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Peralta BenefitsPlan Year July 1, 2020 – June 30, 2021

Important links

For BenefitBridge technical assistance only, please contact BenefitBridge Customer Care at 800.814.1862;

Mon – Fri, 8:00 AM – 5:00 PM, PST or email benefitbridge@keenan.com

For assistance with your benefits questions, please contact the District, Benefits office at 510.466.7229;

Mon – Fri, 8:30 AM – 5:00 PM, PST or email benefits@peralta.edu

Medical plans

Kaiser HMO Plans

2020-2021 Kaiser Senior Advantage Plans Summary of Benefits & Coverage

Universal Benefit Enrollment Form – Retiree & Exceptional Processing

*Retirees enrolling in a Kaiser Permanente Senior Advantage Plan must complete the Kaiser Permanente Senior Advantage Enrollment form (above) and mail to the address on the form. If you are changing your medical plan during open enrollment also complete the Universal Benefit Enrollment Form (above) and mail to the PCCD Benefits Office at the address on the form along with any required dependent documents if applicable. Remember to enclose a copy of the Kaiser Permanente Senior Advantage Form mailed directly to Kaiser

 

Universal Benefit Enrollment Form – Retiree & Exceptional Processing

Universal Benefit Enrollment Form – Retiree & Exceptional Processing

*Retirees enrolling in a Kaiser Permanente Senior Advantage Plan must complete the Kaiser Permanente Senior Advantage Enrollment form (above) and mail to the address on the form. If you are changing your medical plan during open enrollment also complete the Universal Benefit Enrollment Form (above) and mail to the PCCD Benefits Office at the address on the form along with any required dependent documents if applicable. Remember to enclose a copy of the Kaiser Permanente Senior Advantage Form mailed directly to Kaiser

Anthem PPO Traditional & PPO Lite
Self-funded Plans Administered by Trustmark

2020-2021 Summary of Benefits & Coverage

Universal Benefit Enrollment Form – Retiree & Exceptional Processing

*Retirees changing medical plans during open enrollment must complete the Universal Benefit Enrollment Form (above) and mail to the PCCD Benefits Office at the address on the form along with any required dependent documents if applicable.

CASH IN-LIEU OF MEDICAL & DENTAL BENEFITS FORM

If you are an active employee waiving medical and dental benefits please uploaded the completed form with all required insurance verifications during your BenefitBridge online enrollment.

Dental / Vision / District-paid insurance

Additional Documents

Employee Assistance Program (EAP) Administered by MHN
Flexible Spending Medical and Dependent Day Care Expenses under IRS Code 125

*Open enrollment occurs annually November 1-30 for the following plan year (January – December).

CBIZ Open Enrollment 2021 Presentation

Current year forms & Documents:

CBIZ FSA – Transition Guide

CBIZ FSA Handbook with Enrollment Form- 2021

Flexible Spending SPD: 2014-spd-003

CBIZ FSA Claim-form Plan Year 2021

CBIZ Direct-deposit-authorization

CBIZ FSA Change in Status or Termination Form

 

CBIZ CONTACT INFORMATION

EMAIL: cbizflex@cbiz.com

TELEPHONE: 1-925-956-0514

Pre-tax Commuter Expense under IRS Code 132

CBIZ Open Enrollment 2021 Presentation

The maximum amount you may contribute to each account cannot exceed the maximum amount specified in Code Section 132(f).

 The maximum amounts are:

 Parking Expenses $270/month

Transportation Expenses $270/month (Public transportation/vanpool)

CBIZ COMMUTER – Transition Guide

CBIZ Pre-Tax Commuter Handbook with Enrollment Form – 2021

Pre-Tax Commuter SPD: peralta-132-doc

CBIZ PRE-TAX COMMUTER (PARKING ONLY) Claim-form Plan Year 2021

*CBIZ debit card must be used for eligible transit expenses starting 1/1/2021.

CBIZ Direct-deposit-authorization

 

CBIZ CONTACT INFORMATION

EMAIL: cbizflex@cbiz.com

TELEPHONE: 1-925-956-0514

For BenefitBridge technical assistance only,
please contact BenefitBridge Customer Care at 800.814.1862
Mon – Fri, 8:00 AM – 5:00 PM, PST or email benefitberidge@keenan.com

For assistance with your benefits questions,
please contact the District Benefits Office at 510.466.7229
Mon – Fri, 8:30 AM – 5:00 PM, PST or email benefits@peralta.edu