life insurance, CalPERS, and 457/deferred compensation, if applicable, and make any changes you might want. You may also want to change your Power of Attorney for PERS.

5. I went to a contracted (network) hospital under my Anthem Blue Cross plan for emergency care but I don't know if the ER doctor was contracted. Will my visit be covered at the contracted rate?

You must begin the process of adding your spouse and any other new dependents to your health insurance plan(s) as soon as possible after your marriage. All forms required can be obtained from Human Resources.

Submit the following completed forms to Human Resources.

• Personal Information Change form: Submit to Human Resources to begin the process.

• Anthem Blue Cross Change form: To add your new dependent(s) to your medical insurance plan.

• REMIF Enrollment form: To add your new dependent(s) to your dental, vision, and EAP plans.

Note the following:

• Changes to your health insurance plan(s) must be submitted to the insurance agencies within 30 days of the date of your marriage. If you do not add your new dependents within 30 days of your marriage, you will not be able to add them until our next Health Insurance Open Enrollment period.
• You will have three months to provide official documentation for your new dependents. If you do not provide the official documents within three months, your spouse and any other new dependents will be removed from your health insurance plan(s) and cannot be added again until the next Health Insurance Open Enrollment period.

• You should also check the beneficiaries listed for your life insurance, CalPERS, and 457/deferred compensation, if applicable, and make any changes you might want. You may also want to change your Power of Attorney for PERS.

6. Under my Anthem Blue Cross plan, do I need a referral to go to a specialist?

No. You do not need a referral to go to a specialist. However, members will need to go to a PPO-contracted specialist to obtain the maximum benefit:

• 
  Current EPO plan: Members receive no benefit for services by out-of-network providers.
• 
  Current HSA plan: Members receive a reduced benefit for services by out-of-network providers.

The Anthem website, has a "Find A Doctor" link by which members can locate Anthem-contracted doctors/facilities in their area. Members may also call 1-800-810-BLUE (2583).

7. I have a dependent full-time student over 19. How long will my dependent be eligible for coverage on my health insurance?

The age limit for dependent children is up to age 26 regardless of student, marital, or residency status for all plans. This does not extend to spouses or children of such dependents.

8. I have a full-time student over 19. When do I need to send student verification?

With the onset of healthcare reform it is no longer necessary to provide student verification. The age limit for dependent children is up to age 26 regardless of student, marital or residency status for all plans.

9. I have a dependent attending school out of state. Will my dependent still be covered under my health insurance?

Yes. Both our Anthem Blue Cross plans provide coverage outside of California. The Anthem website, http://www.bcbs.com, has a "Find A Doctor" link by which out-of-state students or other members traveling out of state can locate Anthem contracted doctors/facilities in their area. They should confirm that the doctor/facility is still contracted with Anthem when calling to schedule an appointment. Members may also call 1-800-810-BLUE (2583).

10. My Domestic Partner is covered under my health insurance. Are my Domestic Partner's children eligible too?

Children of domestic partners are eligible for coverage under the City's health, dental and vision plans. The age limit for dependent children is up to age 26 regardless of student, marital or residency status for all plans but does not extend to spouses or children of such dependents.
You must begin the process of adding your domestic partner and any other eligible dependents to your health insurance plan(s) as soon as possible after filing you declaration of Domestic Partnership. All forms required can be obtained from Human Resources.

Submit the following completed forms to Human Resources.

• Personal Information Change form: Submit to Human Resources to begin the process.
• Anthem Blue Cross Change form: To add your new dependent(s) to your medical insurance plan.

• REMIF Enrollment form: To add your new dependent(s) to your dental, vision, and EAP plans.

Note the following:

• Changes to your health insurance plan(s) must be submitted to the insurance agencies within 30 days of the date of your declaration. If you do not add your new dependents within 30 days of your declaration. you will not be able to add them until our next Health Insurance Open Enrollment period.

• You will have three months to provide official documentation for your new dependents. If you do not provide the official documents within three months, your domestic partner and any other new dependents will be removed from your health insurance plan(s) and cannot be added again until the next Health Insurance Open Enrollment period.
• You should also check the beneficiaries listed for your life insurance, CalPERS, and 457/deferred compensation, if applicable, and make any changes you might want. You may also want to change your Power of Attorney for PERS.

11. I have other medical and dental coverage and want to waive the medical and dental insurance offered by the City. What do I do?

You may elect to “opt out” of the medical and dental plans completely. One may opt out either during open enrollment or within 60 days of a qualified life event. Please contact Human Resources to obtain required forms and more information.

Employees who “opt out” must provide evidence of other comparable coverage and receive a contribution from the City of $250 monthly. This contribution is fully taxable.

12. I have a flexible spending account (FSA) and I haven't used all of my election amount for this plan year. Will I lose it?

The City offers two types of flexible spending arrangement plans; both plans have a plan year beginning on July 1st and ending on June 30th. One plan is for qualified health expenses and the other plan is for qualified dependent care expenses.

Qualifying Dependent Care Expenses must be submitted by September 15th for the plan year that concluded the preceding June 30th in order to be eligible for reimbursement. Claims can be submitted on line at myflexonline.com. Forms for filing a claim by mail or fax can be found at this same web site. Any unused contributions will be forfeited.

For Health Expenses our Plan was recently changed to allow up to $500 of unused contributions to be carried over to the next plan year. To be applied against any given Plan year, claims must be submitted by September 15th for the plan year that concluded the preceding June 30th. If there is a remaining unused balance, up to $500 will be carried over to the next plan year. If the unused amount exceeds $500 the amount over $500 will be forfeited.