Open Enrollment for Retirees medical insurance is from August 1-August 31

During Open Enrollment, you select your benefits from October 1, 2025, through September 30, 2026.
Changes you make go into effect on October 1, 2025

Open Enrollment for dental insurance is once every three years (the dental open enrollment is happening in 2027).

Open Enrollment is your once-a-year opportunity for retirees to review current benefit elections and make changes such as:

Change medical plans
Drop medical plan
Add or drop dependents

After Open Enrollment ends, you cannot change your benefit elections until the next Open Enrollment, unless you have a ‘qualified status change’.

If you aren't making any changes to your Health Insurance, then no action is required.

Medical benefit summaries and rates

The District offers a choice of five medical plans through our membership in Self-Insured Schools of California (SISC). These rates are effective October 1, 2025:

Rates for self payers not on ERO and those over 65

Rates for ERO - Classified, Faculty

Rates for ERO - Management

Please click on the links below to view the Benefit Summaries of the five medical plans:

Kaiser Permanente HMO

Kaiser Permanente Deductible plan with a Health Savings Account (HSA). This is a HMO deductible plan.

Blue Shield of California HMO

Blue Shield of California PPO

Blue Shield of California PPO Deductible plan with a Health Savings Account (HSA). This is a PPO deductible plan.

Anthem CompanionCare - Medicare Supplement plan

Kaiser Senior Advantage - Medicare Advantage plan

Medicare Part D Notice

Blue Shield drug formularies and doctor search
Enrollment Forms
All enrollment forms should be submitted to Christie Colón in Human Resources
Don't forget to provide the dependent eligibility documentation if you're adding a dependent.

These forms are fillable and signable. Once you've opened the form, please click "Download" to download the signable version:

FOR RETIREES UNDER AGE 65:

Membership Change form

Making changes to your current medical plan (like adding or deleting a dependent)? Please fill out the Membership Change form.

Blue Shield enrollment form

Use this form to enroll for the first time and follow these instructions:
- Blue Shield PPO or HSA – you must write HSA or PPO in the top margin on the form
- Blue Shield HMO – you must select a doctor when enrolling in this plan and include the doctor's IPA & PCP information on the enrollment form:
  
  IPA is the Group Name
  
  PCP is the Primary Care Physician #
  
  Here’s how to search on Blue Shield's website for the IPA and PCP information and to select a Blue Shield HMO doctor in your area:
  
  Click on “Primary Care Physician”
  
  Type in your location
  
  Select Specialty, like “Family Practice”, “Internal Medicine”, etc.
Kaiser enrollment form

Use this form to enroll for the first time and follow these instructions:

* Be sure to check "HMO" or "Deductible plan" in Section A on the enrollment form

FOR RETIREES OVER AGE 65:

Kaiser Senior Advantage enrollment form

Anthem CompanionCare enrollment form

To waive your medical insurance, please contact Christie Colón in Human Resources at ccolon@santarosa.edu or 707-527-4304.

WHAT'S NEW FOR 2025-2026?

Management retirees on the Early Retirement Option (ERO) Kaiser HMO, Blue Shield HMO and Blue Shield PPO will have a premium cost-share.

Blue Shield

MDLive copay change from $10 to $0 effective 10/1/2025.
Midi Health: Virtual Menopause Clinic available as a contracted provider.
PPO Plan – members 45+ are eligible for a free, at-home FIT colorectal cancer screening kit. Request a kit by creating an account at My.QuestForHealth.com.
Costco pharmacy prescriptions are delivered for free with Instacart. Once a prescription is filled, a text is sent to you with the link to access Instacart for free.

Kaiser Permanente

Kaiser discounted gym membership program changed from Active & Fit to One Pass.

Human Resources

Open Enrollment for Retirees

Please click on the links below to view the Benefit Summaries of the five medical plans:

FOR RETIREES UNDER AGE 65:

Membership Change form

Blue Shield enrollment form

Kaiser enrollment form

FOR RETIREES OVER AGE 65:

Kaiser Senior Advantage enrollment form

Anthem CompanionCare enrollment form

WHAT'S NEW FOR 2025-2026?