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Employee Benefits

General Summary, Information & Forms for City Participants

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Employee Benefits & Forms

ACA Regulations & Important Guidelines

Preventive Services Covered under the Affordable Care Act
Glossary of Health Coverage and Medical Terms
American Heart Association Flyers
Premium Assistance Under Medicaid and the Children's Health Insurance Program (CHIP)

Aflac

Aflac is a supplemental insurance that provides an additional layer of financial protection in the event of a serious accident or illness.

Employees can sign up for this service within 30 days of hire, or annually in October, during Open Enrollment for the upcoming year.

Price Sheet
Election Form

City of Chico Dedicated Aflac Website: http://www.aflac.com/chico

Video Link For General Aflac Info:  https://youtu.be/Gn_SuaFbKvM    

Questions? Contact your Aflac representative:
Adam Brubaker
(530) 949-3767
​adam@leftoutins.com

CalPERS Retirement

Customer Service: 888-CalPERS (or 888-225-7377)
www.calpers.ca.gov
CalPERS Beneficiary Designation
Planning Your Service Retirement (Pub 1)
Service Retirement Application (Pub 43)
Retirement Allowance Estimate Request (BSD-470)
Local Miscellaneous Benefits (Pub 8)
Local Safety Benefits (Pub 9)
Service Credit Purchase Options (Pub 12)
Power of Attorney (Pub 30)
Community Property Guide (Pub 38A)
CalPERS Pension Worksheet

Have you created a “My CalPERS” Account yet?  The CalPERS website is a fantastic resource! Members can review their employee and employer contributions and utilize calculators to estimate retirement amounts, as well as access recent forms and publications.  Signing up is easy, visit: https://www.calpers.ca.gov/.

Deferred Compensation (ICMA-RC)

April 2021 Update: Effective early summer 2021, ICMA-RC is becoming Mission Squared Retirement!  Please review the announcement flyer and FAQs for more information.
MissionSquared Retirement Announcement
Name Change FAQs

Another great way to save for retirement – contribute to an ICMA-RC retirement plan automatically each paycheck!

Employees can enroll in Deferred Compensation at any time. Elections and changes are effective the first of the month following the request.

Did you know? CPSA and CPOA members have a 10% match!

Enrolling online is quick and easy!

  1. Go to www.icmarc.org/selfenroll
  2. Enter and confirm your Social Security number, then enter the City’s plan number: 307126
  3. Select your enrollment method:
    • Express: enter your personal information and contribution information. Later, through Account Access, you can submit your investment and beneficiary information.
    • Comprehensive: enter your personal information, beneficiary information, contribution information, investment allocations, and create a user ID.
    • Note: At this time, City employees can only elect dollar amounts and not percentages with ICMA. Please only list dollar amounts.
  4. Use the print enrollment form feature at the end of your online enrollment process to print the form.
  5. Provide HR a copy of your enrollment form and complete a copy of the ICMA Contribution Change Form in order to initiate your contribution through payroll deductions.

Need additional help? Watch a short video guide to see how easy it can be to enroll online. You can also contact the City’s ICMA-RC representative listed below.

Once you’re enrolled, use the following resources:

Extra Forms:
ICMA Contribution Change Form
EZ Enroll Online Flyer
ICMA Enrollment Form
ICMA Beneficiary Designation Form
ICMA Direct Rollover Packet
ICMA Pre-Retirement Catch Up Form
ICMA Withdrawal Packet
Fund Performance Report 02/28/2021

Employee Assistance Plan (MHN)

Customer Service: (800) 322-9707
www.mhn.com
MHN Informational Flyer
MHN Legal Services Flyer
MHN Financial Services Flyer
MHN Evidence of Coverage

Group and Voluntary Life
& Short/Long-Term Disability Insurance (Lincoln Financial Group)

​All active, full-time, permanent employees working at least 20 hours per week and their eligible spouse and children are eligible for coverages.

Enrollment is available within 30 days of hire, or annually in October, during Open Enrollment for the upcoming year.

Group Life: The City of Chico provides City-paid Group Life Insurance of the annual salary, rounded to the next thousand, for qualified employees.

Voluntary Life: This is in addition to the City-paid Group Life Insurance that is provided to qualified employees at no cost!

Coverages Available:

  • Employee: $10,000 increments, up to 5x the employee’s annual earnings, not to exceed $500,000.
  • Employee Accidental Death & Dismemberment (AD&D): $10,000 increments, up to 5x the employee’s annual earnings, not to exceed $500,000. Coverage may be purchased regardless of whether or not voluntary life is purchased.
  • Spouse: $5,000 increments, up to 100% of employee coverage for voluntary life or AD&D.
  • Children, birth – 6 months: $1,000
  • Children, 6 months – 19 (or 26 if full-time student): $2,000 increments, not to exceed $10,000.

www.LFG.com
Summary of Life Insurance Benefits
Lincoln Disability One
Lincoln LifeKeys Flyer
Lincoln Travel Connect Flyer
Life Insurance Beneficiary Designation
Short Term Disability Claim Form
Lincoln City Paid Life and AD&D Policy Certificate
Lincoln Voluntary Life Policy Certificate
Lincoln Voluntary AD&D Policy Certificate

Medical, Dental, & Vision Insurance

2021 Active Employee Benefit Guide

Applications/Change Forms

Benefits Application & Change Form - Active Employees
When adding dependents to your benefits, proof of dependent status is required. Please review the Dependent Verification Instructions, for types of proof accepted.

Opt Outs
Opt-out is available for medical only – dental and vision coverage are non-voluntary, even if you are married to another City employee.
Medical Opt-Out Form & Certification of Other Coverage

Individuals who previously opted out will need to re-verify during Open Enrollment. HR will contact you individually to arrange renewed documentation.

Anthem Blue Cross Medical Insurance
Anthem Customer Service

Customer Service: (800) 967-3015
www.anthem.com/ca/EIAHealth

Plan Summary of Benefits &
Coverage (SBC)
EPO 2021 EPO SBC
HDHP 2021 HDHP SBC
PPO 80/20 2021 PPO 80/20 SBC
PPO 90/10 2021 PPO 90/10 SBC

Anthem Blue Cross General Information
How to Find a Provider Instructions
Anthem Claim Form
Take Care of Yourself - Preventative Services
Anthem Special Services Flyers
Anthem Live Health Online Flyer
Anthem Temporary ID Card Instructions
Anthem Blue Cross Online Resources
Anthem Blue Cross Drug Formulary
Anthem Specialty Pharmacy (HDHP)

Express Scripts
Customer Service: (800) 711-0917
https://www.express-scripts.com/
Medco Frequently Asked Questions
Medco Mail Order Form
Medco Claim Form

Sterling Health Savings Account (HSA)
Customer Service: (800) 617-4729
CustomerService@SterlingHSA.com
www.SterlingHSA.com
2021 Sterling Enrollment Form 
Sterling HSA Salary Redirection Form (Payroll Change Form)
Sterling Change Of Account Form

Delta Dental Insurance
Customer Service: (800) 765-6003
www.deltadentalins.com
Delta Dental SBC
Find a Network Dentist
Delta Dental Dentist Directory
Delta Dental Informational Flyers
Delta Claim Form
Where's My Dental ID Card?

VSP Vision Insurance
Customer Service: (800) 877-7195
https://www.vsp.com/
VSP Vision SBC
Where's my VSP ID Card? Plus other FAQs.
VSP Member Accounts Online
VSP Schedule of Benefits
VSP Primary Eyecare
Exclusive VSP Rebates & Special Offers
VSP Tru Hearing member Discount
VSP Out Of Network Claim Form

Carrum Health
Customer Service: (888) 855-7806
my.carrumhealth.com/EIAHealth
Carrum Flyer
Carrum What to Expect
Carrum Frequently Asked Questions

Modifying Elections & Open Enrollment

After medical, dental, vision, and flexible spending account elections are made, Internal Revenue Service (IRS) regulations generally permit changing those elections only during the next open enrollment (October of each year). However, if you experience a “qualifying event” during the year you may change certain benefit plan elections mid-year. The Human Resources & Risk Management Office must be notified of a qualifying event within 30 days of the event in order to make changes to your elections. No exceptions to the 30 day notification deadline are permitted. 

Open Enrollment
Held in October, annually.

During Open Enrollment, employees can:

  • add or delete dependents from Medical, Dental and Vision or choose a new Medical plan;
  • enroll in, increase or drop Voluntary Life Insurance;
  • enroll/re-enroll in a Section 125 Medical or Dependent Care Flexible Spending Account (FSA);
  • enroll in, or change, AFLAC coverages.

NOTE:  If you do not wish to change your benefits or re-enroll in an FSA, no action is required during Open Enrollment.

ScholarShare 529 College Savings Program

Why save for college with ScolarShare529?
A 529 is one of the best ways to save for higher education. ScholarShare 529 benefits include:

  • 100% tax-free growth can mean more money for higher education.
  • Low fees that ensure your savings primarily go toward education costs.
  • Parent-owned 529 accounts have less impact on financial aid eligibility than other saving methods.
  • Tax-free withdrawals for qualified higher education expenses, like tuition, room and board, books, computers, and more.
  • Eligible for use at most schools nationwide and many abroad – undergraduate and graduate programs, community colleges and trade schools.
  • Overseen by the ScholarShare Investment Board, an agency of the State of California.

Questions?
Click Here to schedule a time to meet with our designated rep, Adal Padilla.

Adal Padilla
(628) 231-6519
Adalberto.Padilla@tiaa.org

Forms:
529 Brochure
529 Guide
529 Enrollment Guide

Section 125 Flexible Benefits Program (Basic Pacific)

Flexible Spending Accounts are part of Section 125, established by the IRS. Section 125 allows employees to set aside money for future medical and child care costs on a pre-tax basis.

Employees can enroll in a Medical FSA or a Limited Purpose FSA (Dental & Vision Only), and/or a Dependent Care FSA.

Enrollment is available within 30 days of hire, or annually in October, during Open Enrollment for the upcoming year.

Customer Service: (800) 574-5448
customerservice@basicpacific.com
www.basicpacific.com
Flexible Spending Account Calculator
2021 FSA Enrollment Form & Worksheet
FSA Medical Information
FSA Dependent Care Information

Section 125 Summary Plan Description

Flexible Spending Accounts MUST be re-elected annually, during Open Enrollment.

Returning Forms to HR

If you complete paper copies, please don’t email items containing social security numbers – it’s too risky.  Instead:

  • Put them in an interoffice envelope and send them to HR.
  • Or, scan the item to the secure HR Scan Drive by using the closest copier:
    • Scan your proxy card
    • Press Scan > Scan to HR.  (Note a slight variation for PD copiers: Scan & Send > One-Touch > HR Scans – you may have to follow the down-pointing arrow/bottom right if there’s an extensive list.)
    • Your document will magically appear in a scan folder on our end and will be acknowledged by an HR staff person within a short period of time (watch your email for a confirmation).  Hold on to your originals until you receive confirmation; otherwise, no need to send the originals to HR.

Still need assistance?

Contact Your HR TEAM!

Retiree/COBRA Benefits

2021 Retiree & COBRA Benefit Guide

The City is contracted with Workterra for Retiree and COBRA insurance administration. Retirees or COBRA participants wishing to make a change must contact Workterra directly at: 888-327-2770.

Turning 65?
Medicare is effective the first of the month your birthday falls in.

Retirees turning 65 within the next year do not need to make an Open Enrollment Election change in anticipation of the eventual Medicare status. Turning 65 is a “qualifying event” and the change can be made within 30 days of your birthday.  Retirees can either:

  • Drop the City’s Retiree coverage, or
  • Retain the City’s coverage to use as a secondary insurance (premiums will change depending on selection).

NOTE: If you drop the City’s Retiree coverage, your dependents cannot stay on the insurance. They will transition to COBRA coverage, which is a limited-term benefit.

Once you have reviewed options and made your choice, contact Workterra at 888-327-2770 to request the change.

Quick Summary

Core Benefits Available

CalPERS Retirement Medical (4 plan options)
457 Deferred Compensation Dental + Orthodontic Benefit
Short Term Disability Vision
Long Term Disability Flexible Spending Account
Employee Assistance
Program
Group & Voluntary Life Insurance

Time Off Benefits

Vacation Sick Leave
Paid Holidays Military Leave
Bereavement Leave Jury Duty Leave
Personal Time Off/
Management Leave*
Maternity/Paternity Leave

*Eligibility Depends on bargaining unit and position.

Historical Summary of Employee Benefits - by Union

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