Open Enrollment & Health Insurance for 2025
Open Enrollment Books and Rates:
Health Insurance Forms & Summaries of Benefits and Coverage
County of Santa Barbara
County of Santa Barbara Summaries of Benefits & Coverage (“SBCs”)
Blue Shield EPO Low Option-
- 2024 EPO Low Option Summary of Benefits
- 2023 EPO Low Option Prescription Drug Summary of Benefits (Non-Medicare)
- 2022 Prescription Drug Plan (Medicare)
Blue Shield EPO High Option-
- 2024 EPO High Option Summary of Benefits
- 2023 EPO High Option Prescription Drug Plan (Non-Medicare)
- 2022 Prescription Drug Plan (Medicare)
Blue Shield PPO-
- 2024 PPO Summary of Benefits
- 2023 PPO Prescription Drug Plan (Non-Medicare)
- 2022 Prescription Drug Plan (Medicare)
Blue Shield HDHP-
Blue Shield Tandem Plan-
Kaiser Traditional HMO Low Option-
- 2024 KP Traditional HMO Low Option Summary of Medical & Prescription Benefits
- 2024 KP Traditional HMO Low Option Summary of Benefits & Coverage
Kaiser Traditional HMO High Option-
- 2024 KP Traditional HMO High Option Summary of Medical & Prescription Benefits
- 2024 KP Traditional HMO High Option Summary of Benefits & Coverage
Kaiser Senior Advantage HMO Low Option-
- 2024 KP Senior Advantage HMO Low Option Summary of Medical & Prescription Benefits
- KP Senior Advantage Plan Overview
Kaiser Senior Advantage HMO High Option-
UnitedHealthcare Medicare Advantage HMO Low Option-
- 2023 UnitedHealthcare Medicare Advantage HMO Low Option Plan Guide
- 2023 UnitedHealthcare Medicare Advantage HMO Low Option Summary of Medical & Prescription Benefits
- 2023 UnitedHealthcare Medicare Advantage HMO Low Option “Your Plan Explained”
- 2023 UnitedHealthcare Medicare Advantage HMO Low Option Additional Drug Coverage
- 2023 UnitedHealthcare Medicare Advantage HMO Low Option Annual Notice of Changes
UnitedHealthcare Medicare Advantage HMO High Option-
- 2023 UnitedHealthcare Medicare Advantage HMO High Option Plan Guide
- 2023 UnitedHealthcare Medicare Advantage HMO High Option Summary of Medical & Prescription Benefits
- 2023 UnitedHealthcare Medicare Advantage HMO High Option “Your Plan Explained”
- 2023 UnitedHealthcare Medicare Advantage HMO High Option Additional Drug Coverage
- 2023 UnitedHealthcare Medicare Advantage HMO High Option Annual Notice of Changes
Delta Dental & DeltaCare USA-
- 2024 Dental Plan Benefit Booklet
- 2024 Dental Plan HMO Provider List
- Delta Dental Virtual Consult Flyer
- Delta Dental BrushSmart Flyer
Rx ‘n Go
Vision Service Plan (VSP)-
County of Santa Barbara Insurance Forms
Medical
- Blue Shield Enrollment / Change Form
- Kaiser – Traditional HMO Enrollment / Change Form
- Kaiser – Medicare Advantage/Senior Advantage Enrollment / Change Form
- Kaiser – Senior Advantage Disenrollment Form
- UnitedHealthcare HMO Low Option Enrollment Form
- UnitedHealthcare HMO High Option Enrollment Form
- UnitedHealthcare HMO Disenrollment Form
Dental
Vision
Subsidy
Santa Barbara Superior Court
Superior Court Summaries of Benefits & Coverage (“SBC’s”)
- 2024 Superior Court EPO Summary of Benefits
- 2024 Superior Court HDHP Summary of Benefits and Prescription Drug Plan
- 2022 Blue Shield Medicare Prescription Drug Plan
- 2023 Prescription Drug Plan for Blue Shield EPO Low Option (Non-Medicare)
- 2022 Prescription Drug Plan for Blue Shield EPO Low Option (Medicare)
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)
RSVP for an in-person Retiree Health Fair:
Santa Maria Retiree Health Fair
Wednesday, October 16 from 9:00 am – 11:00 am
Hearing Room, Betteravia Government Center
511 E. Lakeside Pkwy, Santa Maria, CA 93454
Goleta Retiree Health Fair
Thursday, October 17 from 9:00 am – 11:00 am
SBCERS Board Room
130 Robin Hill Road, Goleta, CA 93117
Instructions & Deadlines
WHAT TO DO IF YOU ARE MAKING CHANGES TO YOUR COVERAGE:
- Review plan benefits, providers and rates.
- Obtain and complete forms.
- Sign and submit forms by Friday, November 1.
WHAT TO DO IF YOU HAVE NO CHANGES TO YOUR COVERAGE:
- You do not have to complete or submit any forms.
- You do not have to contact SBCERS.
- SBCERS will automatically continue your current coverage into 2025 at the new rates.
WHAT TO DO IF YOU DON’T HAVE COUNTY HEALTH INSURANCE:
- You instead have money in your SBCERS Health Reimbursement Arrangement (HRA) account.
- You may opt back in to County Health Insurance by completing and remitting forms.
- You do not have to contact SBCERS to set anything up, you contact Health Equity at 877-924-3967 or www.wageworks.com to seek reimbursement for eligible health expenses you pay out of your own pocket.
- Learn how to collect this money in the “Health Insurance Subsidy” and “Health Reimbursement” sections of the Open Enrollment Guides published in October.
- SBCERS will automatically continue your current HRA account into 2025.
MEDICARE & IMPORTANT NOTICES:
- Turning 65 in 2025? Contact SBCERS three months before your 65th birthday to review options.
- If you (and/or your dependents) have or will have Medicare in the next 12 months, Federal law provides choices for prescription drug coverage. See the “Prescription Drug Coverage and Medicare” section of the Open Enrollment Guides published in October.
INFORMATION AND DEADLINES FOR COUNTY AND SUPERIOR COURT
| Open Enrollment Period: | October 1-31, 2024 |
| Forms and Booklets Availability: | After September 30th |
| Form Submission Deadline: | At SBCERS office no later than Friday, November 1, 2024 |
| Forms Submission Options: | Send securely through your personal mySBCERS portal as a scanned attachment Fax to 805-695-2755 Mail to an SBCERS office Drop in an SBCERS dropbox (available outside both offices) |
| Changes effective: | January 1, 2025 |