HEALTH INSURANCE
OPEN ENROLLMENT September 1, 2021 through September 30, 2021
Medical Health Insurance is administered by CALIFORNIA’S VALUED TRUST and provided by Anthem Blue Cross.
Dental, Vision and Life Insurance is administered by Kansas City Life Insurance Company.
2022/23 Benefit Plan Matrix
Plan: WELLNESS, HDHP, BRONZE
2022/23 Benefit Plan Matrix
Plan: PPO 7C, PPO 8C, PPO 9C, PPO 10C
Premium Rates 2022/23
10 month/11 month/12 month
CVT MD Live
CVT Enrollment/Change Form
CVT Disabled Dependent Certification
CVT Declaration of Domestic Partnership
Termination of Domestic Partnership
PRESCRIPTION MEDICINE COVERAGE
CVS/Caremark Standard Claim Form
CVS/Caremark Secondary Claim Form
CVS/Caremark Mail Order Pharmacy Form
LAB SERVICES
LabCorp is the preferred provider for services in South Lake Tahoe and Nevada. LabCorp: 1625 SR88 #102, Minden, NV 89423 Tel: (775) 782-4532.
Quest Diagnostics is the preferred provider for services within California and outside South Lake Tahoe.
DENTAL INSURANCE
Dental insurance is administered by CVT and provided by Kansas City Life Insurance
Member Assistance: (77) 266-6767 ext. 8200 – Have your Group# and ID# ready
Email:
[email protected]
website: www.kclgroupbenefits.com
Dental Full Benefit Summary
Dental Summary
Dental Insurance Card
Dental Online Portal
Dental Reserve Account
VISION INSURANCE
Vision insurance is administered by CVT and provided by Kansas City Life Insurance
Member Assistance: (77) 266-6767 ext. 8200 – Have your Group# and ID# ready
Email: [email protected]
website: www.kclgroupbenefits.com
Vision Full Benefit Summary
Vision Summary
Vision Network
LIFE INSURANCE
Vision insurance is administered by CVT and provided by Kansas City Life Insurance
Forms can be obtained at www.cvtrust.org/resources/forms
Member Assistance: (77) 266-6767 ext. 8200 – Have your Group# and ID# ready
Email: [email protected]
website: www.kclgroupbenefits.com
Beneficiary Designation Form
Life Insurance Full Benefit Summary
Life Insurance Summary
RETIREMENT PLANS:
CAL STRS Link to Website
CAL PERS Link to Website
For questions about employee benefits, please contact:
Karla Aguirre
Tel: (530) 541-2850 ext. 1041
Email: [email protected]