FORMS
Retired Member 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
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