Valley Water Retirees Information

February 27, 2023 - March 17, 2023, For an April 1, 2023 effective date 

1. 2023 Information Memo

• Retiree Memo (Under age 65) 
• Retiree Memo (Over age 65) 

2. 2023 Retiree Benefits Guide

3. Enrollment Change Form

4. Go Paperless! Opt Out Form NEW! E-Sign and Submit this form online!

5. Summary of Benefits and Coverage (SBCs)

• Blue Shield PPO
• Blue Shield PPO Medicare Advantage Plan
• Blue Shield Access + HMO
• Blue Shield Trio HMO
   
• Kaiser HMO
• Kaiser HMO (Double covered)

Blue Shield PPO/HMO Information 

www.blueshieldca.com 
Group# W0051426
1-855-599-2650

Blue Shield Health Plan Documents

• Blue Shield PPO EOC (Coming Soon)       
• Blue Shield PPO Medicare Advantage Plan EOC
• 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

• Kaiser HMO EOC | Plan Summary
• Kaiser HMO (Double covered) EOC | Plan Summary
• Kaiser Permanente Senior Advantage (KPSA) EOC | Plan Summary
• 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)