Valley Water Retirees Information | Santa Clara Valley Water

Welcome!

This website is intended to provide Valley Water retirees with more information regarding retiree healthcare benefits. If you have any questions, please contact a Benefits staff member at (408) 630-3030 or [email protected]

Open Enrollment 2025	Medicare
February 17, 2025 - March 7, 2025, for an April 1, 2025 effective date 1. 2025 Information Memo: Retiree Memo (Under age 65) Retiree Memo (Current Blue Shield Medicare Advantage Members) Retiree Memo (Medicare Retirees on Blue Shield PPO or Kaiser Senior Advantage) 2. 2025 Retiree Benefits Guide 3. Changing Plans: Enrollment Change Form (Blue Shield/Kaiser) Anthem Medicare Preferred PPO Enrollment Form 5. Summary of Benefits and Coverage (SBCs): Anthem Medicare Advantage PPO Blue Shield PPO Blue Shield HMO Blue Shield Trio HMO Kaiser Chiro Kaiser Double Coverage HMO Kaiser Medicare Advantage Kaiser HMO	NEW Anthem Medicare Advantage Plan with RetireeFirst concierge service: Valley Water is pleased to announce a new and upcoming Medical and Prescription Drug coverage offering specifically for Medicare retirees. The new Medicare Advantage with Prescription Drug (MAPD) Plan will be provided by Anthem Medicare Preferred (PPO). Anthem Medicare Preferred Enrollment Guide Frequently Asked Questions (FAQ’s) Dedicated RetireeFirst advocacy lines are now LIVE: Dedicated local number assigned: (408)868-8964 Dedicated toll-free number assigned: (855)301-8203 Dedicated RetireeFirst/ValleyWater website: www.retireefirst.com/valleywater New: Medicare Mail Order Changing to Amazon effective April 1, 2025 Click here to submit your Medicare Verification Form 2025 Medicare Part B Reimbursement Form: FC_1646_Calendar_Year_2025.pdf FC_1646_Calendar_Year_2025_FILLABLE.pdf FC_1646_SAMPLE_Calendar_Year_2025.pdf FC_1646_Calendar_Year_2025.xlsx Sample Benefits Verification Letter 2024 Medicare Part B Reimbursement Form: FC_1646_Calendar_Year_2024.pdf FC_1646_Calendar_Year_2024_FILLABLE.pdf FC_1646_SAMPLE_Calendar_Year_2024.pdf FC_1646_Calendar_Year_2024.xlsx Sample Benefits Verification Letter 2025 Medicare Part D Reimbursement Form: FC_1946_Calendar_Year_2025_MARCH FC_1946_Calendar_Year_2025_JUNE FC_1946_Calendar_Year_2025_SEPTEMBER FC_1946_Calendar_Year_2025_DECEMBER 2024 Medicare Part D Reimbursement Form: FC_1946_Calendar_Year_2024_DECEMBER_(05-20-24) FC_1946_Calendar_Year_2024_MARCH_(05-20-24) FC_1946_Calendar_Year_2024_JUNE_(05-20-24) FC_1946_Calendar_Year_2024_SEPTEMBER_(05-20-24) NEW: E-sign and submit Medicare Part B Payment Request e-forms online! 2025 Links to submit Medicare Part B Reimbursement Forms online: CY25 Medicare Part B Reimbursement Form Quarter Ending 03/31 CY25 Medicare Part B Reimbursement Form Quarter Ending 06/30 CY25 Medicare Part B Reimbursement Form Quarter Ending 09/30 CY25 Medicare Part B Reimbursement Form Quarter Ending 12/31 2024 Links to submit Medicare Part B Reimbursement Forms online: CY24 Medicare Part B Reimbursement Form Quarter Ending 03/31 CY24 Medicare Part B Reimbursement Form Quarter Ending 06/30 CY24 Medicare Part B Reimbursement Form Quarter Ending 09/30 CY24 Medicare Part B Reimbursement Form Quarter Ending 12/31 2025 Links to submit Medicare Part D Reimbursement Forms online: CY25 Medicare Part D Reimbursement Form Quarter Ending 03/31 CY25 Medicare Part D Reimbursement Form Quarter Ending 06/30 CY25 Medicare Part D Reimbursement Form Quarter Ending 09/30 CY25 Medicare Part D Reimbursement Form Quarter Ending 12/31 2024 Links to submit Medicare Part D Reimbursement Forms online: CY24 Medicare Part D Reimbursement Form Quarter Ending 03/31 CY24 Medicare Part D Reimbursement Form Quarter Ending 06/30 CY24 Medicare Part D Reimbursement Form Quarter Ending 09/30 CY24 Medicare Part D Reimbursement Form Quarter Ending 12/31
Benefits Information	Dental/Vision/Deferred Compensation/ARDE
Anthem Medicare Preferred (PPO): Website Group# Number Blue Shield PPO/HMO Information: www.blueshieldca.com Group# W0051426 1-855-599-2650 New: Action Required- Blue Shield Mail Order Changing to Amazon effective 1/1/25 Blue Shield Health Plan Documents: 2024 Blue Shield Trio EOC 2024 Blue Shield HMO Access EOC 2024 Blue Shield PPO EOC 2024 Blue Shield Medicare Advantage Summary of Benefits 2024 Blue Shield Medicare Advantage EOC 2024 Blue Shield PPO Plan Summary 2024 Blue Shield Medicare Advantage – Get Started with Silver Sneakers 2024 Blue Shield Medicare Advantage SilverSneakers Step-by-Step Enrollment Instructions 2024 Blue Shield Medicare Advantage SilverSneakers Member Flyer Blue Shield HMO EOC (Coming Soon) Blue Shield Privacy Notice Blue Shield Hearing Aid Benefit Treatment Cost Estimator Grievance Form HMO Chiropractic and Acupuncture Benefit Prescription Benefits Prescription Mail Order Program Kaiser Information: www.kp.org Group# 7189 1-800-464-4000 2024 Kaiser Traditional HMO EOC 2024 Kaiser Senior Advantage KPSA) EOC 2024 Kaiser HMO (Double Covered) EOC 2024 Kaiser HMO Plan Summary 2024 Kaiser HMO (Double Covered) Plan Summary 2024 Kaiser Senior Advantage (KPSA) Plan Summary 2024 Kaiser Amendment Adding Chiropractic & Acupuncture 2024 Kaiser Silver & Fit Program Information Travel Benefits for Emergencies to non-Kaiser Facility Visiting Members to other Kaiser Regions Kaiser RX Mail Order	Delta Dental (for eligible retirees only): Delta Dental (EOC) Group# 21266 www.deltadentalins.com 1-800-765-6003 Vision Service Plan (VSP) (for eligible retirees only): Vision Service Plan (VSP) (EOC) Group# 30102594 www.vsp.com 1-800-877-7195 Deferred Compensation: Deferred Compensation Information ARDE: Association of Retired District Employees (ARDE)

Related Files

Attachment	Size
COM Amazon Easy Sign-up Guide_FINAL.pdf	3.01 MB
2024 SCVWD 7189 -DBL COV HMO EOC.pdf	2.06 MB
2024 SCVWD 7189 -HMO 10 EOC.pdf	2.06 MB
2024 SCVWD 7189 -KPSA EOC.pdf	1.38 MB
SCVWD - GMAPD PPO 2024 Webinar 022224.pdf	789.59 KB
2024 Blue Shield Medicare Advantage EOC	2.34 MB
2024 Blue Shield PPO EOC.pdf	2.29 MB
2024 Blue Shield Access HMO EOC.pdf	2.27 MB
2024 Blue Shield Trio HMO EOC.pdf	2.32 MB
2024 Blue Shield Medicare Advantage Summary of Benefits	197.14 KB
FC_1646_Calendar_Year_2024 (11-08-23).pdf	612.85 KB
FC_1646_Calendar_Year_2024 (11-08-23).xlsx	91.39 KB
FC_1646_Calendar_Year_2024_FILLABLE (11-08-23).pdf	762.51 KB
FC_1646_SAMPLE_Calendar_Year_2024 (11-08-23)_New Rates.pdf	442.06 KB
Sample_Benefits_Verification_Letter.pdf	1.74 MB
FC_1646_Calendar_Year_2023_FILLABLE.pdf	761.21 KB
FC_1646_SAMPLE_Calendar_Year_2023.pdf	511.8 KB
FC_1646_Calendar_Year_2023.pdf	297.16 KB
FC_1646_Calendar_Year_2023.xlsx	93.42 KB
Sample_Benefits_Verification_Letter.pdf	1.74 MB
FC_1646_Calendar_Year_2022_FILLABLE_rev.pdf	741.97 KB
FC_1646_SAMPLE Calendar Year 2022.pdf	437 KB
FC_1646 Calendar Year 2022.xlsx	91.53 KB
FC_1646 Calendar Year 2022 FILLABLE.pdf	741.96 KB
FC_1646 Calendar Year 2022.pdf	215.13 KB
2021 SCVWD kaiser-HMO EOC.pdf	2.25 MB
BlueShield_PPO_EOContract2021.pdf	2.48 MB
BlueShield_HMO_EOContract2021.pdf	2.47 MB
ValleyWater2021_Newsletter_Retirees.pdf	2.65 MB
Kaiser_HMO_Early Retirees_2021_SBC.pdf	676.06 KB
Blue_Shield_PPO_2021_SBC.pdf	730.3 KB
Blue_Shield_HMO_2021_SBC.pdf	724.95 KB
2021SCVWD_Annual_Legal Notice-PartD_Creditable_Coverage.pdf	609.87 KB
2021Retiree_Memo_Under65.pdf	235.61 KB
2021Retiree_Memo_Over65.pdf	217.4 KB
FC_1646_Calendar_Year_2021.xlsx	92.08 KB
FC_1646_SAMPLE_Calendar_Year_2021.pdf	428.45 KB
FC_1646_Calendar_Year_2021_FILLABLE.pdf	737.67 KB
FC_1646_Calendar_Year_2021.pdf	147.28 KB
Sample_Benefits_Verification_Letter.pdf	1.74 MB
Kaiser_EOC.pdf	2.26 MB
BlueShield_HMO_EOC_2020.pdf	2.4 MB
BlueShield_PPO_EOC_2020.pdf	2.32 MB
FC_1646_Calendar_Year_2020_FILLABLE.pdf	983.89 KB
FC_1646_Calendar_Year_2020.pdf	138.3 KB
2025 Retiree Memo (Under 65).pdf	195.42 KB
Retiree Memo (Current Blue Shield Medicare Advantage Members) .pdf	315.87 KB
Retiree Memo (Medicare Retirees on Blue Shield PPO or Kaiser Senior Advantage) .pdf	304.63 KB
2025 Anthem MAPD FAQ's.pdf	385.52 KB
2025 Anthem Medicare Advantage Plan PPO.pdf	5.46 MB
2025 Blue Shield HMO Benefit Summary Valley Water.pdf	364.38 KB
2025 Blue Shield PPO Benefit Summary Valley Water.pdf	391.35 KB
2025 Blue Shield Trio HMO Benefit Summary Valley Water.pdf	364.71 KB
2025 Kaiser Chiro Benefit Summary Valley Water.pdf	1.86 MB
2025 Kaiser Double Coverage HMO Benefits Summary Valley Water.pdf	84.61 KB
2025 Kaiser -HMO Benefit Summary Valley Water - Active.pdf	84.22 KB
2025 Kaiser Medicare Advantage _KPSA Benefits Summary Valley Water.pdf	101.39 KB
Retiree Benefits Guide	1.89 MB