PLEASE NOTE: The links on this page open in a new window & the majority are PDFs.

Eligibility Information

Benefit Resource Center flyer

To be eligible to enroll in your employer’s benefit plans, you must be a full time W-2 employee working 30 or more hours a week for the company and satisfy the new hire probation period.

Please refer to the Probation Calendar below and contact the person responsible at your employer for your company benefits. Also refer to the enrollment guidelines in the next section.

Benefit Waiting Period 1st of the month after 60 days
2 Month Calendar for reference
(Anthem uses 1st of month after 2 months)

Enrollment Guidelines

Please read the Enrollment Guidelines to learn when you can come on the plan, add dependents and make other changes.

Health Plan Enrollment Guidelines

Premium Charts

Premium Chart Pak 12-2024

Page 1 – Monthly Premiums
Page 2 – Employer Monthly Allowance
Page 3 – Payroll Deductions – 26 pay periods
Page 4 – Tips
For Fed-COBRA add 2% to Monthly Premium Table

COBRA Center

Your Group is Subject to Federal COBRA

The Initial Notice should be provided to the employee AND spouse (if covered) within 90 days of becoming covered. One notice to the home is allowed if both live at the same address but it must be addressed to both parties.

Please contact your HR department for more information.

Initial Fed-COBRA Notice

Federal COBRA Qualifying Event Notice

Help & Support

PLAN DEPARTMENTS PHONE/MEMBER SERVICES PLAN/POLICY #
Anthem California HMO Members 1-800-627-8797 218775
Anthem California PPO Members 1-800-627-8797 218775
24/7 Registered Nurse Line 1-800-249-3617 218775
Anthem Rx Mail Program 1-866-297-1013 218775
Kaiser Member Services 1-800-464-4000 356920
John Hancock 401K Members 1-800-395-1113 93776
Wayco Insurance Services, Inc. (Broker) 1-951-699-6000 x10 john@wayco.com

Cafeteria Plan

Your Cafeteria “Section 125” Pre-Tax Premium plan allows payroll deductions to be taken “off the top line” before taxes are calculated ~ saving from 25% to 40% depending on your personal tax bracket.

Example of Cafeteria Plan Savings

Medical Plan

Life Insurance

BENEFIT SUMMARIES FORMS LIBRARY WEB SITE LINKS
Life Insurance Plan Highlights
(Coverage for Employee & Eligible Dependents)
Use same forms as in the Medical Plan section Anthem Website
Anthem Resource Advisor Program
(24×7 Support for emotional, legal and financial guidance during life’s challenging times.)
Life Beneficiary Form

Retirement Plan

BENEFIT SUMMARIES FORMS LIBRARY WEB SITE LINKS
About the Match Flyer 401k Enrollment Form John Hancock 401k Website
You will need to register and use your PIN.
401k Plan Highlights 401k Beneficiary Form
JH Online Tools and Info 401k Change Form
For enrollment (still need to print out the form and give to the employer) 401k Withdrawal Form
401k Hardship Withdrawal Form
Hancock Risk Quiz
Summary Plan Description SPD 401k Plan SPD
Please see your employer for enrollment kit
Roll Overs into this plan 401K “Boot Camp” Overview

Dental & Vision

BENEFIT SUMMARIES FORMS LIBRARY WEB SITE LINKS
(If you cover kids under your medical plan) Pediatric Dental/Vision is part of the Medical plans (see forms in Medical Plan Section above)
Pediatric Anthem Dental Info
Pediatric Anthem Vision Info
Pediatric Kaiser Dental Info
Pediatric Kaiser Vision (see summary in Medical Section above KP Gold HMO
Dental – Adults Info (Employer plan)
Vision – Adults enrolled in our Anthem Medical Plan have an annual eye exam covered in-network for $20 co-pay and $0 Co-pay with Kaiser.