Active Employees

The Superior Court offers Court employees and their eligible dependents a self-funded PPO Medical Plan, administered by HealthComp. Plan highlights include:

• Reasonable co-pays and no deductible with services incurred with an "in-network" physician.
• No referral requirement to see a specialist. This will streamline employees’ access to care and save both time and money.
• The addition of an out-of-pocket maximum has been added to Tier 1 (in-network) coverage of $1,500 per individual / $3,000 per family (2 family members must meet $1,500 maximum). This out-of-pocket maximum limits employees’ financial exposure, in the event of a significant volume of claims.
• Certain pre-authorization requirements have been eliminated. This should result in employees being able to access care more efficiently.
• The availability of network providers, with greater geographic access, has been enhanced by utilizing two networks of the Anthem Blue Cross of California PPO network for services rendered in California and First Health / CCN providers will continue to be the “in-network” providers for services rendered outside of California.

Please visit the links below for important information regarding your medical plan and how to locate providers:

• HealthComp Group Enrollment Form 
• Health Care Summary Plan Document
• PPO Medical Plan Benefits-at-a-Glance
• How to Locate a Medical PPO Provider
• How to Access HealthComp's Website
• Medical Claim Form
• Understanding Your Benefit ID Card
• Sample Explanation of Benefits
• Special Enrollment Periods
• Summary of Benefits and Coverage (Medical)
• Medicare

Anthem Blue Cross

1-800-810-2583

• www.anthem.com/ca

First Health/CCN

1-888-685-7774

• www.myfirsthealth.com

HealthComp

1-800-442-7247

• www.healthcomp.com

The Superior Court is proud to bring Court employees a self-funded PPO Dental Plan, administered by HealthComp. The plan includes orthodontia coverage and effective January 1, 2024, we have changed dental networks from Connection Dental and First Dental Health to Anthem Blue Cross PPO Dental Network.  The Court believes that having all benefit component's with one network will cause less confusion for member's and the providers they seek care from.  

Please visit the links below for important information regarding your dental plan and how to find a dentist:

• PPO Dental Plan Benefits-at-a-Glance
• How to Locate a Dental PPO Provider
• Dental Claim Form

Anthem Blue Cross PPO Dental

1-844-729-1565

www.anthem.com/ca

HealthComp

1-800-442-7247

www.healthcomp.com

The Superior Court provides employees participating in the medical plan with comprehensive vision coverage through Vision Services Plan (VSP). When you enroll in the Court’s medical plan, you and your enrolled dependents automatically receive VSP vision coverage.

• Summary of the Court’s Vision Benefits
• VSP Complaint/Appeal Rights
• VSP / TruHearing - Hearing Aid Discount Program
• VSP Reimbursement Form

VSP

1-800-877-7195

www.vsp.com

Announcement: Patent Expiration and Generic Availability

There are several medications which have had, or will have, their patents expire. The expiration of these U.S. patents will allow generic versions to be manufactured and sold at a much lower cost than the brand name counterparts. Members who choose to switch to a generic alternative will save themselves, and the plan, additional costs which are frequently associated with higher-priced, brand medications.

To help inform members of their new cost saving alternatives, the Court has asked our Pharmacy Benefit Manager, Express Scripts, to send notifications to all members who may be currently using medication/s which have expired, or are soon to expire, as well as to members who may obtain new prescriptions for non-preferred brand medications in the future. More information regarding generic alternatives may be found by logging on directly to Express Scripts at www.express-scripts.com.

General Pharmacy Information

Employees enrolled in medical coverage will automatically receive prescription drug coverage. Express Scripts is the chosen pharmacy benefit manager and will administer all prescription drug benefit for retail and mail-order services.

Effective January 1, 2011, Tier I and II prescription copays are no longer waived at Kern Medical Center or its affiliated pharmacies.

Please visit the links below for important information regarding your prescription drug coverage:

Prescription Reimbursement Form
Express Scripts Prescription Order Form

Employees can access and manage their prescription drug benefits easier through the Express Scripts website.

Here are some of the useful resources, tools, and information available to you on www.express-scripts.com:

• Prescription Drug Plan Overview – Provides an overview of the Superior Court’s Prescription Drug Plan.
• Prescription Refill/Renewal – Access to order prescription refills and request renewals.
• Locate a Participating Retail Pharmacy – Locate an In-Network pharmacy or verify that your current pharmacy is In-Network.
• Price a Medication – Obtain pricing and coverage information on a variety of medications, including comparing the cost of generic to brand name medication.
• Drug Information – Research valuable drug information.
• Get Started with Mail Order – Learn more about this easy, convenient service.
• Order Envelopes and Forms – Get extra claim forms and mail order envelopes.
• Health Encyclopedia – Website visitors can access a customized version of adam.com’s medical encyclopedia to find information on symptoms, diseases, injuries, and other health conditions.
• Health Toolbox – Members can use a series of interactive tools to help them assess, track and plan their medications and health activities, communicate with their doctor or pharmacist, and actively manage their diseases.
• Health News – A website where visitors can view a daily feed of health-related news items written in a way that’s easy for the health care consumer to understand.
• Nonprescription Items – Shop for nonprescription over the counter items at a discounted price.

Express Scripts

1-800-988-1913

www.express-scripts.com

Effective January 1, 2024, OptumHealth EAP has undergone a name change and will be better known as OptumHealth Emotional Wellbeing Solutions (EWS).  Optum's Emotional Wellbeing Solutions is designed to address personal, emotional and workplace issues in their earliest stages. They offer 24/7/365 access to counseling services, child and elder care referrals, financial and legal advice services and much more. It is completely confidential and you and anyone living in your household will have access to up to six (6) free, confidential face-to-face visits with a licensed counselor, per circumstance, per year, with no limitations of how frequently the sessions can be scheduled. In addition, for those that prefer more anonymity or who do not have the time to attend face-to-face visits, OptumHealth offers unlimited access to telephonic EWS (formerly known as EAP) counseling services as well. In the event you, or your household member are in need of more than six (6) visits for the same circumstance in a calendar year, OptumHealth will assist in finding a counselor/therapist within the Court’s mental health benefit offered under our existing medical plan through Anthem Blue Cross, provided the member is a covered person on that plan.

Knowing that the initial call is sometimes the most difficult step in getting help, OptumHealth’s master’s-level employee assistance specialists will greet each incoming call with a warm, caring and supportive approach and will focus on going the extra mile to ensure your experience with the EWS is a beneficial one.

OptumHealth offers an extensive selection of EWS providers in Bakersfield and the surrounding areas. They also provide a comprehensive website that offers self-help and resource tools for the various types of services the EWS benefit covers.

To access this beneficial program, you can simply call OptumHealth at the number listed below or visit their website for more information.

• Summary of Benefits and Coverage (EAP)

OptumHealth EWS (EAP)

(866) 248-4098

www.liveandworkwell.com

*Register with the company code: KERN to access benefits through the OptumHealth website

The Court has experienced a higher than normal premium rate increase for the medical and prescription component of the benefit plan for the 2024 plan year. As such, employees will pay the bi-weekly premium amounts listed below for the 2024 plan year. Employee only coverage will continue to be covered in full for all participants, and for those who were hired prior to April of 1997, the Court will continue to pay 100% of the premiums for employees and their eligible dependents.

Rates effective January 1, 2024

For information about the Court’s benefits, you may contact the companies that help manage our plans. Below is a list of our vendors’ phone numbers and websites. If you need further assistance, please contact the Human Resources Department. 

The Court considers a Registered Domestic Partner an eligible dependent for purposes of enrollment on an employee's Health Benefit Plan offered through the Superior Court. In order to enroll a registered domestic partner, the employee must do so within the regular Open Enrollment periods each year, or within 31 days of the date the employee and their domestic partner received a State certified Affidavit of Domestic Partnership.

*All payroll deductions for registered domestic partners are subject to a post-tax deduction, unless the employee certifies that the Domestic Partner qualifies as a tax dependent.  For more information on the tax dependent status of a Domestic Partner, please read the below "Domestic Partner Tax Treatment" document.

• Certification of Dependent Status
• Change in Dependent Tax Status
• Domestic Partner Tax Treatment
• Notice of Termination of Domestic Partnership

Your health benefits package includes medical, prescription drug, dental, and vision coverage for employees and their eligible dependents.

HealthComp, our Third Party Administrator, is responsible for processing all Medical and Dental claims incurred, as well as the Flexible Spending Account claims.

HealthComp understands that, as plan participants, employees may have questions about their health plan and how HealthComp can best be of service to them. A specialized team of Customer Service Representatives has been selected for the Court’s health plan and is available to assist employees between the hours of 6:00 a.m. and 4:30 p.m. Monday-Friday (PST). To reach one of HealthComp’s knowledgeable Customer Service Representatives, please call 1-800-442-7247.

In addition, HealthComp also provides members 24/7 access to their website where employees can access their own personal health benefit information anytime, anywhere, 24 hours per day. Some of the information employees can find on their website includes: current eligibility, benefit plan design, claim status, provider directories and helpful links, including wellness information and research tools on health topics. Please visit www.healthcomp.com and register to learn more.

How to Access HealthComp's Website

HealthComp

1-800-442-7247

www.healthcomp.com

Annual Flu Vaccinations

In an attempt to mitigate the spread of COVID-19, the Court has regretfully decided to once again postpone the on-site flu vaccination clinics typically scheduled in the Fall of each year.  While there are no longer social distancing requirements, on-site vaccination clinics are often accompanied by staff standing in somewhat large groups, and in close proximity to one another, while awaiting their turn.  While the Court will not be offering these on-site clinics, all employees are strongly encouraged to continue to obtain their annual flu vaccinations; either directly through their healthcare provider, or through their preferred local retail pharmacy. 

As a reminder, if you are enrolled in the Court’s Medical and Prescription component of the health benefit plan, you may take advantage of the Pharmacy Vaccination Program, which provides enrolled members routine vaccinations at no out-of-pocket cost when obtained through participating pharmacies.  If you are not enrolled in the Medical/Prescription component of the Court’s health plan and are still interested in obtaining an annual flu vaccination, please contact the Kern County Health Department at (661) 321-3000 to inquire about scheduling an appointment for free or low cost services, which may be available to you and/or your family.

If your pharmacy neglected to bill the Court's insurance plan resulting in an out of pocket expense to you and/or your enrolled dependent(s), you may submit the claim form located below to seek reimbursement. Claim for Reimbursement forms must include the employees name, the dependents name (if applicable) and have a copy of the receipt showing proof of payment as well as the Rx form showing the recipients name.

Claim for Reimbursement - Flu Vaccine

For more information, please contact Benefits and Payroll Administrator Kristin Bush at x86173, or Kristin.Bush@kern.courts.ca.gov

Pharmacy Vaccination Program

Effective January 1, 2020, all employees who are enrolled in the Medical/Rx component of the Court’s Health Benefit Plan (and their enrolled dependents) will be able to obtain many routine vaccinations and immunizations at local retail pharmacies without having to incur up-front, out-of-pocket costs and having to seek reimbursement.

While routine vaccines and immunizations have been covered by our Medical plan since its inception, the employee/enrolled dependent was required to obtain such vaccines/immunizations through their healthcare provider, often having to incur a co-pay at the doctor’s office for the visit. Employees/enrolled dependents have also always been able to obtain vaccines/immunizations at local retail pharmacies; however, pharmacies will only bill Pharmacy Benefit plans, not Medical plans; therefore, any vaccination/immunization received through the pharmacy resulted in the employee/enrolled dependent having to cover the out-of-pocket expenses associated with that vaccine and completing additional paperwork to seek reimbursement if they wanted to re-coupe the costs they had incurred. While employees and their enrolled dependents can still obtain vaccinations/immunizations at their healthcare providers office (co-pays may still apply), after January 1, 2020, there will be no need to submit a claim for reimbursement when obtaining vaccinations/immunizations at a participating pharmacy. This will result in easier access to care, more convenience to employees and their covered dependents, and a cost savings to both the covered member as well as the Court’s Benefit Plan.

• Pharmacy Vaccination Program Information Flyer

Over-the Counter (OTC)SARs-CoV-2 Testing Member FAQs

Under the Families First Coronavirus Response Act (FFCRA) and recent regulatory guidance, certain health plans are required to provide benefits for items and services related to testing for SARS-CoV-2 (the virus that causes COVID-19) until the current public health emergency ends.

What will those covered under the plan have to pay?
Under the FFCRA, for qualifying tests, your health plan may not impose any cost-sharing requirements (including deductibles, copayments, and coinsurance), prior authorization, or other medical management requirements. For this reason, such items and services covered will come at no cost to those covered under your plan.

Do I need a prescription or an order from a doctor for testing?
A prescription or doctor’s order is no longer required for your plan to pay the cost of any qualifying over the counter (OTC) testing purchased from January 15, 2022 until the current public health emergency ends. The manner by which the plan will directly cover or reimburse for such testing is described below.

How do I submit my qualifying OTC test expenses for reimbursement?
Members enrolled in the Superior Court of California, County of Kern PPO Plan can submit a completed OTC COVID Test Claim Form, along with your receipt(s) to Healthcomp for reimbursement of qualifying OTC tests. The claim form can be completed electronically by logging in to HCOnline here and clicking on “Member Forms”, then “COVID Test Claim Form” which can be located under the Downloadable Forms section. You may also submit the form by mail - P.O. BOX 45018, FRESNO, CA 93718-5018, or fax - FAX (559) 499-2464. The OTC COVID claim form can also be found on the Superior Court intranet under Departments; Human Resources; and the “COVID Tests” link among other benefit-related material, or under the Forms/Documents link and typing in the keyword COVID.

• HealthComp OTC COVID Test Claim Form

How can I receive FDA-approved rapid antigen home tests?

• Starting January 19, members can request free rapid antigen home tests, without shipping fees, from the federal government here
• Rapid antigen home tests are also available at local drugstores or online.

Is there a limit to how often I can be reimbursed for the cost of tests?
Yes, the plan will only provide reimbursement for a maximum of eight (8) tests purchased within any thirty (30) day period, per covered individual. But note, OTC tests purchased with a doctor’s order or prescription will not count against this eight (8) test limit.

May I use this benefit to purchase tests for an individual not covered by my plan?
No. Tests purchased under these rules must be for the covered individual’s personal use. The test cannot be for employment-related purposes (e.g., fitness to return to work) either. You may be required, when seeking reimbursement, to legally attest to the fact that test(s) purchased were for your own use or for the use of another covered individual under whose benefit the test was purchased, and that the test will not be reimbursed by another source and was not used for resale or employment purposes.

Must I show proof of purchase for over-the-counter tests?
Yes. As explained above, when you seek reimbursement for the purchase of over-the-counter testing, you will be required to show documentation that proves that the tests were actually purchased and paid for. An itemized receipt is adequate proof of purchase for reimbursement.

What kind of testing would be best for me and those covered under my plan?
There are different kinds of tests designed to detect SARS-CoV-2 which you can choose. The information below may help guide you in choosing what kind of testing to seek. Your personal physician may have a recommendation on which type of test is most appropriate for you.

Polymerase Chain Reaction (PCR) tests

Generally, the most sensitive tests are polymerase chain reaction (PCR) tests, which look for certain genetic material found in the virus. These tests are performed via a nasal swab, and usually done in a clinical setting by a technician, nurse, or other professional. PCR tests must then be sent to a laboratory which will generate a result, typically within a few days.

Antigen tests

Popular at-home tests (which are the kind you purchase over the counter) are usually antigen tests. These tests are fast, and will generate a result you can read yourself, within just a few minutes. However, according to the FDA, antigen tests are less sensitive than PCR tests, and are more likely to provide a false negative result. Many such tests are intended to be used serially, meaning that the test-taker should take the test on two separate days to minimize the possibility of giving the false impression that the test-taker is negative for SARS-CoV-2.

It is important to note that no test is 100% reliable. If you experience symptoms associated with COVID-19 or have any questions about testing, you should follow the guidance of your doctor and public health professionals, and limit your exposure to others, even if you have received a negative result through testing.

What home tests have been approved by the Food and Drug Administration (FDA) as qualifying tests?
These manufacturers and brand names have been approved by the FDA (this list is periodically updated by the FDA on its website, see below)

• Abbott Diagnostics' BinaxNOW
• SD Biosensor's COVID-19 At-Home Test.
• Siemens' Clinitest.
• IHealth Labs' iHealth test.
• Quanterix Corp.'s Simoa.
• Salofa Oy's Sienna-Clarity.
• Becton, Dickinson and Company's BD Veritor System.
• Nano-Ditech Corp.'s Nano-Check.
• Access Bio's CareStart.
• InBios' SCOV-2 Ag Detect.
• GenBody Inc.'s GenBody COVID-19 Ag.
• Ortho Clinical Diagnostic's Vitros.
• Phase Scientific's Inicaid.
• Quidel's QuickVue.
• OraSure Technologies' InteliSwab.
• LumiraDX UK's LumiraDx.
• Princeton BioMeditec's Status.
• Celltrion USA's Celltrion DiaTrusst.

More information about approved tests is available from the FDA’s website: here

What options are available if the availability of at-home testing is limited in my area?
The Federal Government now offers four (4) free at-home SARS-CoV-2 tests to every American household. These can be ordered online at COVIDtests.gov, and are shipped at no cost: https://www.covidtests.gov/