HEALTH PLANS

GCCCD offers two medical plans for full-time employees and classified employees who work at least 20 hours per week. These plans are Kaiser and Direct Health.  

Kaiser is a Health Maintenance Organization (HMO) plan. If an employee selects Kaiser, all healthcare will be provided through Kaiser doctors and facilities, or their affiliates upon referral only.  

The Direct Health plan allows participants flexibility to select the providers and facilities of their choosing, and pay out-of-pocket costs accordingly. There are three levels of coverage, called “tiers.” Tier 1, the least expensive tier, covers Sharp community doctors and facilities. Tier 2 covers the Blue Cross network of doctors, and Tier 3 covers providers not affiliated with either Sharp or Blue Cross.

For more information on the differences between Kaiser and Direct Health, including out-of-pocket expenses, download the medical plan comparison chart.  Frequently Asked Questions are below.

Helpful Tools
Eligibility
Employee Benefits Summary
Health Plan Comparisons
GCCCD Direct Health Plan Document
GCCCD Direct Health Amendment
GCCCD Direct Health Formulary
Request for Direct Health Claims Review/Appeal
    For Medical or Labs (Form and Process)
    For Pharmacy Review or Pre-authorization call 1-800-460-8988
Adjunct Faculty Insurance information: Q&A, Enrollment Kit (Spanish), How to make changes, change form

Links to our Health Partners:
Anthem/Blue Cross (Direct Health)
BRMS (Direct Health Claims Administration)
CCN USA
Cobra
Kaiser
Sharp
US Script (Direct Health Pharmacy Coverage)
VSP or call 1-800-877-7195

Frequently Asked Questions

Q:  What are the Health plans offered by the District?

   A:  GCCCD offers Kaiser and Direct Health medical plans.

Q:  Are there websites for the medical plans?

   A: Yes, please see the Links section above on this webpage.

Q:  What if I don’t enroll in a health plan upon my hire?  Can I enroll later on?

   A: If you do not enroll in medical coverage within 30 days of becoming eligible, you will be automatically enrolled in Kaiser and have to wait until Open Enrollment, each October-November if you want to switch plans or add dependents.  Coverage would begin the start of the next plan year, which is January 1.  

Q:  Can I choose NOT to enroll in any of the health plans offered by the district?  If so, will the District pay for my current private health plan carrier?

   A:  At this time GCCCD does not allow eligible employees to opt-out of medical coverage. If you do not enroll yourself, GCCCD will enroll you in the Kaiser coverage. The District will not pay for your enrollment in other coverage.

Q:  Do any of the plans offered by the District deny you coverage due to pre-existing conditions?

   A:  The GCCCD plans do not deny coverage for pre-existing limitations.

Q:  Will I be required to take a physical exam prior to being accepted into a health plan?

   A: No physical exam is required to enroll in the medical plans if you are eligible.

Q: What if I need to add on a dependent later in the year?

   A:  Certain life changes allow you or your dependents to make changes outside of Open Enrollment, such as birth, adoption, divorce, and a few others. Contact the Benefits Office to see if your situation qualifies to make mid-year changes.

Q:  Can I remain in the GCCCD Health Plans if I stop working for GCCCD?

   A: If you are no longer employed with GCCCD, you and your eligible dependents would be offered an opportunity to enroll in COBRA continuation coverage. You will receive enrollment forms from the district.

Q:  Will my family members be able to continue coverage should I suddenly die?

   A: If you should pass away, your eligible dependents would be offered an opportunity to enroll in COBRA continuation coverage. They will receive enrollment forms from the district.