Page 1

RETIREE EDITION FY21


VR R Benefi Benefits fits Fair Flye Flyer Flyer.pdf er.pdf pdf 1 5/13/2 5/13/2020 2020 3:09:21 PM PM

SAN DIEGO

PEBA

2020

VIRTUAL

BENEFITS FAIR Join us ONLINE for our first ever VIRTUAL BENEFITS FAIR: •Attend Live Events •Download Forms & Brochures

•Chat 1-on-1 with Representatives •Visit Virtual Booths

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JUNE 1ST & 2ND 9am - 5pm

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TO LEARN MORE & REGISTER GO TO:

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WWW.SDPEBA.ORG/RETIREEFAIR Exhibitors: 127 Retiree Association American Specialty Health Identity Guard Best Health CalCoast CalPERS CIGNA CIGNA-SCAN Delta Dental

CONTACT US! Phone: Text: Fax: Email:

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888-315-8027 619-547-1600 619-431-3078 info@sdpeba.org

Kaiser Liberty Mutual Met Life Dental Met Life Legal National University Nationwide Pet Purchasing Power Risk Management San Diego Blood Bank

Website: Facebook: Twitter: Address:

Sharp Community Medical SDCERS SDPEBA CSDREA Sharp Health Plan Sharp Reese Steely VSP

www.sdpeba.org facebook.com/SDPEBA @SDPEBA 9620 Chesapeake Drive, Ste 104 San Diego, CA 92123


Retiree TTable able of Contents.pdf Contents pdf 1 5/13/2 5/13/2020 5/13 2020 0 3:11:10 PM PM

SAN DIEGO

PEBA TABLE OF CONTENTS

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Virtual Fair Table of Contents Letter from SDPEBA Enrollment Notes Benefit Changes Rate Sheet About SDPEBA Sharp Healthcare Sharp Life Cycle Find a Provider MetLife Dental VSP Vision Plan MetLife Legal Plans Nationwide Pet Insurance Identity Guard Liberty Mutual Purchasing Power Online Registration SDPEBA FAQs Contact Page

1 2 3 4 5 6 7-8 9-16 17 18 19-24 25-26 27-28 29-30 31-32 33-34 35 36 37 38

IMPORTANT: This magazine contains brief descriptions of various benefits offered by SDPEBA. It is recommended that you review the official plan documents for a detailed description of coverage, benefits, copays, limitations, and exclusions. Should there be a disagreement between this magazine and the official plan documents governing the program, or any ambiguity/errors in the magazine, the official plan documents will take/have precedence. PRIVACY: Your security and privacy is important to us. The mailing of this magazine was handled through your participating association and your contact information was not shared with any of the providers in this magazine.

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Letter fr from Manager.pdf 1 5/11/2 5/11/2020 2020 5:20:25 5:20:25 PM PM

After nearly 11 years of service in the Flexible Benefits division of Risk Management, I am very excited to join the SDPEBA team! I have always enjoyed serving City employees and retirees and am honored to be able to continue to do so as the Benefits Manager for SDPEBA. This year, open enrollment will be very different from any other open enrollment we have ever experienced. With the limitations of social distancing in place due to the COVID-19 pandemic, all scheduled benefits fairs have been cancelled. Our goal is to help retirees get the information and support they need to make important decisions regarding their benefits - and this year is no different. SDPEBA has been working extensively to find ways to provide an Open Enrollment experience that will keep everyone safe while still providing the high-quality support and service you deserve. And as a result, we are very excited to share with you what you can expect for FY21:

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• SDPEBA will be hosting a Virtual Benefits Fair (VBF) which will allow you to gather information and interact with the benefit providers safely from your home. • During the VBF there will be educational sessions provided from each medical plan (Sharp, Kaiser, and CIGNA), as well as other plans and programs. • A NEW identity protection program call Identity Guard is being offered to protect you and your family from identity theft, cyber bullying, safeguard your devices and more! • To help streamline and improve accuracy of enrollments, you can now enroll for Dental, Vision, MetLife Legal, and Identity Guard online via https://enroll.sdpeba.org.

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Please know that SDPEBA’s commitment to serving goes well beyond open enrollment. Our team will follow-up with every retiree who signs up for a SDPEBA plan to verify that your cards have been issued/received, make sure you know how to access services, as well as let you know that “We got you” if you need any additional assistance or support with your benefits throughout the year. As much as we appreciate your business when you enroll into one of our high-quality plan offerings, our hope is to earn your business by showing how much we care! Please be sure to visit our website at www.sdpeba.org and sign up to get on our email list. This is a great way to receive announcements about new products or upcoming events. Although a virtual experience will never compare to the real thing, I just want to “Thank you” for joining us to make this open enrollment and FY21 the best experience that we can- TOGETHER! Take care and Be safe! Sincerely,

Michael Williams SDPEBA Benefits Manager 3


Open Enrollment Notes.pdf es.pdf 1 5 5/11/2020 /11/2 11/2020 2020 7:48:18 7:48:18 PM

OPEN ENROLLMENT NOTES 1.

All San Diego City retirees are eligible for the Sharp Health Plans, membersip is not required.

2. To enroll for SDPEBA benefits (excluding Sharp Health PLans) you must be a member of

one of the participating associations - AFSCME 127 Retirees, MEA, POA, REA, or RFPA.

3. If you are not a member of one of the participating associations, you can join as you enroll for benefits. Benefits and membership enrollment are done on the same form.

4.

SDPEBA enrollment in dental, vision, legal, and identity protection will be done online at https://enroll.sdpeba.org. If you are already enrolled, we encourage you to complete the online enrollment to confirm your benefits. If you are not able to go online, or if you are having issues enrolling online, please call our office at 888-315-8027.

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5. If you want to add, change, or cancel Sharp Health Plan (either through Medicare or our

Non-Medicare plan) you will need to submit a Sharp enrollment form. There are separate forms for the Medicare and Non-Medicare plans.

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6. If you are currently enrolled in a City retiree plan such as Kaiser, CIGNA, or SCAN and want to switch to a Sharp Health retiree plan you must: a. complete a Sharp enrollment form and send to SDPEBA b. notify SDCERS that you are cancelling your old plan.

7.

SDPEBA forms and plan brochures can be downloaded online at www.sdpeba.org or you can call our office at 888-315-8027 to have them mailed to you.

8.

If you are unable to access the website, please email info@sdpeba.org or call 888-315-8027 to get more information or to have brochures or forms mailed to you.

9. If you have questions about Kaiser, CIGNA, SCAN, United Concordia Dental, or your

healthcare allotment, please call SDCERS at 800-774-4977. SDPEBA staff are unable to answer questions about those plans and cannot provide you with your current allotment amount. SDCERS has partnered with CareCounsel to help retirees with questions and can be reached at 888-227-3334.

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Benefit Benefi fit Changes.pdf 1 5/12 5/12/2020 /2 2020 2 020 11:36:27 AM

SAN DIEGO

PEBA

BENEFIT CHANGES FOR SDPEBA PLANS ONLY

SHARP HEALTH PLAN - NON MEDICARE CLASSIC -

3.8% Increase/Name Change

The Early Retiree plan is now named the Non-Medicare Classic Plan which is our most comprehensive plan, with the lowest copays and access to the largest network of providers throughout San Diego and Southern Riverside Counties. This plan includes valuable extras, such as accupuncture/chiropractic services, hearing aid, and vision coverage.

SHARP HEALTH PLAN - NON-MEDICARE SELECT NEW PLAN

The Non-Medicare Select Plan balances the cost of your monthly premium alongside your copays. This year, we’ve even lowered the copays for office visits and other services. Note: Rady Children’s Health Network (formerly Children’s Physicians Medical Group) does not participate in the Select Plan/Premier Network.

SHARP ADVANTAGE PLAN (MEDICARE) 0% Increase | No Plan Changes

Sharp Direct Advantage is the Sharp option for Medicare Retirees. This comprehensive plan is a Medicare Advantage Plan, which combines Medicare Part A, Part B, and Part D, along with extra benefits, to ensure comprehensive coverage. Note: If your spouse/dependent is not eligible for Medicare, then he/she will need to review the Non-Medicare Plan Options as their benefits & copays may differ than the Medicare plan.

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METLIFE DENTAL HMO - 0% Increase | No Plan Changes

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METLIFE DENTAL PPO - 0% Increase

The plan year maximum will increase $250 from $1,500 to $1,750.

VSP VISION - 0% Increase | No Plan Changes

Note: This VSP Vision is a 2-pair plan and very different than the one offered directly through SDCERS, we encourage you to look at both plans.

METLIFE LEGAL

(FORMERLY HYATT LEGAL)

- 0% Increase | No Plan Changes

IDENTITY GUARD - NEW IDENTITY PROTECTION CARRIER SDPEBA will now offer Identity Guard as our identity protection plan.

PLEASE VISIT WWW.SDPEBA.ORG FOR SPECIFIC PLAN DOCUMENTS If you have questions about Kaiser, CIGNA, SCAN, Delta Dental, or your healthcare allotment, please call SDCERS at 800-774-4977. IMPORTANT: It is recommended that you review the official plan documents for a detailed description of coverage, benefits, copays, limitations and exclusions. Should there be a disagreement between this document and the official plan documents governing the program, or any ambiguity/errors in this document, magazine, or website, the official plan documents will take precedence. 5


Rate Sheet.pdf 1 5/11/2 5/11/2020 2020 7:48:00 48:00 PM

SAN DIEGO

PEBA

FY21 RATE SHEET

MEDICAL

(Rates listed below are monthly)

SHARP Non-Medicare

Retiree Only Retiree +1 Dep w/Medicare Retiree +1 Dep w/o Medicare Retiree +1 Dep w/Medicare & 1 w/out Medicare Retiree +2 or more Dep w/o Medicare C

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SHARP ADVANTAGE Medicare Retiree Only Retiree +1 Dep w/Medicare Retiree +1 Dep w/o Medicare Retiree +1 Dep w/Medicare & 1 w/out Medicare Retiree +2 or more Dep w/o Medicare

DENTAL

MET LIFE DENTAL HMO

Retiree Only Retiree & Spouse/DP Retiree & Child(ren) Family

(0% increase)

$21.00 $40.90 $40.90 $58.46

VISION

VSP VISION PLAN

Retiree Only Retiree & Spouse/DP Retiree & Child(ren) Family

Classic Plan

Select Plan

$1,378.16 $1,579.16 $2,756.32 $2,957.32 $4,134.48

$1,187.97 $1,388.97 $2,375.95 $2,576.94 $3,563.92

Classic Plan

Select Plan

$201.00 $402.00 $1,579.16 $1,780.16 $2,957.32

$201.00 $402.00 $1,388.98 $1,589.97 $2,576.95

(3.8% increase)

(0-3.5% increase)

MET LIFE DENTAL PPO

(0% increase)

(0% increase)

(0% increase)

Retiree Only Retiree & Spouse/DP Retiree & Child(ren) Family

$66.50 $124.50 $143.00 $208.50

LEGAL (0% increase)

$18.50 $32.50 $32.50 $53.50

MET LIFE LEGAL PLAN

(0% increase)

Retiree Only Retiree & Spouse/DP Retiree & Child(ren) Family

$23.40 $23.40 $23.40 $23.40

For information and details on SDPEBA sponsored plans including: Sharp, MetLife Dental, VSP Vision, MetLife Legal Plan, Purchasing Power, Aflac, UNUM Long Term Care, Life Insurance, Nationwide Pet Insurance, Identity Guard and Liberty Mutual Auto & Home Insurance visit:

Website www.SDPEBA.org

Phone 888-315-8027.

If you have questions about Kaiser, CIGNA, SCAN, Delta Dental, or your healthcare allotment, please call SDCERS at 800-774-4977. 6


What is SDPEBA.pdf 1 5/11/2 5/11/2020 2020 7:44:51 7:44:51 PM

WHAT IS SDPEBA? SDPEBA stands for the San Diego Public Employee Benefit Association and is a partnership between AFSCME 127, AFSCME 127 Retirees, the City of San Diego Retired Employees’ Association (REA), the Retired Fire and Police Association (RFPA), and the San Diego Municipal Employees Association (MEA). SDPEBA was created to provide benefits to the members of MEA, REA, and RFPA. By pooling their combined memberships, SDPEBA can access group benefits and provide superior customer service while working to keep costs down. SDPEBA is here to help! We are committed to providing quality customer service all year round to any retiree who enrolls in any of our sponsored plans. Below is a list of the services we provide.

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ENROLLMENT

PROVIDER REVIEW

Signing up for benefits can be confusing, but our team is here to help retirees with enrollment questions via phone, email, text, or in person. We participate in various SDCERS events to provide information, answer questions, and assist with enrollment paperwork. We also handle all the paperwork to process the benefits with the insurance carriers and to start deductions with SDCERS. Our goal is to make sure everyone is properly in the system on their effective date.

Throughout the year we track questions and issues about our providers and obtain feedback from retirees about how well our plans are performing. We then review this information regularly with our providers to identify trends or specific problems. This collaboration allows us to proactively work to make improvements to our benefit programs and the customer service experience throughout the year.

CASE MANAGEMENT

EDUCATION

In the event you experience a problem with one of SDPEBA’s sponsored benefits, our team will advocate on your behalf to address your issue. We will work diligently to make sure the insurance providers are following our contracts and providing the best possible service to our enrollees.

Signing up for benefits is just the start, getting the most out of them is key. Throughout the year we publish articles on the SDPEBA website that help educate retirees about their benefits and how to use them. We also work to educate people on wellness and encourage them to participate in our Best Health Wellness program.

SUPPORT STAFF

24/7 SELF SUPPORT

One of the most important things we do at SDPEBA is providing support for the benefits we offer. We handle thousands of calls and emails throughout the year from retirees who need assistance with their benefits. It can be a simple call about an ID card, or a complex call about assistance with a referral. Every call is important to us!

SDPEBA has a 24/7 Self Support site at https://support.sdpeba.org. This site is built to allow retirees to access information through an automated system outside of our normal office hours of Monday through Friday, 9am to 5pm. The site is updated regularly with answers to many of the questions asked by retirees. If the answer isn’t there, the site allows you to submit a question and our team will respond the next business day.

Questions? Contact us! Phone: Text: Fax: General Info: Support:

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888-315-8027 619-547-1600 619-431-3078 info@sdpeba.org support@sdpeba.org

Website: Facebook: Twitter: Address:

www.sdpeba.org facebook.com/SDPEBA @SDPEBA 9620 Chesapeake Drive, Ste 104 San Diego, CA 92123


Team Page v2.pdf 1 5 5/12/2020 /12/2 12/2020 2020 1:59:04 1:59:04 PM PM

OUR TEAM Michael Williams Benefits Manager

michael@sdpeba.org

Jaycie Matthews

I’m excited to be part of this amazing and dynamic team, and to help deliver the SDPEBA promise of high quality affordable benefits and top notch support!”

Jonathan Hayes

Claims Representative

General Manager

jaycie@sdpeba.org

jonathan@sdpeba.org

CA Lic #0C16155

CA Lic #0L7183

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Kathryn Hayes

Katie Jones

Claims Representative

Claims Representative CA Lic #4027507

CA Lic #0E72088

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katie@sdpeba.org

kathryn@sdpeba.org

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Portia Myers

Robbie Chasse

Claims Representative

Operations Manager

portia@sdpeba.org

CA Lic #0N04341

robbie@sdpeba.org

Will Stover

Yesi Miranda

Benefits Specialist

Claims Representative

will@sdpeba.org

yesi@sdpeba.org

CA Lic #0E11576

CA Lic #0L67805

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Sharp1.pdf 1 5/11/2 5/11/2020 2020 8:28:56 :56 PM

As par artt of the h Sharp HealthCare fa family y, we provide direct access to The Sharp Experience, fro fr om hea ealt lth insurance to healtth care re.. We believe San Diegans deserve more, so our 0 GL 0H G FD FDUH$GYDQWDJHDQGHDUO\ \ UHW HWLU LUHH HH SOD DQVDUHGHVLJQHGVSHFLȴFDOO\WRGRMXVWWKDW

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Heal alth h ins nsur uran a ce by Sa an Di D egans, forr Sa fo San n Dieganss

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Simple Easy to enroll with personalized support

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Sharp Health Plan | sharphealthplan.com/SDPEBA


Sharp2.pdf 1 5/11/2 5/11/2020 2020 0 8:29:40 8:29:40 PM

Elite-rated medical groups :LWKWKH6KDUS'LUHFW$GYDQWDJH1HWZRUN\RXȇOOČ´QGDIDPLO\RISURYLGHUVFORVHWRZKHUH\RXOLYHDQG I spend time. Our network includes Sharp Rees-Stealy Medical Group and Sharp Community Medical g possible p rating g for Standards of ExcellenceTM, Group (SCMG), both awarded “Eliteâ€? status,1 the highest in addition to our regional partner, Greater Tri Cities IPA. Providers are located throughout San Diego &RXQW\ \VRQRPDWWHUZKHUH\RXDUHIURP&KXOD9LVWDWR(O&DMRQWR'HO0DUZHȇYHJRW\RXFRYHUHG

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13 Hospitals*

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10 Medical Groups*

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45+ Urgent Care Centers*

450+ Pharmacies*

370+ Vision Providerrs

MinuteClinicsÂŽ Nattionwid de

Recipiients of “Elite� status in the 2019 Nattion ional Sttanda dard rds of rds Excellence survey by America’s Physician Gro oupss. * This only applies to the Sharp Direct Adva va anta age netwo twor ork. k. 1

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Sharp3.pdf 1 5/11/2 5/11/2020 2020 0 8:30:08 PM

Get the care you as soon as you n After-Hours Nurse Advice Registered nurses are available through Sharp Nurse ConnectionŽ after hours DQGRQZHHNHQGV7KH\FDQWDONZLWK\RXDERXWDQLOOQHVVRULQMXU\KHOS\RX decide where to seek care and provide advice on any of your health concerns. 5 p.m. – 8 a.m., Monday to Friday, and 24 hours on weekends 1-855-562-8853 (TTY / TDD users call 711), select the option to speak with a nurse

Video and phone visits If you have a medical concern or need a follow-up appointment — and you'd like WRVDYHDWULSWRWKHGRFWRU VRÉ?FHČƒDYLGHRRUSKRQHYLVLWPLJKWEHWKHLGHDO option. Plus, you'll be able to have your appointment from wherever is most convenient for you.1

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Call your PCP or visit sharpmedicareadvantage.com/videoandphonevisits

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MinuteClinicÂŽ

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MinuteClinic is the walk-in medical clinic located inside select CVS PharmacyÂŽ stores. MinuteClinic provides convenient access to basic care without an appointment.2

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sharpmedicareadvantage.com/minuteclinic

Emergency Travel Services When faced with a medical emergency while traveling 100 miles or more away from home or in another country, we connect you to doctors, hospitals, pharmacies and other services.3 sharpmedicareadvantage.com/travel

COVID-19, Stay informed! To access the latest information regarding how to access the care you need while staying safe, we invite you to visit our dedica ated COVID-19 webpage. sharpmedicareadvantage.com/covid19

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Sharp Health Plan | sharphealthplan.com/SDPEBA


Sharp4.pdf 1 5/11/2 5/11/2020 2020 8:30:40 :30:40 PM

No-cost wellness program Best Health is a comprehensive wellness program available to all members at no H[WUDFRVW2Î?HULQJUREXVWRQOLQHZHOOQHVVWRROVLQWHUDFWLYHOHDUQLQJPRGXOHV one-on-one health coaching and more, Best Health provides resources you can use to reach your health goals. Visit yourbesthealth.com to learn more.

Personal health coaching • Get free personalized, one-on-one coaching in a sixweek, phone based program designed to supportt yo you in becoming and staying your he heal alth thie iest stt. • 'HȴQH\RXUSHUVRQDOZHOOQH HVV JRDOVDQG G FR RFU FUHD UHDWH DWH D health action plan. • Make positive changes during weekly 30-minute sessionss ZLWKRXU1DWLRQDOO\%RDUG&HUWLȴHG+HDOWK&RDFKHV

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• Access all the Best Health online tools from your mobile device. • Complete your Wellness Assessment and rece eiv ve customized recommendations. • Connect a variety of compatible physical activity trackers like Apple Health, Fitbit, Garmin and more.

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Online learning modules • Learn about stress-management, healthy hy y eating, sleep, emotional health, exercise and more on the Best Health website or app p. • Engage in a variety of interactive acttiv ivit itiies to it increase your health IQ.

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Select doctors offer this service.2 MinuteClinic does not tre reat all med diccal al con o diiti tion o s, s, EXWGRHVSURYLGHEDVLFFDUHIRUPLQRULOOQHVVHVDQGLQMXULHV HV < <RXU RX XUVK UVK VKDU DUH RI WKH KH FRV R W for a MinuteClinic visit is equal to what you pa pay fo forr an urgen nt ca care r vissit re it. t Th Ther h re is is no 3 e available to o assist you 24 4 hours a day, copayment for flu vaccinations They are seven days a week. Be sure to state you u arre a Sh S arp Heal He ealth t Plan member and d use e the Sharp reference number: 01-AA-SH HP P--09 0907 73. 3 12


Sharp5.pdf 1 5/11/2 5/11/2020 2020 0 8:31:07 PM PM

Medicare-eligible plan information Eligibility requirements for Medicare retirees %HD0HGLFDUHEHQHȴFLDU\ZLWK3DUW$DQGHQUROOHGLQ3DUW% <RXPXVWFRQWLQXH to pay your Medicare Part B premium.) Be a City of San Diego retiree or that person's Medicare-eligible spouse or dependents. Membership in MEA, REA, RFPA or SDPEBA is not UHTXLUHGWRMRLQ6KDUS'LUHFW$GYDQWDJH Be a resident of San Diego County. (Medicare product is not available in South Riverside county.) Please Note: If your spouse/dependent is not eligible for Medicare, then he/she will need to review the 1RQ0HGLFDUH(DUO\5HWLUHH3ODQ2SWLRQVDVWKHLUEHQHȴWV FRSD\VPD\GL΍HUIURPWKH0HGLFDUHSODQ

0HGLFDUHEHQHȴWVDWDJODQFH*

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Sharp Direct Advantage Network

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6KDUS'LUHFW$GYDQWDJH +02 &LW\RI6DQ'LHJR5HWLUHH3ODQ%HQHȴWV

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Monthly Plan Premium

$201

Out-of-Pocket Maximum (medical)

$1,500

Primary Care Physician Visit

$10

Specialist Physician Visit

$10

Urgently Needed Services

$10

Emergency Room

$50

Inpatient Hospital Care

$0 per day

Outpatient Hospital Care

$50

Skilled Nursing Facility

$0 per day for days 1-100

Durable Medical Equipment

$0

Retail Prescriptions (up to 30 days) 1

$10 / $10 / $20 / $20 / 25% / $0

2

Mail-Order Prescriptions (up to 90 days) 1

2

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Lab Services

$0

X-rays

$0

Diagnostic Radiology Services (such as MRIs, CT scans)

$0

* This information is not a complete description of benefits. Contact the plan for more information. You must continue to pay your Medicare Part B premium. 1 City of San Diego retiree Medicare members have no coverage gap (also called "donut hole"). 2 Drug Tiers: Preferred Generic / Generic / Preferred Brand / Non-preferred / Specialty / Select Care 13

Sharp Health Plan | sharphealthplan.com/SDPEBA


Sharp6.pdf 1 5/11/2 5/11/2020 2020 8:31:2 8:31:25 :31:25 5 PM PM

Medicare-eligible retirees

Sharp Direct Advantage is a Part C Plan Our Medicare Advantage plan includes prescription drug cov vera age. Part A + Part B + Part D + ([WUD%HQHȴWV = Our Part C Plan

([WUDEHQHȴWV* Acupuncture and chiropractic care Up to 30 combined acupuncture and/orr y chiropractic visits per year for $10 copay C

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)UHHȴWQHVV UHVRXUFHV • Participating clubs include 24 Hour Fitness, Curves, Jazzercise, LA Fitness and more • $WKRPHȴWQHVVRSWLRQVDYDLODEOH

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Vision • $20 annual routine eye exam m • $130 maximum allowance fo or fra ra ames or contacts every two years

Hearing aids $1,000 maximum allowance eve ery y 3 years

We're here to help Contact Sharp Health Plan's dedicated Med dica care Customer ca Care Team at 1-855-562-8853 (TTY/TDD: 71 11)).

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Sharp7.pdf 1 5/11/2 5/11/2020 2020 8:31:50 0 PM

ation Eligibility requirementts for non-Medicare retiree es Be a City of San Diego retiree orr a spouse and / or dependent of that persson. Live in the Sharp Health Plan se ervice area (San Diego and southern Riverside counties). Please Note: Membership in MEA, RE EA, RFPA or SDPEBA is not required. C

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Two plan options

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$OO6KDUS+HDOWK3ODQ+02RSWLRQVRÎ? Î?HUH[WHQVLYH medical coverage. Covered services always LQFOXGHGRFWRURÉ?FHYLVLWVKRVSLWDOVWWD\VVXUJHU\ outpatient procedures, periodic immu unizations, phys ph y ical exams, prescription drugs an ys nd more. Ch Ch hoo oo o ose the he e pla lan n th that at mee eets your need ds and budget.

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We're here to hellp Cont Co nta nt act Sh act ac Sharp Sha rp He Heal alth th Plan' n'ss dedicated Early Retiree C stomer Care Team at 1-888-840-4747 Cu 7 (TTY/TDD:711).

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Sharp Health Plan | sharphealthplan.com/SDPEBA


Sharp8.pdf 1 5 5/11/2020 /11/2 11/2020 2020 8:32:07 PM PM

Early retirees

(DUO\UHWLUHHEHQHČ´WVDWDJODQFH

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Choice Network

Premier Network

Early Retiree Classic Plan

NEW! Early Retiree Select Plan

Plan Medical Groups

Sharp Community Medical Group (SCMG), Sharp Rees-Stealy, Rady Childrenâ&#x20AC;&#x2122;s Health Network/CPMG, Greater Tri Cities IPA, Primary Care Associates Medical Group

Sharp Community Medical Group (SCMG), Sharp Rees-Stealy

Calendar Year Medical Deductible

None

None

Calendar Year Out-of-Pocket Maximum

$1,5001 per individual / $3,0001 per family

$3,0001 per individual / $6,0001 per family

Preventive Care Visit

$0

$0

Primary Care Physician Visit

$20

$20

Specialist Physician Visit

$20

$30

Urgent Care Services

$20

$30

Emergency Room Services

$75

$100

Outpatient Surgery

$0 per procedure

15% coinsurance2

Inpatient Hospital Services

$100 per admission

$500 per admission

Retail Prescriptions (up to a 30-day supply)

$15 / $30 / $50

$20 / $354 / $704

Mail-Order Prescriptions* (up to a 90-day supply)3

$30 / $60 / $100

$40 / $704 / $1404

Acupuncture and chiropractic care

$15, 40 combined visits

Discounts available through the wellness program

Hearing aids (every 36 months)

$1,000 allowance

N/A

Routine eye exam (every 12 months)

$0

N/A

Not all SCMG providers are included in the Premier Network.

*

Please refer to your y plan p documents for complete p information. *Drug g Tiers: Preferred Generic / Preferred Brand / Non-preferred. 1Copayments for supplemental benefits (assisted reproductive technologies, g chiropractic p services, acupuncture, p vision and hearing aids) do not apply to the annual out-of-pocket maximum. 2 Of contracted rates. 3 Save money on maintenance medications. Please visit sharphealthplan.com/mailorder for more information. 4 $150 brand deductible Sharp p Health Plan is an HMO with a Medicare contract. Enrollment with Sharp p Health Plan depends p on contract renewal. ATTENTION: If you y do not speak p English, g , language g g assistance services,, free of charge, g are available to you. y Call 1-855-562-8853 (TTY/TDD: 711). ATENCIĂ&#x201C;N: si habla espaĂąol, p tiene a su disposiciĂłn servicios gratuitos de asistencia lingßística. Llame 1-855-562-8853 (TTY/TDD: 711). Sharp p Health Plan complies p with applicable pp Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. +B%HQHČ´WV6'3(%$

16


City of San Diiego Employees City of San Diiego Employees

* $OORIRXUSODQVR΍HUGLUHFWDFFHVVWRRXUHOLWHUDWHG $OORIRXUSODQVR΍HUGLUHFWDFFHVVWRRXUHOLWHUDWHG*FDUHDQG7KH6KDUS([SHULHQFH FDUHDQG7KH6KDUS([SHULHQFH®®7KHEHVW SODQIRU\RXLVRQHWKDWEDODQFHV\RXUQHHGVDQGEXGJHWEDVHGRQ\RXUFLUFXPVWDQFHVDQGDJH SODQIRU\RXLVRQHWKDWEDODQFHV\RXUQHHGVDQGEXGJHWEDVHGRQ\RXUFLUFXPVWDQFHVDQGDJH Visit sharphealthplan.com/SDPEBAtotolearn learnmore. more. Visit sharphealthplan.com/SDPEBA

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Find a Provider.pdf 1 5/11/2 5/11/2020 2020 7:48:51 48:51 PM

FIND A PROVIDER Sharp Non-Medicare Plan Choice Network

1. Go to www.sharphealthplan.com/findadoctor 2. Choose the Choice network from the drop-down. 3. Enter your zip code and type of provider to narrow your search. Press Search Providers.

Sharp Non-Medicare Select Plan Premier Network

1. Go to www.sharphealthplan.com/findadoctor 2. Choose the Premier network from the drop-down. 3. Enter your zip code and type of provider to narrow your search. Press Search Providers

Sharp Direct Advantage (Medicare) Plan - Sharp Advantage Network

1. Go to www.sharphealthplan.com/findadoctor 2. Choose the Sharp Advantage network from the drop-down. 3. Enter your zip code and type of provider to narrow your search. Press Search Providers

Dental HMO

1. Go to www.metlife.com 2. At top of page under Support, click Find a Dentist. 3. At next page under “Your Network” select Dental HMO/Managed Care. 4. Enter zip code or name of Dentist or Practice Name then click Find. 5. Select plan MET100 then click GO

Dental PPO

1. Go to www.metlife.com 2. At top of page under Support, click Find a Dentist. 3. At next page under “Your Network” select PDP Plus. 4. Enter zip code or name of Dentist or Practice name then click Find.

1. Go to www.vsp.com 2. Under “Find a VSP Doctor” enter your zip code and click “Search”. 3. The next screen will provide you with a list of providers and the ability to refine your search. SDPEBA is on the Choice Network.

To find a provider for CIGNA, Delta Dental, or Kaiser, please consult the plan brochures available at www.sdcers.org 18


Dental Insurance

Why is having a good dental plan so important? Because keeping a healthy smile can be important to maintaining overall health.

Metropolitan Life Insurance Company | 200 Park Avenue | New York, NY 10166 L0420002750[exp0421][All States][DC,GU,MP,PR,VI]

19

ADF# D2062.19

Š 2020 MetLife Services and Solutions, LLC


Dental Insurance

Maintaining good oral health matters Staying on top of your care is the key to preventing costly problems that can add up. Plus, going to the dentist regularly can help prevent problems that have been linked to stroke or heart disease.1 Visits to the dentist can be expensive. From preventive care major services, dental insurance can be a smart way to help protect your smile and your pocketbook.

Having dental coverage makes it easier to visit the dentist and can help lower your costs.2 You get support to keep up with dental cleanings and other preventive care that can help you avoid costly problems and live healthier. Now that’s something to smile about.

Regular visits to the dentist are key to having a healthy smile.3

Smiles are free, but they are worth a lot Staying on top of your dental care is the key to preventing costly problems that can add up.

Two valuable plan options for San Diego Public Employee Benefit Association (SDPEBA) members •

Dental PPO

Dental HMO/Managed Care

1. American Dental Association; Dentists: Doctors of Oral Health, www.ada.org/en/about-the-ada/dentists-doctors-of-oral-health. Accessed April 2020. 2. Savings from enrolling in a dental benefits plan will depend on various factors, including the cost of the plan, how often members visit the dentist and the cost of services rendered. Office visit co-payment may apply. Please refer to your schedule of benefits. 3. American Dental Association; Your Guide to Finding and Paying for Dental Care, http://www.mouthhealthy.org/en/dental-care-concerns/paying-for-dental-care. Accessed April 2020.

Group dental insurance policies featuring the Preferred Dentist Program are underwritten by Metropolitan Life Insurance Company, New York, NY 10166. Dental Managed Care plan benefits are provided by Metropolitan Life Insurance Company, a New York corporation, in NY. Dental HMO plan benefits are provided by: SafeGuard Health Plans, Inc. a California corporation, in CA; SafeGuard Health Plans, Inc. a Florida corporation, in FL; SafeGuard Health Plans, Inc., a Texas corporation, in TX; and MetLife Health Plans, Inc., a Delaware corporation, and Metropolitan Life Insurance Company, a New York corporation, in NJ. The Dental HMO/Managed Care companies are part of the MetLife family of companies. “DHMO” is used to refer to product designs that may differ by state of residence of the enrollee, including but not limited to: “Specialized Health Care Service Plans” in California; “Prepaid Limited Health Service Organizations” as described in Chapter 636 of the Florida statutes in Florida; “Single Service Health Maintenance Organizations” in Texas; and “Dental Plan Organizations” as described in the Dental Plan Organization Act in New Jersey.

20


Dental Insurance

Comparing your choice of plans The information below compares the two plan options to help you make a more informed decision. Please refer to the enrollment materials for complete details. Dental PPO • •

Dental HMO/Managed Care

Flexibility to choose any licensed dentist, in or out of the network4 In-network dentists have agreed to MetLife’s negotiated fees for covered services, which are typically 30–45% below the average charge for the same or similar services in the same geographic area5 No paperwork, in- or out-of-network, if your dentist submits your claims for you Features

Preferred Dentist Program (PPO)

Broad network of carefully screened general dentists and specialists who provide quality dental care at reduced cost At time of enrollment, pre-select a dentist who participates in the network No waiting periods, claim forms, deductibles or annual maximums

Dental HMO/Managed Care Plan

Choice of Dentists

You have the flexibility to choose any licensed dentist, in or out of the network, and still receive benefits. Your costs may be higher when you go to an out-ofnetwork dentist.

This plan requires you to pre-select a dentist who participates in the network in order to receive benefits. Each enrolled family member may select a different participating dentist, and has the ability to change dentists up to one time each month.

Specialty Care

No referral needed for specialty care.

Your selected participating dentist will provide you with the name of a network specialist. Just call that specialist to schedule your appointment. No pre-authorization is required.6 Any co-payment for services is listed on your plan’s Schedule of Benefits. This co-payment applies whether the services are provided by your selected participating dentist or by a participating specialist.

Access to Dentists when Traveling

When traveling within the U.S., you have access to one of the largest networks in the industry You may also use an out-of-network dentist.4

Because dental HMO ⁄ managed care programs are based on the use of defined networks, general dental care is not accessible while traveling. The only exception is in an emergency situation when you are unable to receive care from your selected participating dentist. Please refer to your plan coverage documents provided in your enrollment booklet for details.

Network Discounts

All participating dentists have agreed to accept negotiated fees as payment in full for covered services. These fees typically range from 30% – 45% less than the average charges in the same community.5

This plan provides access to hundreds of dental services that may be considerably lower than your cost would be without this plan.2

Quality of Network Dentists

All participating dentists have to go through a rigorous upfront and ongoing selection and review process.7

All participating dentists have to go through a rigorous upfront and ongoing selection and review process.

Benefits

This plan typically includes a yearly deductible and an annual benefits maximum. Please refer to the Plan Summary included in your enrollment booklet for benefits specific to your plan offering.

This plan is not subject to deductibles. Out-of-pocket costs for covered services are typically calculated based on co-payments as listed in the plan’s Schedule of Benefits. Please refer to your enrollment booklet for information specific to your plan offering.

4. Your out-of-pocket costs may be greater when you visit a dentist who does not participate in the MetLife network. 5. Based on internal MetLife analysis. Negotiated fees refer to the fees that participating dentists have agreed to accept as payment in full for covered services rendered by them, subject to any copayments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change. 6. In California, orthodontic and pedodontic specialty services require pre-approval. Your general dentist will contact SafeGuard (a MetLife company) for pre-approval. Once approved, your dentist will contact you with the name of a network specialist. 7. Certain providers may participate with MetLife through an agreement that MetLife has with a vendor. Providers available through a vendor are subject to the vendor’s credentialing process and requirements, not MetLife’s. If you should have any questions, contact MetLife Customer Service.

21


Dental Insurance

How can a dental PPO plan benefit you? By making it easier to get the care you need and lower your out-of-pocket costs.8 Know what your plan covers 9...Dental insurance pays a portion of the costs associated with dental care. Different plans pay different percentages for procedures across these 3 standard service types.

Preventive Care

Basic Care

for example

for example

cleanings, X-rays and exams

How it works While eating dinner one evening Katie bites down and breaks a crown. The next day, Katie visits her dentist, who participates in the MetLife network. The going rate for a crown in her area is about $1,462.10 But since Katie’s participating dentist has agreed to provide the service for $680 for covered MetLife enrollees, and Katie’s plan covers 50% for this type of procedure, Katie’s out-of-pocket costs are only

$340, that’s a savings of $1,122, subject

Major Care for example

fillings and extractions

bridges, crowns and dentures

Dentists’ usual fee10 $1,462 Charge by MetLife participating dentist $680 Katie’s out-of-pocket costs

Depending on the fees her dentist charges, this bill could have cost Katie over a thousand dollars. By using a participating dentist, Katie maximizes her plan benefits and may pay less than a quarter of the typical cost.

$340

$0

$250

$500

$750

$1,000 $1,250

$1,500

to deductible and annual maximum.

What you need to know about dental PPO insurance: •

Flexibility to go to any dentist — in or out of network4

Access to thousands of participating dental locations across the U.S.

Take advantage of negotiated fees that are typically 30-45% less than average charges in the same area5

8.

Savings from enrolling in a MetLife dental benefits plan featuring the Preferred Dentist Program will depend on various factors, including the cost of the plan, how often participants visit the dentist and the cost of services rendered.

9.

Those services defined under your dental schedule of benefits are covered. Please see the schedule of benefits for a more detailed list of covered services.

10. Based on MetLife data for a crown (D2740) in ZIP code 19151. This cost reflects the 80th percentile Reasonable and Customary (R&C) fee. R&C fees are calculated based on the lowest of 1) the dentist’s actual charge, 2) the dentist’s usual charge for the same or similar services or 3) the usual charge of most dentists in the same geographic area for the same or similar services as determined by MetLife. This example is used for informational purposes only. Fees in your area may be different.

22


Dental Insurance

How can a dental HMO/managed care plan benefit you? By making it easier to get the care you need and lower your out-of-pocket costs.2 Lower out-of-pocket costs on hundreds of procedures.2 You get coverage for a wide range of services through a network of carefully selected participating dentists who agree to significantly lower costs than typical dental charges.

Here are some of the services included in this plan11 for example

for example

cleanings, X-rays and sealants

for example

fillings and extractions

crowns and root canals

How it works At the time of enrollment, you pre-select a participating dentist to receive benefits. Each enrolled family member may select a different participating dentist. Your primary care dentist also helps coordinate specialty6 care for you. John’s primary care dentist identifies a molar that failed to erupt and advises that John needs to have it extracted.

The cost of an impacted tooth extraction ranges from $225-$600 per tooth in the U.S.12 By using a participating dentist, John pays the copay only, which depending on his exact plan, could range from just

Cost to remove impacted tooth Range from $225 - $600 John’s copay $60 max

$0

$10-$60

$100

$200

$300

$400

$500

$600

for soft tissue impacted tooth extraction.13

What you need to know about a dental HMO/managed care plan: •

Significantly lower costs for dental services2 through a growing network of participating dentists

No deductibles, annual maximums or claims forms to complete

Scheduled fees for materials and procedures requiring multiple services (i.e. root canals and crowns)

11. Certain limitations apply to some services; please review your schedule of benefits for full details. 12. Wisdom Teeth Removal Cost, http://health.costhelper.com/wisdom-teeth-removal.html. Accessed April 2020. 13. Please refer to the plan’s schedule of benefits and evidence of coverage and disclosure statement for a more detailed list of covered services, limitations and exclusions.

23


Dental Insurance

What does dental insurance protect? Dental problems can be unpredictable and expensive. For example, did you know that a crown can cost up to $1,462?10 Dental insurance not only helps you pay for your dental care, it can help prevent problems. When your preventive care is covered, you’re more likely to go for cleanings and checkups — this can help you avoid problems before they become too costly or complicated.

Why choose a dental PPO plan:

Why choose a dental HMO/managed care plan:

Advantages. It’s simple:

Advantages. It’s simple:

See whatever dentist you want. Even if your dentist isn’t in the network, you can go to him or her — just remember you usually save more when you stay in network.8

The plan can help significantly lower your costs2 for hundreds of dental services through a wide network of carefully selected dentists.

You have a wide choice of participating dentists. Plus, dentists in the network are carefully selected.7

You will usually know exactly what your costs will be.

There are no deductibles or annual maximums.

Take advantage of negotiated fees that are typically 30–45% less than average charges in the same area.5

There’s no paperwork for you — the dentist handles it. He or she will also coordinate your specialist care.

Your dentist usually handles claims — which means less paperwork for you

Why should I enroll now? •

Help protect your smile and your wallet. You and your family can get the dental care you need in the coming year, and can save money, too.2

To learn more visit www.sdpeba.org. To enroll retirees must complete the retiree enrollment form and submit that to the SDPEBA office by the end of open enrollment. You can obtain the retiree enrollment form online at www.sdpeba.org. If you do not have web access or need additional assistance please contact SDPEBA at (888) 315-8027, or email info@sdpeba.org.

Like most insurance policies, insurance policies offered by MetLife and its affiliates contain certain exclusions, exceptions, reductions, limitations, waiting periods and terms for keeping them in force. Please contact your plan administrator for costs and complete details.

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A LOOK AT YOUR VSP VISION COVERAGE

SEE HEALTHY AND LIVE HAPPY WITH HELP FROM SDPEBA (RETIREE PLAN) AND VSP. As a VSP® member, you get personalized care from a VSP network doctor at low out-of-pocket costs. VALUE AND SAVINGS YOU LOVE. Save on eyewear and eye care when you see a VSP network doctor. Plus, take advantage of Exclusive Member Extras for additional savings. PROVIDER CHOICES YOU WANT. With an average of five VSP network doctors within six miles of you, it’s easy to find a nearby in-network doctor. Plus, maximize your coverage with bonus offers and additional savings that are exclusive to Premier Program locations. Prefer to shop online? Use your vision benefits on Eyeconic®—the VSP preferred online retailer. QUALITY VISION CARE YOU NEED. You’ll get great care from a VSP network doctor, including a WellVision Exam®—a comprehensive exam designed to detect eye and health conditions.

GET YOUR PERFECT PAIR

EXTRA $20 + TO SPEND ON FEATURED FRAME BRANDS*

UP TO

40%

SAVINGS ON LENS ENHANCEMENTS

SEE MORE BRANDS AT VSP.COM/OFFERS.

Contact us: 800.877.7195 or vsp.co)

25

USING YOUR BENEFIT IS EASY! Create an account on vsp.com to view your in-network coverage, find the VSP network doctor who’s right for you, and discover savings with exclusive member extras. At your appointment, just tell them you have VSP.


YOUR VSP VISION BENEFITS SUMMARY SDPEBA (RETIREE PLAN) and VSP provide you with an affordable vision plan.

BENEFIT

PROVIDER NETWORK: VSP Choice

DESCRIPTION

COPAY

FREQUENCY

YOUR COVERAGE WITH A VSP PROVIDER WELLVISION EXAM

Focuses on your eyes and overall wellness

$0

Every plan year*

FRAME

$150 allowance for a wide selection of frames $170 allowance for featured frame brands 20% savings on the amount over your allowance $150 Costco® frame allowance

$0

Every plan year

LENSES

Single vision, lined bifocal, and lined trifocal lenses Impact-resistant lenses for dependent children

$0

Every plan year

LENS ENHANCEMENTS

Standard progressive lenses Premium progressive lenses Custom progressive lenses Average savings of 20-25% on other lens enhancements

CONTACTS (INSTEAD OF GLASSES)

$150 allowance for contacts; copay does not apply Contact lens exam (fitting and evaluation)

PRESCRIPTION GLASSES

$0 $95 - $105 $150 - $175

Every plan year

Up to $60

Every plan year

FRAME

$150 allowance for a wide selection of frames $170 allowance for featured frame brands 20% savings on the amount over your allowance $150 Costco® frame allowance

$0

Every plan year

LENSES

Single vision, lined bifocal, and lined trifocal lenses Impact-resistant lenses for dependent children

$0

CONTACTS (INSTEAD OF GLASSES)

$150 allowance for additional contacts Contact lens exam (fitting and evaluation)

ADDITIONAL PAIRS OF EYEWEAR

Up to $60

Every plan year

Glasses and Sunglasses Extra $20 to spend on featured frame brands. Go to vsp.com/offers for details. 20% savings on additional glasses and sunglasses, including lens enhancements, from any VSP provider within 12 months of your last WellVision Exam. EXTRA SAVINGS

Retinal Screening No more than a $39 copay on routine retinal screening as an enhancement to a WellVision Exam Laser Vision Correction Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities

YOUR COVERAGE WITH OUT-OF-NETWORK PROVIDERS Get the most out of your benefits and greater savings with a VSP network doctor. Call Member Services for out-of-network plan details. Coverage with a retail chain may be different or not apply. Log in to vsp.com to check your benefits for eligibility and to confirm in-network locations based on your plan type. VSP guarantees coverage from VSP network providers only. Coverage information is subject to change. In the event of a conflict between this information and your organization’s contract with VSP, the terms of the contract will prevail. Based on applicable laws, benefits may vary by location. In the state of Washington, VSP Vision Care, Inc., is the legal name of the corporation through which VSP does business. *Plan year begins in August

TO ENROLL VISIT HTTPS://ENROLL.SDPEBA.ORG

*Only available to VSP members with applicable plan benefits. Frame brands and promotions are subject to change. Savings based on doctor’s retail price and vary by plan and purchase selection; average savings determined after benefits are applied. Ask your VSP network doctor for more details. ©2020 Vision Service Plan. All rights reserved. VSP, VSP Vision Care for life, Eyeconic, and WellVision Exam are registered trademarks, VSP Diabetic Eyecare Plus Program is servicemark of Vision Service Plan. Flexon is a registered trademark of Marchon Eyewear, Inc. All other brands or marks are the property of their respective owners. 

26


FY21-MetLife-Legal-RetireeFlyer.pdf FY2 21-MetLife fe-Legal-RetireeFlye er.pdf 1 5/13/2 5/13/2020 2020 3:16:38 3:16:38 PM PM FY21-MetLife-Legal-RetireeFlyer.pdf FY2 21-MetLife fe-Legal-RetireeFlye er.pdf 1 5/13/2 5/13/2020 2020 3:16:38 3:16:38 PM PM

PRODUCT OVERVIEW

Legal Plans Legalaccess Plans Provides to legal expertise

PRODUCT OVERVIEW

for both expected and unexpected events. Provides access to legal expertise for both expected and unexpected events.

Legal experts on your side, whenever Legal experts on your side, whenever you need them you need them

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Quality legal assistance can be pricey. And it can be hard to know where to turn to ¿Qd an attorney you trust. For a monthly fee, you can have a team of top attorneys ready Quality legal assistance can be pricey. And it can be hard to know where to turn to ¿Qd an to help you take care of life’s planned and unplanned legal events. attorney you trust. For a monthly fee, you can have a team of top attorneys ready to help you take care formally of life’s planned and unplanned legal gives events. MetLife Legal Plans, known as Hyatt Legal Plans, you access to experts who can assist you with a broad range of personal legal needs you might face throughout your life. This MetLife Legal Plans, formally known as Hyatt Legal Plans, gives you access to experts who can could be when you’re buying or selling a home, starting a family, dealing with identity theft, or assist you with a broad range of personal legal needs you might face throughout your life. This caring for aging parents. could be when you’re buying or selling a home, starting a family, dealing with identity theft, or caring forbe aging parents. You may thinking — why would top attorneys need or want to join a legal plan network? But even experienced attorneys need to grow their practice. By providing exceptional You may be thinking — why would top attorneys need or want to join a legal plan network? service to you and other plan members, they can gain more clients through your referrals. But even experienced attorneys need to grow their practice. By providing exceptional That’s how we’ve established a large network of highly experienced attorneys, averaging service to you and other plan members, they can gain more clients through your referrals. 25 years of experience. That’s how we’ve established a large network of highly experienced attorneys, averaging 25 years of experience. Reduce the cost of legal services with MetLife Legal Plans. Reduce the cost of legal services with MetLife Legal Plans.

How it works How it works Our service is tailored to your needs.

With network attorneys available in person, by phone, or by email and online tools to do-it-yourself or plan your next move — we make it easy to Our service is tailored to your needs. With network attorneys available in person, by phone, get legal help. And, you will always have a choice in which attorney to use. You can choose one or by email and online tools to do-it-yourself or plan your next move — we make it easy to from our network of SUHTXDOL¿Hd attorneys, or use an attorney outside of our network and be get legal help. And, you will always have a choice in which attorney to use. You can choose one reimbursed some of the cost.1 from our network of SUHTXDOL¿Hd attorneys, or use an attorney outside of our network and be reimbursed some of the cost.1 access to our attorneys for all legal matters covered under Best of all, you have unlimited

the plan. For a monthly premium conveniently paid through payroll deduction, an expert is on Best of all, you have unlimited access to our attorneys for all legal matters covered under your side as long as you need them. the plan. For a monthly premium conveniently paid through payroll deduction, an expert is on your side as long as to you need your them.family, MetLife Legal Plans is here to make life a little easier. Whatever you need protect Whatever you need to protect your family, MetLife Legal Plans is here to make life a little easier.

For added peace of mind, your spouse and dependent children are covered. For also added peace of mind, your spouse and dependent children are also covered.

27

Our attorneys Our attorneys are here to help are here to help when you’re: when you’re: • Getting married •• Buying selling Getting or married a home • Buying or selling • Starting a home a family •• Dealing Starting with a family identity theft • Dealing with • Sending kids off identity theft to college • Sending kids off • Caregiving to college for aging parents • Caregiving for • And agingmore parents • And more


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Untitled-2.pdf 1 5/13/2 5/13/2020 2020 0 3:18:54 PM PM

Discover the greatest pet insurance plans ever offered. My Pet Protection® is offered exclusively to employees and gives your pet superior protection at an unbeatable price.

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90% back on vet bills1 Exclusive to employees, not available to the general public Same price for pets of all ages 2

Best deal: average savings of 30% over similar plans from other pet insurers Wellness plan option that includes spay/neuter, vaccinations and more

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Here’s how My Pet Protection helped Nationwide® pet parents

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Between big-ticket emergency vet bills and basic preventive care, My Pet Protection coverage helped keep these pet parents’ bank accounts in the black.

Diagnosis & treatment: Foreign body removal from stomach

$3,000

$1,500

$2,000

$1,000

$1,500

2,565

$

$2,000

2,083

$

$1,000

$500

Diagnosis & treatment: Vaccinations and blood tests

378

$

250

$

$0

1,372

$

$1,000

1,235

$

340

$

$0

$0

Luna, mixed breed dog

Diagnosis & treatment: Tooth infection with multiple extractions

Bosco, goldendoodle*

Whiskey, American pit bull terrier*

*Annual deductible met on previous claim Claim amount

Reimbursement by Nationwide

Annual deductible

Sample reimbursements are based on actual claims but have been edited for clarity. Coverage for wellness services only available on My Pet Protection with Wellness®.

Sign up multiple pets with individual plans and receive a discount3 for even more savings.

Get a free, no-obligation quote today at 29


Untitled-2.pdf 2 5/13/2 5/13/2020 2020 3:18:54 :54 PM PM

Choose a plan that’s as unique as your pet.

Visit any vet anywhe , re

Get back 90% of the vet bill for these items and more. 1

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Accidents, including poisonings and allergic reactions Injuries, including cuts, sprains and broken bones Common illnesses, including ear infections, vomiting and diarrhea Serious/chronic illnesses, including cancer and diabetes Hereditary and congenital conditions Surgeries and hospitalization X-rays, MRIs and CT scans Prescription medications and therapeutic diets Wellness exams Vaccinations C

Spay/neuter

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Routine blood tests

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Just like all other pet insurers, we don’t cover pre-existing conditions.* However, we go above and beyond with extra features such as emergency boarding, lost pet advertising and more. Plus, both plans have a low $250 annual deductible and a generous $7,500 maximum annual benefit. *Any illness or injury that your pet had prior to the start of your policy will be considered a pre-existing condition.

Easy enrollment

1

Select the species (dog or cat)**

2

Provide your zip code

Pick your plan

Submit claims right from your smartphone with the free VitusVet app.

®

Available to all pet insurance members. Unlimited, 24/7 access to a veterinary professional ($150 value). Only from Nationwide®.

3

Get your pet insurance reimbursements deposited directly to your bank.

Download from the App Store

Download from Google Play

Email, fax and snail mail claim submissions also available.

Learn more today.

Some exclusions may apply. Certain coverages may be subject to pre-existing exclusion. See policy documents for a complete list of exclusions. 2Average based on similar plans from top competitors’ websites for a 4-year-old Labrador retriever in Calif., 90631. Data provided using information available as of December 2017. Pet owners receive a 5% multiple-pet discount by insuring two to three pets or a 10% discount on each policy for four or more pets.

1

3

Insurance terms, definitions and explanations are intended for informational purposes only and do not in any way replace or modify the definitions and information contained in individual insurance contracts, policies or declaration pages, which are controlling. Such terms and availability may vary by state and exclusions may apply. Underwritten by Veterinary Pet Insurance Company (CA), Columbus, OH, an A.M. Best A+ rated company (2018); National Casualty Company (all other states), Columbus, OH, an A.M. Best A+ rated company (2018). Agency of Record: DVM Insurance Agency. Nationwide, the Nationwide N and Eagle, and Nationwide is on your side are service marks of Nationwide Mutual Insurance Company. ©2019 Nationwide. 19GRP5832 2-19 19GRPMPP2CARDFLR

30


Cybercrime reports are up 300% since the beginning of the COVID-19 pandemic1 Your employer wants to keep you protected with Aura Identity Guard® … for free.

Remote working and increased time online have put employees at increased risk of identity theft, data intrusion, and a host of other cybercrimes.1 Aura Identity Guard can help. For nearly 25 years, Identity Guard’s industry-leading products and services have made it easier for customers to manage their identity and faster for them to recover from cybertheft. HOW AURA IDENTITY GUARD PROTECTS YOU AND YOUR FAMILY Harnesses the power of IBM® Watson™ to analyze billions of pieces of data across the Internet and Dark Web, monitoring for fraud and cybertheft Curates personalized alerts to notify you of suspicious activity and potential threats Shields your children from cyberbullying and other forms of harm through best-in-class social media monitoring that leverages Watson’s natural QFSLZFLJHQFXXNƳHFYNTSX^XYJR Assesses your cybertheft risk by using a unique algorithm to analyze your personal accounts and online behavior Safeguards your devices with safe browsing tools that include protection against malware, ransomware and phishing Provides assistance through the remediation process via around-the-clock customer service and an insurance policy that enables you to recoup losses up to $1 million2

Sign up today and receive free protection until August 1, 2020

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Protected nearly

50,000,000

XFYNXƳJIHZXYTRJWX

24 years

experience in identity theft

protection


PLAN DETAILS SERVICE FEATURES IBM® Watson™ AI Instant-On Monitoring Canada Coverage *RFNQ 9J]Y3TYNƳHFYNTSX Near Real-time Alerts Near Real-time Credit Monitoring Alert Risk Management Score Fully Managed Restoration $1 Million Insurance with Stolen Funds Reimbursement2vv US-based Customer Support – W2 Employees DARK WEB Address Monitoring Bank Account Number Monitoring Credit/Debit Card Account Number Monitoring Driver’s License Number Monitoring Email Monitoring Passport Number Monitoring Phone Number Monitoring SSN Monitoring Health Insurance Number Monitoring Lost Wallet Vault Child’s Info CREDIT 3 Bureau Credit Report Monitoring 3 Bureau Annual Credit Report & Score Credit Inquiry 1 Bureau Monthly Credit Score Tracker IDENTITY MONITORING Public Records Court Records Telecom/Utility Account Monitoring Change of Address Synthetic Identity Fraud Child Monitoring (PII)

To enroll please visit: https://enroll.sdpeba.org

FINANCIAL HSA & 401K Monitoring Investment Account Monitoring Bank Account Takeovers Checking and Savings New Account Applications Bank Transaction Alerts Credit/Debit Card Transaction Alerts Pay Day Loan Monitoring ADDITIONAL PROTECTION TOOLS Scams, Malware & Phishing Monitoring Social Media Reputation Monitoring Social Report/Digital Exposure Report Online PC Protection Tools Online Privacy Anti-phishing Cyberbullying MOBILE APP Alerts Credit Score Account Access Touch ID RESTORATION Pre-Existing Conditions Unauthorized Account Creation Unauthorized Electronic Fund Transfer Recovery Deceased Family Member Remediation Dedicated Case Manager Medical Identity Theft Coverage $1 Million Insurance with Stolen Funds Reimbursement1

Retiree Plans IDG Monthly Rate Premier Plan Individual

$11.35

Premier Plan Family

$19.35

“FBI Sees Cybercrime Reports Increase Fourfold During COVID-19 Outbreak.” Entrepreneur. April 20, 2020. Identity Theft Insurance underwritten by insurance company subsidiaries or affiliates of American International Group‚ Inc. The description herein is a summary and intended for informational purposes only and does not include all terms‚ conditions and exclusions of the policies described. Please refer to the actual policies for terms‚ conditions‚ and exclusions of coverage. Coverage may not be available in all jurisdictions. 1 2

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PurchasingPower SDM_Magazine azine Ad.pdf 1 5/13/2 5/13/202 5/13/2020 2020 0 3:22:20 3:22:20 PM

Get what you need when it matters most

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Shop today & receive

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off*

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In times when paying with cash or credit is challenging, Purchasing Power is here for you with a program you can trust. Get what you need now, and pay over time – right from your paycheck. No credit check. Fixed payments. No hidden fees. Appliances

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Can I Participate? • • • •

You must be at least 18 years of age You must earn at least $16,000 a year You must have a bank account or credit card (to be used in case of non-payment via payroll deduction)

Shop now at www.SDPEBA.PurchasingPower.com or call 1-888-923-6236 checkout for discount to be applied. Offer is subject to change and/or end without notice. Go online to purchasingpower.com/exclusions for full details. **Pricing is based upon 26 pay periods per year which may vary by customer. Products and pricing are available while supplies last and are subject to change without notice, so go online for the latest offering. Individual eligibility requirements and spending limits may apply. “A Better Way to Buy” is a trademark, and “Purchasing Power” is a registered trademark of Purchasing Power, LLC. Other trademarks or registered trademarks used are the property of their respective owners. © 2020 35 Purchasing Power, LLC. All rights reserved.

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Online Enrollment.pdf 1 5/13/2 5/13/2020 2020 0 3:20:53 3:20:53 PM PM

ONLINE ENROLLMENT

SDPEBA’s Online Enrollment System launches June 1st! C

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Enroll st June 1 th June 30

SDPEBA is launching a new online enrollment system this year to improve the enrollment experience, lower paper waste, and reduce errors. Retirees can enroll online for SDPEBA’s dental, vision, legal, and identity protection plans. To get started, visit:

https://enroll.sdpeba.org You will need to register at this site and create an account. Once you have your account started you can begin your enrollment process. You will be able to add/term/change your SDPEBA benefits all at this platform.

To access this new enrollment process you must have already had benefits with SDPEBA. If you have not enrolled in any of our benefits, you may not be in our new enrollment system. If while at https://enroll.sdpeba.org the system is unable to locate your account, please contact SDPEBA at 888-315-8027 or email support@sdpeba.org and our friendly staff can quickly add you over the phone, and grant you access immediately. Note: Enrollment in Sharp Health Plan still requires a manual form. Enrollment in SDCERS’s sponsored CIGNA, Delta Dental, Kaiser, and Scan Plan is handled by SDCERS, and is not part of SDPEBA’s online enrollment system. 36


Frequently requently Aske Asked ked Questions.pdf 1 5/12/2 5/12/2020 2020 11:12:44 11:1 :44 AM AM

FREQUENTLY ASKED QUESTIONS The SDPEBA team gets thousands of calls, emails, and other inquiries over the year. To help answer some of these questions we have developed a list of the top ten frequently asked questions.

1. DO I HAVE TO BE A MEMBER OF SDPEBA?

You must be a member of at least one of the participating organizations listed in question #2 in order to access SDPEBA benefits (excluding Sharp Health Plan, it is open to all retirees). If you are not a member, you can easily join one when you enroll in a benefit.

2. WHICH ASSOCIATIONS PARTICIPATE IN SDPEBA?

AFSCME 127, City of San Diego Retired Employees Association, Retired Fire and Police Association, San Diego Municipal Employees Association, and the San Diego Police Officers Association.

3. IF I AM NOT MAKING ANY CHANGES, DO I NEED TO ENROLL ONLINE OR SUBMIT A FORM?

NO. Only people who are adding new benefits, making changes to current benefits, updating personal information, or canceling a benefit will need to enroll online or submit a form. We do encourage everyone to enroll online to make sure their benefits are accurate.

4. WHEN ARE MY BENEFITS EFFECTIVE?

When you sign up for health, dental or vision benefits during the FY21 open enrollment period, benefits become effective on 8/1/20. Since these benefits are prepaid, you will see the first deduction for the benefits on your July pension check.

5. WHO DO I CALL TO GET INFO ABOUT MY RETIREMENT HEALTH ALLOTMENT?

Only SDCERS can provide information on your health allotment. Please contact them at 800-774-4977.

6. WHO DO I CALL TO INQUIRE ABOUT THE RETIREE MEDICAL TRUST?

SDPEBA does not have information about the Retiree Medical Trust. You can contact them directly at 888-524-0115.

7. WHEN WILL I GET MY ID CARDS?

SHARP HEALTH PLAN - ID cards will arrive near 8/1/20. If you have not received your card by 8/15/20 please contact us to request a new card. METLIFE DENTAL PPO - No cards are sent out for this plan. You will get an email with instructions on how to use the plan on 8/1/20. METLIFE DENTAL HMO - Only new enrollees who have selected a primary care dentist will get an ID card around 8/1/20. If you have not received your card by 8/15/20 please contact us to request a new one. VSP VISION - No cards are sent out for this plan. You will get an email with instructions on how to use the plan on 8/1/20. METLIFE LEGAL - No cards are sent out for this plan. You will get an email with instructions on how to use the plan on 8/1/20.

8. HOW TO SELECT METLIFE HMO?

You can contact SDPEBA at 888 315-8027 or by emailing support@sdpeba.org and request a provider listing be sent to you to make your selection. Once you have chosen a dentist you can contact SDPEBA with your selection and we will process your request with MetLife.

9. HOW DO I GET AN IN-NETWORK PROVIDER LISTING FOR SHARP, METLIFE OR VSP?

On page 18 of this magazine provides step by step instructions for finding a provider. If you are having issues or need assistance, call SDPEBA at 888-315-8027 or email support@sdpeba.org

10. HOW DO I GET A BENEFITS BREAKDOWN LETTER FOR THE RETIREE MEDICAL TRUST?

If you are required to furnish a benefits breakdown letter to the Retiree Medical Trust, just call 888 315-8027 or email support@sdpeba.org and ask for the RMT benefits breakdown letter. Letters normally take two business days to process and be mailed out.

To view more online help articles visit https://support.sdpeba.org 37


Contact Page.pdf 1 5/11/2 5/11/2020 2020 7:49:15 :15 PM PM

SDPEBA

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CONTACT INFORMATION

Phone: Text: Fax: Website: Facebook: Twitter: Address:

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888-315-8027 619-547-1600 619-431-3078 www.sdpeba.org facebook.com/SDPEBA @SDPEBA 9620 Chesapeake Drive, Ste 104 San Diego, CA 92123

Email: To learn more about benefits: For help with an existing benefit :

info@sdpeba.org support@sdpeba.org

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SDCERS

SDCERS: 800-774-4977 | www.sdcers.org Care Counsel: 888-227-3334 | www.carecounsel.com staff@carecounsel.com

PROVIDERS

Identity Guard: Liberty Mutual (Annabel Buso): MetLife HMO: MetLife Legal Plans: MetLife PPO: Nationwide Pet Insurance: Purchasing Power: Sharp Direct Advantage: Sharp Non-Medicare: UNUM (Will Stover): VSP Vision:

855-443-7748 760-795-0451 800-880-1800 800-821-6400 800-275-4638 888-899-4874 880-315-8027 855-820-2112 888-840-4747 619-535-7240 800-877-7195 38


Back Cove Cover.pdf er.pdf 1 5/11/2 5/11/2020 2020 7:44:40 7:44:40 PM

SAN DIEGO

PEBA

9620 Chesapeake Drive Suite 104 San Diego, CA 92123

PRSRT STD U.S. POSTAGE PAID PERMIT # 100 CLAREMONT, CA Return Service Requested

Open Enrollment C

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June 1 - 30, 2020 A Helpful Resource Just For You!

FY21 BENEFITS GUIDE

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IMPORTANT DATES June 1st – Retiree Open Enrollment Begins June 1st – SDPEBA Online Enrollment Site Opens June 1 & June 2 – SDPEBA Retiree Virtual Fair June 5th – SDPEBA Drive Thru Materials Pick Up Day June 30th – SDPEBA Online Enrollment Closes @ 5:00 PM June 30th – Retire Open Enrollment Ends August 1st – New Benefit Period Starts

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PROUDLY SERVING THE MEMBERS OF: 7

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Profile for SDPEBA

SDPEBA-Retiree Magazine  

SDPEBA-Retiree Magazine  

Profile for sdpeba

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