HEALTH INSURANCE
OPEN ENROLLMENT September 1, 2016 through September 30, 2016
Health Insurance is administered by CALIFORNIA’S VALUED TRUST and provided by Anthem Blue Cross.
2016/17 Benefit Plan Matrix
(Plan: Wellness-1/7C)
2016/17 Benefit Plan Matrix
(Plan: 8C/9C/10C/Bronze)
2016/17 Benefit Plan Matrix - HDHP-1
2016/17 Employee Premiums
(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 Delta Dental.
LTUSD’s Group# is 7901-3201
Member Assistance: (866) 499-3001 – Have your Group# and ID# ready
Dentist Referral: (800) 427-3237
Delta Provider Search
VISION INSURANCE
Vision insurance is administered by CVT and provided by Vision Service Plan (VSP)
LTUSD’s Group# is 21000491
Member Assistance: (800) 877-7195 Mon-Fri 5am-7pm PST
VSP Doctor Search
VSP Out of Network Claim Form
LIFE INSURANCE
Vision insurance is administered by CVT and provided by MetLife
Forms can be obtained at www.cvtrust.org/resources/forms
Employee Assistance Program (EAP)
RETIREMENT PLANS:
CAL STRS Link to Website
CAL PERS Link to Website
For Questions about employee benefits please contact:
Dana Lincoln
Tel: (530) 541-2850 ext. 1041
Email: dlincoln@ltusd.org