Retiree & Survivor Reimbursement Programs

Phone: 425-452-3521 Toll Free: 1-866-897-1996

Email: 105@naviabenefits.com

Navia Benefit Solutions
PO Box 53250
Bellevue, WA 98015

• Participant Online Registration Instructions
• Peralta CCD Participant Facing Contact Sheet
• Revised Peralta Medicare Reimbursement Claim Form – Updated Navia Info 11 30 2023
• Direct Deposit Form-Initial mailing
• Medicare A, B & D Premium Reimbursement Plan Summary Plan Description (SPD) 2015
• Medicare Reimbursement Plan Policy Statement 10.2015

Navia HRA accounts are specifically for retirees/survivors and eligible dependents enrolled in a Kaiser or Anthem plan with the Self-Insured Schools of California (SISC).

Phone: 559-256-1320 Toll Free: 866-777-1320

Email: spsclaims@naviabenefits.com

Navia Benefit Solutions
PO Box 5809
Fresno, CA 93755

Forms and Documents

• Welcome Letter with Navia Plan-Specific Contact Information
• Example Explanation of Benefits
• Mobile App and Portal Registration Instructions
• Reimbursement Request Form
• Direct Deposit Request Form

HRA Schedule of Benefits (Retired Before 7/1/04)

• Anthem (SISC)
• Kaiser Senior Advantage HMO (SISC)
• Kaiser Traditional HMO (SISC)
  
  

HRA Schedule of Benefits (Retired Between 7/1/04 and 6/30/12)

• Anthem (SISC)
• Kaiser Senior Advantage HMO (SISC)
• Kaiser Traditional HMO (SISC)

HRA Schedule of Benefits (Retired After 7/1/12)

• Anthem Local 39 (SISC)
• Anthem Local 1021 & Confidential (SISC)
• Anthem Managers & PFT (SISC)
• Kaiser Senior Advantage Local 39 (SISC)
• Kaiser Senior Advantage Local 1021 & Confidential (SISC)
• Kaiser Senior Advantage Managers & PFT  (SISC)
• Kaiser Traditional HMO Local 39 (SISC)
• Kaiser Traditional HMO All EXCEPT Local 39 (SISC)

Phone: (510) 466-7229

Email: benefitclaims@peralta.edu

Peralta Benefits Office Address:

333 E. 8^th Street
Oakland, CA 94606

If you are enrolled in Retiree First’s Anthem Medicare Advantage Prescription Drug Plan or Traditional Medicare w/ United American Supplemental Plan, you must submit reimbursement requests to Peralta Benefits Office for review and approval. Prior to processing your claim, you must be issued a vendor number and will be required to submit a vendor application and W-9 form to the Benefits Office (if you have not been issued a vendor number as a retiree). Upon receipt of your vendor number, your claim will be processed within 30 days.

Forms & Documents

• Procedures for Filing a Claim
• PCCD Retiree Health Request Form for Reimbursement
• Retiree Healthcare Reimbursement Denial Appeal Form
• Retiree Healthcare Reimbursement Procedure
• Vendor Application
• W-9 Form