Palmdale School District

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    WELCOME CLASSIFIED RETIREES!

    GROUP NUMBERS ARE LISTED FOR YOU USE.

     

    Remember, you can only be on an over 65 plan if ALL members on your plan are over 65. For instance,

    if you spouse is over 65 and you are under 65, then you will be on the under 65 plan.

Plan Description Co-Pay Prescriptions Group Number Telephone Website
BLUE SHIELD OF CALIFORNIA 800.642.6155 http://www.blueshieldca.com
BSC 100A $10 $5-20 RX SC12640ER1 RET <65
SC12640RM1 RET 65+ W/A & B
BSC 100A $20 $9-35 RX SC12650ER1 RET <65
SC12650RM1 RET 65+ W/A & B
BSC 90A $20 $9-35 RX SC12660ER1 RET <65
SC12660RM1 RET 65+ W/A & B
BSC 80C $20 $9-35 RX SC1330-0ER1 RET <65
SC1330-0RM1 RET 65+ W/A & B
BSC 80C $20 $200/$25-50 064857P121005 RET <65 WWW.BLUESHIELDCA.COM
KAISER PERMANENTE
Kaiser w/Chiro $0 $5 225543-0991 1-800-464-4000 http://www.kp.com
DENTAL PROVIDER Call or use website to find dentist
Delta Dental PPO w/ $1,500 Annual Max Incentive Plan 7079 2900 1-800-765-6003 http://www.deltadentalins.com
VISION PROVIDER Call or use website to find a provider
Vision Service Plan (VSP)- Plan C $15 2465604A 800-877-7195 http://www.vsp.com
ADDED BENEFITS
Grand Rounds $0 1-844-252-3056 http://www.grandrounds.com/sisc
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    MEDICARE CARDS

    When an active employee switches to district-paid retiree status, please include the Medicare cards of the employees and/or spouses of the employees who are over 65 or may have Medicare due to a disability.
    Over 65 retirees and dependents must have both Medicare A & B in order to stay on SISC health coverage.

     

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