Sequoia Union High School District

Q&A from May 23rd, 2022 Webinar on Shift to SISC for SUHSD Retirees 

Q. Is the Anthem Companion Care plan a PPO? 
A. Yes, it is a PPO. 

A. No, Kaiser will provide SISC with the Medicare enrollment information that is needed. 

Q. For retirees receiving quarterly reimbursements from the District, will the retirees continue to receive  quarterly reimbursements from the District 
A. Yes, retirees currently receiving quarterly reimbursements from the District will continue to receive  quarterly reimbursements from the District. 

Q. For retirees in the UHC PPO currently seeing a Sutter or Palo Alto Medical Foundation physician, with  those physicians be in the Anthem Companion Care PPO network? 
A. Yes, Sutter and PAMF are in the Anthem Companion Care PPO network. To confirm for a specific  doctor, check with Lauri Phillips at SISC (email at laphillips@siscschools.org).  

 

Q. Does this affect CalPERS long term care? 
A. No the shift to SISC does not affect CalPERS long term care or pension. 

 

Q. How will premium be paid to SISC? 
A. For retirees with 100% lifetime coverage, the District will pay SISC directly. For retirees without 100%  lifetime coverage, the retiree will pay SISC and then be reimbursed by the District. STRS pension funds  will not be used to pay the premium. 

 

Q. How does Silver and Fit compare to Silver Sneakers? 
A. The two programs are similar. Silver and Fit tends to provide a better benefit than Silver Sneakers.  

 

Q. To whom do we give enrollment forms? 
A. Additional information will be sent out in October, including instructions on who to give the forms.

Q. Will the Kaiser Senior Advantage program for Uber rides continue? 
A. Yes, the Kaiser Senior Advantage program for Uber rides will continue. All the Kaiser Senior  Advantage program supplementary programs will continue. 

 

Q. As a retired Kaiser Senior Advantage member, am I required to shift to SISC? 
A. Yes, everyone in CalPERS today for medical coverage will be moving to SISC for medical coverage. It is  not an automatic change. Retirees will need to fill out the form applicable to their choice of plan. The  enrollment form, a copy of your Medicare card, and documentation on any dependents will be required.  

 

Q. What specialists are in what networks? If in the PERS Platinum plan, will the same specialists be  available in the SISC Anthem Companion Care? 
A. All specialists from the PERS Platinum plan will be in SISC Anthem Companion Care network.  

 

Q. If my doctor doesn’t accept Medicare assignment, what should I do? 
A. Please contact Lauri Phillips at SISC to find the best plan option for you (email at  laphillips@siscschools.org). 

 

Q. Does Silver and Fit cover all YMCAs? 
A. Silver and Fit has a website where you can search for whether specific YMCAs are included. The web  address is https://www.silverandfit.com/search.  

 

Q. Is Anthem Companion Care the only option for people formerly in the UHC plan? 
A. Alternative SISC plans are also available. Please contact Lauri Phillips at SISC to find the best plan  option for you (email at laphillips@siscschools.org). 

 

Q. Am I required to go to Costco for prescription drugs? 
A. In Anthem Companion Care, Costco is the mail order prescription drug provider. For walk-up  pharmacy service, Costco is not required.

 

Q. Will premiums be withdrawn from my pension? 
A. No, for retirees without 100% District lifetime benefits, any premiums will need to be paid directly to  SISC by the retiree. Information will be provided to set up automatic payments.  

 

Q. Will reimbursements from the District be monthly or quarterly? 
A. Reimbursements will continue to be quarterly.  

 

Q. How will out of state coverage work? 
A. Kaiser enrollees not in California will need to enroll with Kaiser directly, not through SISC. Anthem  plans will work for any physician accepting Medicare assignment nationwide. 

 

Q. If a spouse is not considered a dependent, can the spouse be covered? 
A. From a SISC perspective, a covered spouse need not be a dependent on a tax return. Spouses must be  married or registered domestic partners to be covered.