2019 Retiree Benefits: Frequently Asked Questions

Click here to view, download or print a PDF of the following FAQs.

 

Open Enrollment

1. When is Open Enrollment and when are the new plans effective?

Open Enrollment will be from October 1 - October 18 this year and all elections will be effective January 1 - December 31, 2019.

2. Where can I get more information on the 2019 Benefits?

The 2019 Open Enrollment webpage slocounty.ca.gov/2019oe contains the most up to date information including valuable resources such as the 2019 Open Enrollment Employee & Retiree Brochure, plan documents and contact information for the carriers.

3. How do I complete open enrollment if I want to make changes this year?

Retirees have two options to complete enrollment:

  1. Call the SLO Retiree Enrollment Line at 1-855-230-0745 Ext. 4453
  2. If you are currently enrolled in County benefits you can also log on to BenXcel.net

4. How do I complete enrollment in dental and vision if I am not currently enrolled in any plans?

  1. If you are a County retiree that is currently not enrolled in any County benefits (medical, dental or vision), you may enroll in dental and/or vision benefits for the 2019 plan year by calling the SLO Retiree Enrollment Line at 1-855-230- 0745 Ext. 4453 to enroll over the phone.
  2. You may also contact the County for paper enrollment forms, please allow sufficient time for mailing. All paper forms must be received by October 18 at 5 PM.
  3. If you are not currently enrolled in any County benefits, you are unable to access the County's online enrollment system BenXcel. 

 

Online Enrollment

5. What is my BenXcel login ID?

BenXcel login instructions can be found here on our webpage. If you cannot remember your password, you can reset it at BenXcel.net by clicking the "Forgot Password?" button. If you are still having trouble logging in to BenXcel, contact BCC at 1-800-685-6100 for password or technical assistance.

6. How do I know if I completed my enrollment or if I did it correctly?

A personal confirmation statement is generated based on your current and future enrollment elections. You can access your confirmation statement anytime by logging into BenXcel.net. It is your responsibility to review your confirmation statement in detail to ensure you have enrolled in the correct plans and have included your dependents as you intended. You will be enrolled in your benefits based on your confirmation statement. You will not be able to change your enrollment elections until next open enrollment unless you experience a qualifying event. 

 

General

7. Do I have to provide eligibility documents for my dependents?

Eligibility documents such as a marriage or birth certificate are required for dependents you are adding to your insurance plans for the first time. You do not have to submit eligibility documentation for dependents that are already enrolled on your County insurance plans. For information on what documents are required, click here.

8. If I take no action, will my coverage automatically carry over from last year?

Yes, if you take no action your plan enrollment and dependents covered will automatically rollover to the following year. If you were impacted by a plan change, your plan will automatically rollover to the identified equivalent.

9. What is the County Contribution to my County medical plan in 2019?

In 2019, the County will contribute either $136 or $139 per month to the cost of your County medical plan. The amount you receive is based on your bargaining unit at retirement. The County information will display the full medical premium costs without the County Contribution. The County contribution amount will be applied toward your medical premium before your monthly pension deduction each month.

 

Medical

10. I received a notification that my plan name is changing to Anthem PPO Medicare, do I need to take action?

No, unless you would like to make a change to your enrollment or covered dependents, no action is required. For most, the biggest change is that plan benefits will be enhanced to include an improved hearing aid benefit. New medical ID cards will be mailed to you with the new plan name by December 31.

11. Are the medical or pharmacy provider networks changing?

No, the Anthem provider networks available will not be changing. Whether or not a provider chooses to accept an insurance network is the providers choice and is always subject to change. Always verify with your provider that they accept your insurance by providing them your Medicare and medical insurance ID cards.

12. Will I get a new Medical ID card?

Yes, because the County has added the plan names to the ID cards, all members who currently participate in the medical benefits will receive new ID cards prior to January 1st from Anthem.

  1. One ID card is issued to the subscriber and one to a spouse/domestic partner
  2. Two cards will be issued in the subscriber’s name for subscriber plus child(ren) enrollees
  3. ID cards with child dependent names can be requested by calling the member service number on the ID card

Login at Anthem.com to print a copy of your member ID card now or call Anthem at 1-800-967-3015 for any additional questions on ID cards. The County does not have access to Anthem Member ID numbers.

13. Will I get a new Pharmacy ID card?

  1. No, if you are currently enrolled in a medical plan, you will not receive a new pharmacy ID card. If you are enrolling in a medical plan for the first time or making plan changes then you will receive a new ID card prior to January 1st.
  2. Two ID cards are issued to the subscriber in the subscriber’s name only. No ID cards are issued with dependent names.
  3. Contact Express Scripts at 800-496-4165 to order a new ID card.   

14. I live out of state, do the County plans cover areas outside of California?

Yes, all medical plans have access to Anthem's Nationwide PPO network. Contact Anthem at 1-800-967-3015 to find an in-network provider in your area.

15. Am I covered by my medical insurance when I travel internationally?

If you are enrolled in an Anthem medical plan, you have access to emergency care while traveling internationally. For more information on covered services, please call Anthem's customer service number found on the back of your ID card or 1-800-967-3015.

16. What is Carrum Health and am I eligible for this benefit?

Carrum Health is a voluntary surgery benefit program that offers specific surgeries at Centers of Excellence with top-quality hospitals and surgeons for no out of pocket costs. This benefit is separate from, and in addition to, the benefits already provided under Anthem medical plans. This benefit is not administered by Anthem and must be accessed directly through Carrum Health or by contacting them at 888-855-7806. Eligible members include Early Retirees (Non-Medicare), COBRA participants and their dependents who are enrolled in PPO or EPO health plans. For more information on Carrum Health, please click here.

 

Medicare

17. How do the County Medicare plans work?

The County offers Coordination of Benefit (COB) plans that are designed to cover the costs that Medicare does not. Medicare is the primary payer and your Anthem plan is the secondary payer. Present both your Medicare ID card and Anthem ID card to your provider and always confirm that your provider accepts Medicare. Providers that do not accept Medicare are not covered even if they are in Anthem's network.

18. How do I know if my provider accepts Medicare?

Always be sure to ask your provider if they accept Medicare in addition to being in Anthem's network. When utilizing your County benefits Medicare is the primary payer and Anthem is the secondary payer. Present both your Medicare ID card and Anthem ID card to your provider. Under the County Medicare plans, providers that do not accept Medicare are not covered even if they are in Anthem's network.

19. Do the County's Medical plans include Medicare Part D Pharmacy benefit?

Yes, the County's Medicare plans include a Part D prescription benefit. Do not enroll in a separate Part D plan or your county medical plan will be terminated by the Centers for Medicare & Medicaid Services (CMS). For more information on your Medicare prescription coverage, please click here.

20. Myself or my dependent are turning 65 this year, how does this impact our County medical benefits?

Turning 65 is a Qualifying Event to transition to a County sponsored Medicare plan at a lower monthly premium for both the retiree and any enrolled dependents. To be eligible for a County Medicare plan, the member turning 65 must enroll in Part A & Part B through the Social Security Administration (SSA). About 60 - 90 days before the members 65th birthday, you will receive a Medicare enrollment packet from our third-party administrator, BCC. The enrollment packet will ask for you to select a new plan and provide your Medicare Part A & B effective dates and Health Insurance Claim Number (HICN) located on your Medicare card. If there are others enrolled on the plan, their plan will not change. This is only a qualifying event for a member to transition to a Medicare plan, no other changes are permitted. You must complete and postmark the enrollment form to BCC by your 65th birthday to either transition to a Medicare plan or to opt out of County medical coverage. Failure to complete and return this form will be considered opting out of County Medical and will result in termination of your non-Medicare medical plan at the end of the month following your 65th birthday. To review your County Medicare plan options and premiums, click here.

21. Will I get a new Anthem & Express Scripts ID card when I transition to Medicare?

Yes, you will receive news ID cards for both Anthem and Express Scripts once you transition to Medicare. Be sure to discard your old ID cards and use the news ones or you may be billed for services incorrectly.

22. I need Medicare advising, is there someone I can talk to?

Yes! We always encourage our retirees to reach out to the Health Insurance Counseling Advocacy Program (HICAP) sponsored by the Central Coast Commission for Senior Citizens. HICAP does not sell anything but provides free and unbiased information and counseling about Medicare so you can make informed decisions. You can visit their website or call them at 1-800-510-2020.

 

Billing & Claims

23. I have a claims question, what should I do?

Claims questions should first be addressed with your provider. Always verify that you are utilizing your newest ID card and that the provider has billed the correct group number and member ID. If your provider is having an issue verifying your eligibility they should contact Anthem directly to resolve any billing issues. When your provider bills Anthem an Explanation of Benefits (EOB) will be generated outlying the amount that you owe. If your provider bills you a different amount than what is on your EOB, contact your provider to resolve. If you believe there is an error on your EOB, contact Anthem.

24. I’m enrolled in Medicare & my provider billed me for my deductible, do I have one?

No, retirees on Medicare do not have a deductible for medical. Contact your provider and confirm they have billed Medicare primary and Anthem secondary. If they have, contact Anthem.

25. What is an EOB?

When your provider bills Anthem an Explanation of Benefits (EOB) will be generated outlying the amount that you owe. The EOB will also tell you how much your plan has covered. An EOB is not a bill. If your provider bills you a different amount than what is on your EOB, contact your provider to resolve. If you believe there is an error on your EOB, contact Anthem.

26. How Do I Get My EOB?

An EOB is automatically mailed to you from Anthem. You will not receive an EOB if you have elected for paperless EOBs, at which point you can view them on your Anthem portal. You will also not receive an EOB if the claim was processed and completely covered by your insurance because you will not owe anything out of pocket.

 

Dental & Vision

27. Am I able to make changes to my dental and vision insurance?

You may only enroll or drop dental and vision coverage annually during open enrollment. Certain dependent qualifying events may allow you to edit dependents on plans you are currently enrolled in, but those events are limited.

28. Will I get a new ID card for dental and vision?

No, Aetna and VSP do not issue ID cards. To utilize your benefits, provide the below group numbers with the subscriber’s social security number. Aetna Dental DMO, Group # 883524 VSP, Group #00105558

29. If I am on COBRA Delta Dental and it runs out, is that a qualifying event to elect Aetna outside of Open Enrollment?

No, if you are a County retiree that has elected to remain on Delta Dental through COBRA coverage, that benefit expires 18 months after your separation date. Losing COBRA coverage is not a Qualifying Event to elect Retiree Dental through Aetna. You are responsible to find your own dental coverage if there is a gap period from the time your COBRA benefit expires and open enrollment for the following plan year.