Open Enrollment 2024-2025
Make changes online August 1 - 30
Changes will take effect October 1, 2024
No Changes, No Action Required!
All retirees can change their medical/dental insurance plans, or add/delete dependents. We are no longer using the eBenefits portal for insurance changes, you will use the digital form links on this webpage and in the Open Enrollment Retiree Presentation. Review insurance plan options in the Open Enrollment Retiree Presentation. There is a special section at the bottom of this page for individuals who retired on or after October 1, 2020. (Recorded webinar from August 2024) Passcode: 99QjF@oy (2024 Retiree Open Enrollment Presentation pdf Slides)
Please be sure your Palomar College address and emergency contact information is up to date. Address/Emergency Contact Form
The medical and dental contributions listed below apply October 1, 2024 through September 30, 2025 for people who retired on, or after, 10/1/2020.
Medical Insurance Information
Anthem CaliforniaCare HMO U65 (Plan Summary) - (no retiree contribution required)
Anthem 80E PPO U65 (Plan Summary) - (no retiree contribution required)
Anthem 100A PPO U65 (Plan Summary) - Single $207.00, 2-Party $404.00, Family $570.00 (Retired on/after 10/2020)
Anthem PPO EGWP +65 (Plan Summary) - (no retiree contribution required)
Kaiser HMO U65 (Plan Summary)- (no retiree contribution required)
Kaiser HDHP U65 (Plan Summary) - (no retiree contribution required)
Kaiser Senior Advantage +65 (Plan Summary) - (no retiree contribution required)
Dental Plan Information
DeltaCare USA DHMO (Plan Summary) - (no retiree contribution required)
Delta PPO (Plan Summary) - $44.30 contribution (Retired on/after 10/2020)
Delta Premier Incentive (Plan Summary) - $71.00 contribution (Retired on/after 10/2020)
How to enroll or make changes:
- Review the "2024 Retiree Open Enrollment Presentation Slides"
- Find the plan from the list below that you would like to change
- Click the text to pull up the digital form
- Carefully complete the fields on the digital form
- Use the "sign" button to create a signature and sign the form
- You will receive an emailed copy of the completed form as confirmation of your submission
- The Benefits Office will automatically receive a copy of the form
MEDICAL FORMS
Anthem PPO U65
Anthem PPO +65 (this is an email not a digital form)
Anthem PPO 80E
Anthem HMO
Kaiser HMO U65
Kaiser HMO +65 (this is an email not a digital form)
Kaiser HDHP
DENTAL FORMS
Delta Premier
Delta PPO
DeltaCare USA DHMO
Annual Required Notifications:
HIPAA Privacy Notice
Insurance Marketplace Notice
COBRA General Notice
Newborns Health Protection Act
Children's Health Insurance Program
Medicare Creditable Coverage Disclosure
Patient Protection Disclosure
Special Enrollment Notice
Women's Health & Cancer Rights Notice Notice
Group Number
- Anthem PPO/EGWP (Group# 4R001A): Plan Summary (click here)
All members must be 65 or older to be on this plan - SISC Medicare 101 (click here) Password = SISCMedicare101
Part D Reimbursement & Resources
- Medicare Part D IRMAA Reimbursement (click here)
- EGWP Welcome Letter (click here)
- Medicare IRMAA website (click here)
- Medicare Part D Formulary (click here)
Other Plan Resources
- Medicare Provider Search (click here) & Anthem Provider Search (click here)
- MD Live telephone/skype medical advice (click here)
- Advance Medical Second Opinion (click here)
- Employee Assistance Plan (click here)
- Anthem "Sydney" app (click here)
- +65 Silver & Fit
- Lark Diabetes Prevention Program
Group Number
- Anthem PPO 100A (Group# 40795L): Plan Summary (click here)
One or more of the members are under the age of 65 - Anthem PPO 80E (Group# 40795P): Plan Summary (click here)
- Anthem HMO (Group# 57APGB): Plan Summary (click here)
- SISC Medicare 101 (click here) Password = SISCMedicare101
Other Resources
- Anthem Provider Search (click here)
- Carrum for knee/hip/spine surgery (click here)
- MD Live telephone/skype medical advice (click here)
- Teledoc Expert Second Opinion/Advice (click here)
- Employee Assistance Plan (click here)
- Anthem "Sydney" app (click here)
- Lark Diabetes Prevention Program (click here)
- Cancer Diagnosis Benefit (click here)
- Hinge Health (click here)
Group Number
- Kaiser HMO under 65 (Group# 225543-3028RBN): Plan Summary (click here)
- Kaiser HDHP with District funded HSA (Group# 234480-0075RBN): Plan Summary (click here)
- Kaiser Senior Advantage +65 (Group# 225543-3028RBN): Plan Summary (click here)
- SISC Medicare 101 (click here) Password = SISCMedicare101
Other Resources
- Kaiser Medicare Information (click here)
- Your care your way telephone/skype (click here)
- Advance Medical Second Opinion (click here)
- Employee Assistance Program (click here)
- Kaiser Active & Fit (+65 Silver & Fit)
Premier Group Number
- Delta Dental Premier (Group#7046-03902) - employees hired prior to 1/1/1996
Premier Plan Summary
- Plan Summary (click here)
PPO Group Number
- Delta Dental PPO (Group #7046-03908) - employees hired on or after 1/1/1996
PPO Plan Summary
- Plan Summary (click here)
Other Resources:
- Delta Dental Website/app (click here)
Palomar College Retirees' Association - PACRA
PACRA is a non-profit, on-campus organization for the purpose of serving the needs and interests of Palomar College and its retirees. Membership is open to all retired employees of the College, their spouses. surviving spouses, Associate Members appointed by the Board of Directors and any active employees who desire to become members.
Retired Public Employees Association - RPEA
click hereAnthem
- Anthem Active and Fit - under age 65 (click here)
- Anthem Silver and Fit - over age 65 (click here)
Kaiser
- Kaiser Active and Fit - under age 65 (click here)
- Kaiser Silver and Fit - over age 65 (click here)
Other Resources
- Aging and Independence Information (click here)
- UCSD Center for Healthy Aging (click here)
- San Diego County Health Advocates (click here)