• Welcome!

• About this Handbook

• Benefits at a Glance

• Health Care Eligibility at a Glance
• Enrollment Options at a Glance
• Health Care Coverage at a Glance

• HAP Medical at a Glance
• EAP at a Glance
• Mental Health/Substance Abuse at a Glance
• Prescription Drugs at a Glance
• Dental Coverage at a Glance
• Vision Coverage at a Glance

• Flexible Spending Accounts at a Glance
• Health Account at a Glance
• Disability Coverage at a Glance
• Life and Accident Insurance at a Glance
• Retirement Plans at a Glance
• Time Off Benefits at a Glance
• Work/Life Benefits at a Glance

• What If.

• Work Events

• You Join PG&E
• You Transfer from a Management or Administrative & Technical Position
• You Reach Regular Status
• You Work a Reduced (Part-Time) Schedule
• You Take an Unpaid Leave of Absence
• You Leave PG&E
• You Retire

• Family Events

• You Get Married or Enter into a Registered Domestic Partnership
• You Become Divorced or Legally Separated, or End a Registered Domestic Partnership
• You Have or Adopt a Child or Become a Foster Parent or a Legal Guardian
• You Move
• You Lose Other Coverage, After Declining Company Coverage
• Your Spouse or Registered Domestic Partner Retires

• Health Events

• You Are Injured or Sick and Absent from Work
• You Are Disabled Long-Term and Go on LTD
• You Become Terminally Ill or Die While an Active Employee

• Annual Enrollment

• You Enroll for Benefits Each Year
• You Need to Make a Mid-Year Change

• Other Rules

• Change-in-Status Events
• Timeline for Health and Welfare Benefit Enrollment

• Health Care Benefits

• Health Care Participation

• Eligible Dependents

• Ineligible Dependents
• If Eligibility Is Denied

• Cost of Coverage

• Contributions for Full-Time Employees
• Contributions for Part-Time Employees
• Contributions for Employees on Leaves of Absence
• Contributions for Employees on Long-Term Disability
• Medicaid and the Children's Health Insurance Program (CHIP) Offer Free or Low-Cost Health Coverage to Children and Families

• Enrollment

• New Hire Enrollment
• Annual Open Enrollment
• Declining Medical, Dental and/or Vision Coverage

• Changing Your Coverage

• HIPAA Special Enrollment Periods

• If You Have Other Coverage

• Which Plan Is Primary for You?
• Which Plan Is Primary for Your Children?
• Coordination with Medicare
• Medicare and Active Employment
• Reductions/Exclusions for Duplicate Coverage
• Subrogation and Reimbursement
• For KPIC Members Only

• When Coverage Ends

• Your Dependents
• Extended Benefits When Coverage Ends

• Continuing Coverage Under COBRA

• Eligibility
• When COBRA Coverage Ends
• Cost of COBRA Continuation Coverage
• How to Obtain COBRA Continuation Coverage
• Review of COBRA Determination of Ineligibility

• Conversion to an Individual Medical Policy

• Medical Coverage

• The Health Account Plan (HAP)

• The HAP at a Glance
• How the HAP Works

• Network Providers
• Non-Network Providers
• Deductibles
• Plan Maximums

• Out-of-Pocket Maximums
• Lifetime Maximums
• Coinsurance and Benefit Percentages
• Outpatient Hospital Services
• Physician Office Visits

• How Benefits Are Determined

• Reasonable and Customary (R&C) Charges - Anthem HAP
• Covered Health Services
• Medically Necessary Services
• Special Situations - Emergency Care and Treatment Away From Home
• Receiving Care in Other Kaiser Permanente Regions
• Emergency, Post-Stabilization, and Out-of-Area Urgent Care Received from Non-Network Providers - KPIC HAP
• Treatment Away From Home

• Medical Management Programs

• Medical Management - Anthem Blue Cross

• Utilization Review Program
• Authorization Program
• Medical Necessity Review Process
• Personal Case Management

• Medical Management Programs - KPIC

• Utilization Review Program
• Pre-Authorization and Referrals

• What the HAP Covers

• Acupuncture
• Ambulance Services
• Chiropractic Care
• Home Health Care and Hospice Care

• Services in Your Home
• Hospice Facility

• Hospital Care - Inpatient
• Hospital Care - Outpatient
• Organ and Tissue Transplants

• Bone Marrow Donor Search
• How to Obtain Authorization
• Transportation and Lodging

• Inpatient Prescription Drugs
• Professional Services
• Psychiatric Care and Substance Abuse Treatment
• Skilled Nursing Facility
• Other Covered Medical Services and Supplies

• Women's Health and Cancer Rights Act
• Newborns' and Mothers' Health Protection

• What the HAP Doesn't Cover
• Mental Health and Substance Abuse Coverage

• How Benefits Are Provided

• Deductibles, Limits, and Coinsurance
• How to Obtain Benefits
• In Case of Emergency
• What Is Covered Under the HAP
• Medical Management and Authorization Programs
• Medically Necessary
• What Is Not Covered Under the Mental Health/Substance Abuse Provisions of the HAP
• More About Mental Health and Substance Abuse Treatment Benefits
• Claims and Appeals Process

• Prescription Drug Coverage

• Plan Benefits

• Plan Benefits for Anthem HAP Members
• Plan Benefits for KPIC Members
• Generic Incentive Provision - Anthem HAP
• Step Therapy Provision - Anthem HAP

• Eligibility
• How the Plan Works

• For Anthem Blue Cross HAP members
• For KPIC HAP members

• What the HAP Covers
• What the HAP Does Not Cover
• Coordination of Benefits - Anthem HAP
• Claims and Appeals

• Glossary
• Claims and Appeals Process

• Claims and Appeals - Medical Benefits

• Filing a Claim
• Payment of Benefits for Non-Network Benefits - Anthem Blue Cross
• Benefit Determinations (Before an Appeal Is Filed)
• To Resolve a Problem
• If Your Claim Is Denied
• Your Right to Appeal
• Your Right to External Review by an Independent Review Organization (IRO)
• PG&E Voluntary Claims and Appeals Review Process

• Binding Arbitration for the KPIC HAP
• Claims and Appeal Process - Mental Health and Substance Abuse Benefits

• Filing a Claim
• Inquiries, Benefit Certifications, and Claims
• Your Right to Appeal
• Your Right to External Review by an Independent Review Organization (IRO)
• PG&E Voluntary Claims and Appeals Review Process

• Claims and Appeals - Prescription Drug Benefits

• Filing a Claim
• Benefit Determinations (Before an Appeal Is Filed)
• To Resolve a Problem
• Your Right to Appeal
• Your Right to External Review by an Independent Review Organization (IRO)
• PG&E Voluntary Claims and Appeals Review Process

• Wellness Program

• Eligibility
• Wellness Program at a Glance

• Health Advocacy Services
• Health Screenings
• Telephonic Health Coaching
• Online Health Risk Questionnaire
• Health & Wellness Portal
• Tobacco Cessation Program
• Gym Discounts

• Employee Assistance Program (EAP)

• EAP Coverage at a Glance
• Eligibility and Cost

• Cost

• Confidentiality

• Circumstances Limiting Confidentiality

• How to Use the Program

• Referrals
• Leaves of Absence

• Claims and Appeals Process

• Filing a Claim
• Appeal Procedures
• Arbitration
• PG&E Claims and Appeals Review Process

• Medical Coverage for Participants on Long-Term Disability

• Health Account

• Health Accounts at a Glance
• Eligibility
• How the Health Account Works

• How to Earn Credits for Your Health Account
• Setting Up Your Health Account
• Reimbursement of Eligible Health Care Expenses
• Deadline for Submitting Health Care Claims and Receipts
• Availability of Health Account Credits for Reimbursement
• Additional Health Account Credits for Financial Hardship

• What's Eligible and What's Not

• Health Account Eligible Expenses
• Ineligible Expenses
• Partial Prepayments
• If Eligibility Is Denied

• Health Account Claims and Appeals
• More About the Accounts

• If You Have Both a Health Care Flexible Spending Account (HCFSA) and a Health Account
• If You Take a Leave of Absence Without Pay
• If You Are on Long-Term Disability
• If You Leave the Company
• If You Retire
• If You Are Re-Hired by the Company
• The Health Account and COBRA for Spouses, Registered Domestic Partners and Dependents

• Dental Coverage

• Dental Coverage at a Glance
• How Dental Coverage Works

• Non-Participating Dentists
• Predetermination of Costs

• What's Covered
• Plan Limitations
• What's Not Covered
• Claims and Appeals

• Claims and Inquiries
• Complaints and Appeals
• PG&E's Voluntary Claims and Appeals Review Process

• Vision Coverage

• How the Plan Works

• Non-VSP Providers
• Benefits with VSP Providers
• Benefits with Non-VSP Providers

• What the Plan Does Not Cover
• Value-Added Discounts from VSP Doctors
• Claims and Appeals

• Claims
• Complaints and Appeals
• Your Right to External Review by an Independent Review Organization (IRO)
• PG&E Voluntary Claims and Appeals Review Process

• Flexible Spending Accounts (FSAs)

• Flexible Spending Accounts (FSAs) at a Glance
• How this Section Is Organized
• How Health Care Flexible Spending Accounts (HCFSAs) and Dependent Care Flexible Spending Accounts (DCFSAs) Work

• Eligibility, Enrollment and Administration
• Setting Up Your Flexible Spending Accounts
• Putting Money into Your Flexible Spending Accounts (FSAs)
• Health Care Flexible Spending Account (HCFSA)
• Deadline for Submitting Health Care Claims and Receipts
• Dependent Care Flexible Spending Account (DCFSA)
• Deadline for Submitting Dependent Care Claims and Supporting Documentation
• When Reimbursements Are Available
• Flexible Spending Account (FSA) Limitations
• Questions About Claims for Reimbursement

• Health Care Flexible Spending Account (HCFSA)

• Eligible Expenses
• Ineligible Expenses
• Partial Prepayments
• Claims and Appeals

• Dependent Care Flexible Spending Account (DCFSA)

• Whose Expenses Are Eligible?
• Eligible Expenses
• Ineligible Expenses
• Tax Credits

• What Happens.

• If You Take a Leave of Absence Without Pay
• If You Are on Long-Term Disability or Workers' Compensation
• If You Retire or Leave the Company
• If You Have Both a Health Care Flexible Spending Account (HCFSA) and a Health Account

• Sick Leave & Disability

• The Coverage Available
• Eligibility, Enrollment and Cost
• Sick Leave

• Earning Sick Leave
• Family Sick Leave
• Sick Leave Bonus Vacation Award
• Using Sick Leave
• Terminated Employees

• Long-Term Disability (LTD) Plan

• How Disability Is Determined
• What the LTD Plan Does Not Cover
• What Happens to Your Other Benefits
• Plan I
• Plan II
• Plan III
• Claims and Appeals - Plans I, II and III

• Workers' Compensation

• Procedures in the Event of an Industrial Injury or Illness

• Supplemental Benefits for Industrial Injury Plan

• When Benefits Begin
• How Much the Plan Pays
• When Benefits End
• Claims and Appeals

• Life and Accident Insurance Plans

• Group Life Insurance

• Employee Supplemental Life Insurance
• Dependent Life Insurance
• Eligibility, Enrollment and Cost
• How Your Benefit Is Paid

• Will Preparation Services
• Estate Resolution Services
• Accelerated Benefit Option (ABO)
• Assignment of Benefits

• Changing the Level of Your Coverage
• What Happens.
• When Coverage Ends

• Converting Your Coverage to an Individual Policy

• Accidental Death and Dismemberment (AD&D) Insurance

• Employee Voluntary AD&D Insurance
• Dependent Voluntary AD&D Insurance
• Eligibility, Enrollment, and Cost
• How Your Benefit Is Paid

• Beneficiary Designation
• Travel Assistance and Identity Theft Solutions
• Hospital Confinement Benefit
• Additional AD&D Benefits
• Exclusions to AD&D Benefits

• What Happens.
• When Coverage Ends

• Claims and Appeals for Group Life and AD&D

• Claims Relating to a Benefit
• Claims Relating to Eligibility
• State Legal Notices for Group Life Coverage

• Business Travel Insurance (BTI)

• Eligibility
• How Business Travel Insurance Works

• Amount of Coverage
• BTI Benefits
• Limitations and Exclusions

• Claims Information

• Claims Review Procedure

• Retirement Benefits

• Retirement Plan at a Glance

• The Retirement Plan Benefit Formulas
• Retirement Plan Highlights

• Retirement Plan - Final Pay Pension Benefit

• Final Pay Pension Benefit at a Glance
• Participating in the Final Pay Pension
• How the Final Pay Pension Works
• Your Pension Benefit

• Credited Service
• Vesting
• Breaks in Service

• When Benefits Are Payable

• Early Retirement Benefits
• Deferred Retirement Benefits
• Benefits If You Leave PG&E Before Age 55
• Minimum Distributions
• Mandatory Distributions
• Pre-Retirement Survivor's Pension
• Payments to a Lost Participant or Beneficiary

• Payment Options

• Single Life Pension
• Joint Pension
• Past Employee Contributions to the Retirement Plan
• Changing Your Election
• Facility of Payment

• No Guarantee of Employment
• Military Service
• Your Responsibility to Maintain a Current Address
• Borrowing, Pledging, and Assigning Interests in the Plan
• What Happens.

• If You Leave the Company with a Vested Benefit and Want to Start Your Pension
• If You Transfer to or from a Non-Union Position
• If You Get Divorced
• If You Die Before You Retire
• If You Want to Begin Receiving Your Pension Benefit
• If You Are Rehired
• If You Also Have a Cash Balance Pension
• If Your Benefit Is Affected by IRS Limits

• Claims and Appeals
• The Pension Benefit Guaranty Corporation
• Tax Considerations

• Retirement Plan - Cash Balance Pension Benefit

• Cash Balance Pension Benefits at a Glance
• Participating in the Cash Balance Pension
• How the Cash Balance Pension Works

• Pay Credits
• Covered Pay
• Interest Credits
• A Cash Balance Pension Account Example
• Vesting

• When Benefits Are Payable

• When Your Employment Ends
• Mandatory Distributions
• Minimum Distributions
• Death Benefits

• Payment Options

• Optional Forms of Annuity Payments
• Making Your Payment Election
• Changing Your Election
• Loss or Reduction of Benefits
• Facility of Payment

• No Guarantee of Employment
• Military Service
• Your Responsibility to Maintain a Current Address
• Borrowing, Pledging, and Assigning Interests in the Plan
• What Happens.

• If You Leave the Company
• If You Get Divorced
• If You Die Before You Retire
• If You Die Within 30 Days of Your Retirement Date
• If You Are Rehired on or After January 1, 2013
• If You Also Have a Benefit Under the Final Pay Pension Formula
• If Your Benefit Is Affected by IRS Limits
• If You Take a Leave of Absence or Go on LTD

• Claims and Appeals
• The Pension Benefit Guaranty Corporation
• Tax Considerations

• Retirement Savings Plan

• Retirement Savings Plan at a Glance
• Participating in the Plan

• Enrolling in the Plan
• Automatic Enrollment in the Plan
• Beneficiary Designation

• Contributions

• Vesting
• Employee Contribution
• Catch-Up Contribution
• Matching Employer Contribution
• Rollover Contributions from Previous Employer Plans
• Contribution Limits

• Investing

• Investment Options
• PG&E Corporation Stock Fund Information
• Monitoring and Making Changes to Your Investments

• Accessing Your Account

• Loans
• In-Service Withdrawals
• Distributions After Your Employment Has Ended

• Investment and Advisory Services

• Financial Engines
• Fidelity Education and Modeling Tools

• Taxes and Penalties
• What Happens

• If You Are on an Authorized Leave of Absence
• If You Leave PG&E or Retire
• If You Die
• If You Transfer to or from a Union Classification
• If You Get Divorced
• If You Get Rehired

• Additional Plan Information

• Significant Accounting Policies and Investment Disclosure
• Fees and Expenses
• Plan Administration and the Corporation's Power and Duties
• Participant Account Activity and Plan Service Provider
• Claims and Appeals Procedures
• Borrowing, Pledging, and Assigning Interests in the Plan
• Future of the Plan
• Qualified Domestic Relations Orders (QDROs)
• Facility of Payment
• No Guarantee of Employment
• Military Service
• Missing Participants
• Requests for Documents

• Retiree Medical Coverage

• Your Medical Plan Options
• Eligibility

• Surviving Dependents

• Changing Your Coverage
• Retiree Medical Savings Account (RMSA)

• What Is the RMSA?

• Postretirement Life Insurance

• Amount of Coverage

• Time Off and Leaves

• Time Off and Leaves at a Glance
• Vacation Program

• Earning Vacation
• Illness While on Vacation
• Service Anniversary Days
• How to Schedule or Defer Your Vacation
• Work In-Lieu of Vacation
• Excess Vacation Payout
• Voluntary Vacation Transfer
• Vacation Pay Upon Termination
• Re-employment with the Company

• Paid Holidays

• When a Holiday Falls on a Weekend or Non-Workday
• Work Performed on a Holiday

• Floating Holidays

• Part-Time Employees

• Leaves of Absence

• Determination for Eligibility and Entitlements under FMLA/CFRA Leave
• Types of Leave
• Union Business Leave

• Other Time Off

• Jury Duty
• Funerals
• Adoption
• Voting
• Family School Partnership Act (FSPA)
• Victims of Domestic Violence, Sexual Assault or Stalking Act (VDVA)
• Victims of Crime Act (VCA)
• Victims of Crime to Testify
• Civil Air Patrol Leave
• Emergency Duty Leave and Volunteer Firefighter Training
• San Francisco Family Friendly Workplace Ordinance (SF FFWO)

• Work/Life Benefits

• Adoption Expense Reimbursement Program

• Eligibility
• What the Program Covers
• How to Apply
• Claims and Appeals

• Commuter Transit Program

• Eligibility
• Benefits
• Forfeitures

• Employee Discount

• Requesting the Discount and Change of Residence

• Legal/Financial Solutions (ValueOptions)

• Eligibility
• Cost
• How to Use Legal/Financial Solutions

• PG&E Children's Center

• Eligibility and Enrollment
• Claims and Appeals

• Tuition Refund Program

• Eligibility
• Tuition Refund Application
• Course Approval Criteria
• Excluded Programs and Courses of Study
• Tuition Costs Covered
• Tuition Costs Not Covered
• What the Program Will Pay

• Work/Life Program (ValueOptions)

• Rules, Regulations & Administrative Information

• Plan Amendment and Termination
• Plan Administration
• Your Rights Under ERISA
• Health Information Privacy and Data Security
• Forfeiture of Unclaimed Benefit Payments
• Facility of Payment
• Administrative Information

• The Health and Welfare Benefits Pre-Tax Plan
• The Pacific Gas and Electric Company Health Care Plan for Active Employees
• The Pacific Gas and Electric Company Health Care Flexible Spending Account Plan
• The Long-Term Disability Plan
• The PG&E Corporation Disability Plan
• The Supplemental Benefits for Industrial Injury Plan
• The Pacific Gas and Electric Company Group Life Insurance Plan
• The PG&E Corporation Business Travel Insurance Plan
• The Pacific Gas and Electric Company Retirement Plan
• PG&E Corporation Retirement Savings Plan for Union-Represented Employees (formerly called the Pacific Gas and Electric Company Savings Fund Plan for Union-Represented Employees)
• The Pacific Gas and Electric Company Health Care Plan for Retirees and Surviving Dependents
• The Pacific Gas and Electric Company Postretirement Life Insurance Plan
• The Pacific Gas and Electric Company Children's Center Program
• The Tuition Refund Program

• Contacts

• Archives