FORMS
County Health Insurance Forms
- Medical – Blue Shield Enrollment / Change Form
- Medical – Kaiser – Traditional HMO Enrollment / Change Form
- Medical – Kaiser – Senior Advantage Enrollment / Change Form
- Medical – Kaiser – Senior Advantage Disenrollment Form
- Medical – UnitedHealthcare HMO Low Option Enrollment Form
- Medical – UnitedHealthcare HMO High Option Enrollment Form
- Medical – UnitedHealthcare HMO Disenrollment Form
- Dental – Delta Dental Enrollment/Change Form (PPO and HMO)
- Dental – Waiver Form
- Vision – VSP (Vision Service Plan) Enrollment / Change Form
- Subsidy – Pooling Subsidy Election Form (retirees with retired SBCERS County spouse/partner)
- Subsidy – Combining Subsidy Election Form (recipients of multiple benefit payments only)
Superior Court Health Insurance Forms
- Medical – Blue Shield Enrollment / Change Form
- Dental – Delta Dental Enrollment / Change Form (PPO and HMO)
- Dental – Waiver Form
- Vision – VSP (Vision Service Plan) Enrollment / Change Form
- Subsidy – Pooling Subsidy Election Form (retirees with retired SBCERS Court spouse/partner)
- Subsidy – Combining Subsidy Election Form (recipients of multiple benefit payments only)
PLAN MEMBERSHIP
Current County Employees can view their retirement plan in the “Miscellaneous” box of their Online Earnings Statement, available on Employee Self Service Plus (ESS+).
There are four plans in which General members are enrolled: Plan 2, Plan 5, Plan 7 and Plan 8.
|
Plan Assignment |
Membership Date |
Bargaining Unit |
|---|---|---|
|
General Plan 2 |
Jul 1, 1986 through Jan 10, 1999 |
By Member Election |
|
General Plan 5A |
Before Oct 10, 1994 |
Not Applicable |
|
General Plan 5B |
On or After Oct 10, 1994 |
10, 11, 14, 15, 17, 20, 35, 36, 40, 41, 42 or 43. |
|
General Plan 5C |
On or After Oct 10, 1994 and Before June 24, 2012 |
21, 22, 23, 24, 25, 26, 27, 28, 29 or 32. |
|
General Plan 7 |
On or After June 25, 2012 and Before Jan 1, 2013 |
21, 22, 23, 24, 25, 26, 27, 28, 29 or 32. |
|
General Plan 8 |
On or After Jan 1, 2013 |
Not Applicable |
APCD members are classified as General Members. There are three plans in which APCD members are enrolled: APCD Plan 1, APCD Plan 2, and General Plan 5.
|
Plan Assignment |
Membership Description |
|---|---|
|
APCD Plan 1 |
If you became a member on or after July 3, 1995 |
|
APCD Plan 2 |
If you became a member before January 1, 1981 |
There are three plans in which Safety members are enrolled: Safety Plan 4 (for Fire and Probation employees), and Safety Plan 6 (for Sheriff and District Attorney Investigator (DAI) employees). Within each plan there are tiers (designated by A, B, or C) based on your membership date and/or bargaining unit:
|
Plan Assignment |
Membership Description |
|---|---|
|
Safety Plan 4A |
Fire employees who became members prior to 10/10/94 (& all Carp/Summerland Fire employees regardless of membership date) |
|
Safety Plan 4B |
Employees in Probation management/executive classifications or in the classification of Fire Chief who became members on or after 10/10/94 |
|
Safety Plan 4C |
All Probation employees represented by the Probation Peace Officers Association (regardless of membership date), and Fire employees who became members on or after 10/10/94 (except Fire Chief) |
|
Safety Plan 6A |
Sheriff/DAI employees who became members prior to 10/10/94 |
|
Safety Plan 6B |
Sheriff/DAI employees who became members on or after 10/10/94 |
|
Safety Plan 8 |
All Safety members hired on or after 1/1/2013; Single Rate |
OTHER HELPFUL LINKS
- SBCERS 2019 Payroll Calendar
- Empower Retirement (Formerly Great West) – Deferred Compensation 457 Plans
- CalPERS – California Public Employees Retirement System
- Medicare – Medicare
- IRS – Internal Revenue Service
- EDD – California Tax Service Center
- SSA – Social Security
- RESBC – Retired Employee’s of Santa Barbara County