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Resources

Health Forms & Booklet

Important Changes to CITY OF SAN DIEGO RETIREE HEALTHcare Plans

The City of San Diego and the San Diego Public Employee Benefits Association (SDPEBA) have changed the effective date of their healthcare plan offerings. Starting January 1, 2023, the City-sponsored retiree health plans will be effective based on the calendar year, rather than the fiscal year. 
 

CITY OF SAN DIEGO RETIREE HEALTH OPEN ENROLLMENT - Calendar YEAR 2023

Health Open Enrollment for 2023 took place from November 1 to November 30, 2022.

Booklets containing rates and additional information have been mailed to all City retirees. You can download an electronic copy and the comparison chart at the bottom of this page. The health providers are the same as last year – so if you are NOT changing your health plan, you do not have to take any action.

CareCounsel is there to help! CareCounsel Member Care Specialists are available for your healthcare inquiries and concerns. You can call them at (888) 227-3334 or e-mail staff@carecounsel.com Monday through Friday, 6:30 a.m. to 5:00 p.m. PST. CareCounsel also provides helpful videos on their website that may answer your questions about Medicare, here: https://carecounsel.com/medicare.html.

You may send any health-related documents/forms to SDCERS via email, fax, or U.S. mail:

Email: health@sdcers.org - attachments must be in PDF format only (before sending, please read the important security note below. Also, if you are using an Apple product to send the email, in Mail, please select "Format" and click on "Make Plain Text" - we've received reports of emails not getting through our firewalls if this extra step isn't taken when using an Apple product.)

Mail: SDCERS, Attn. Health Reimbursements, 401 West A Street, Suite 800, San Diego, CA 92101 

Fax: (858) 581-5314 

If you plan to send health forms and other confidential information through email (PDF attachments only), read SDCERS' Privacy Policy here.

The Health Insurance Portability and Accountability Act of 1996's (HIPPA) Privacy Rule gives SDCERS who receive health coverage the right to be informed of the privacy practices of their health plans, as well as to be informed of their privacy rights with respect to their personal health information. 

Note: These plans are only available to eligible City of San Diego retirees.​

City Retiree Health Booklet

Health Plans Comparison Chart 2023 Health Plans Comparison Chart 2023
Comprehensive City Retiree Health Book 2023 Comprehensive City Retiree Health Book 2023

Enrollment Forms

Cigna Enrollment/Disenrollment Form Cigna Enrollment/Disenrollment Form
Delta Dental Enrollment/Disenrollment Form Delta Dental Enrollment/Disenrollment Form
Kaiser Enrollment Form Kaiser Enrollment Form
Kaiser Senior Advantage Enrollment Form Kaiser Senior Advantage Enrollment Form
Kaiser Senior Advantage Disenrollment Form Kaiser Senior Advantage Disenrollment Form
SCAN Enrollment Form SCAN Enrollment Form
SCAN Disenrollment Form SCAN Disenrollment Form
Sharp Direct Advantage Enrollment Form Sharp Direct Advantage Enrollment Form
Sharp Direct Advantage Disenrollment Form Sharp Direct Advantage Disenrollment Form
Sharp HMO Enrollment Form Sharp HMO Enrollment Form
VSP Enrollment Form VSP Enrollment Form

Plan Information

Plan Information

CIGNA

Cigna HMO Benefit Summary Cigna HMO Benefit Summary
Cigna Select HMO Benefit Summary Cigna Select HMO Benefit Summary
Cigna Open Access Plus Benefit Summary Cigna Open Access Plus Benefit Summary
Cigna Surround Benefit Summary Cigna Surround Benefit Summary
Cigna HMO COB Prescription Drug Summary Cigna HMO COB Prescription Drug Summary
Cigna Surround Prescription Drug Summary Cigna Surround Prescription Drug Summary
Cigna HMO COB Benefit Summary Cigna HMO COB Benefit Summary
Cigna Medicare Vision Benefit Summary Cigna Medicare Vision Benefit Summary
Cigna Under 65 Vision Benefit Summary Cigna Under 65 Vision Benefit Summary

SCAN

SCAN Benefit Summary SCAN Benefit Summary
SCAN Independent Living Power SCAN Independent Living Power
SCAN UCSD Affiliated Network SCAN UCSD Affiliated Network

Kaiser

Kaiser Permanente 2023 Open Enrollment Brochure Kaiser Permanente 2023 Open Enrollment Brochure
Kaiser Permanente Benefit Summary Kaiser Permanente Benefit Summary
Kaiser Permanente Member Resource Guide California Kaiser Permanente Member Resource Guide California
Kaiser Permanente Mental Health and Wellness Brochure Kaiser Permanente Mental Health and Wellness Brochure
Kaiser Digital Health Offerings Kaiser Digital Health Offerings
Kaiser Senior Advantage Benefit Summary Kaiser Senior Advantage Benefit Summary
Kaiser Medicare Guide Kaiser Medicare Guide

Sharp

Sharp Classic Benefit Summary Sharp Classic Benefit Summary
Sharp Direct Advantage Benefits Summary Sharp Direct Advantage Benefits Summary
Sharp Select Benefit Summary Sharp Select Benefit Summary

Delta Dental

Delta Dental DHMO Plan Summary Delta Dental DHMO Plan Summary
Delta Dental PPO Plan Summary Delta Dental PPO Plan Summary

VSP

VSP Benefit Summary VSP Benefit Summary
VSP Exclusive Member Extras VSP Exclusive Member Extras
VSP Flyer - A Look at Your VSP Vision Coverage VSP Flyer - A Look at Your VSP Vision Coverage
Put Your Eyes at Ease with VSP LightCare Put Your Eyes at Ease with VSP LightCare

Reimbursement Forms

Reimbursement Forms

Annual Privately Secured Reimbursement Form Annual Privately Secured Reimbursement Form
Annual Privately Secured Reimbursement Instructions Annual Privately Secured Reimbursement Instructions
Certification of Medicare Status and Medicare Part B Reimbursement Certification of Medicare Status and Medicare Part B Reimbursement
COBRA Insurance Reimbursement Form COBRA Insurance Reimbursement Form
Health Insurance Reimbursement Form Health Insurance Reimbursement Form