Open Enrollment 2013 Information & Forms

OPEN ENROLLMENT INFORMATION Presenting the 2013 CalPERS Health Plans
Click on the following to link to short video clips explaning the 2013 Health Plans: **2013 HEALTH PLANS**
2013 Health Benefit Summary
2013 Health Program Guide
2013 Open Enrollment News
A special note for current PERSCare Enrollees (Faculty) Open Enrollment Supplement - SMCFA members
FAQs PERS Select, PERS Choice & PERSCare
Freedom to Choose Brochure
For more information, contact Heather Memarian Memarian_Heather@smc.edu 310.434.4205 Vanna Ratnaransy Ratnaransy_Vanna@smc.edu 310.434.4060

OPEN ENROLLMENT FORMS Links to the Enrollment change forms are to be found below; forms are also available in the Office of Human Resources. Please refer to completed samples and complete fully before submitting to human resources. This will expedite any changes you elect to make. If you are making more than one open enrollment change, you can list all of your changes on the Open Enrollment Election form and submit them with all of your applicable enrollment forms.
CALPERS HEALTH PLAN CHANGES Annual Health Plan Open Enrollment Election Form for 2013 CalPERS Health Enrollment Form	SAMPLES of Completed Forms: PLAN CHANGE (i.e., PERS Care to PERS Choice) PLAN CANCELLATION NEW PLAN ENROLLMENT
DENTAL PLAN CHANGES: Annual Health Plan Open Enrollment Election Form for 2013 Delta Dental Dual Enrollment Form	SAMPLES of Completed Forms: PLAN CHANGE (i.e, Delta Care HMO to Delta Dental PPO) PLAN CANCELLATION NEW PLAN ENROLLMENT
VISION PLAN CHANGES: Annual Health Plan Open Enrollment Election Form for 2013 Vision Enrollment Form	SAMPLES of Completed Forms: PLAN CANCELLATION NEW PLAN ENROLLMENT