Benefits New Hire Enrollment Forms
Most forms are in the interactive PDF format. If further assistance is required, please contact the Benefits Office at (209) 575-6547.
Classified/Management: Benefits begin the first of the month following your date of hire. If your start date is the first of the month, your benefits will also begin on that date.
Faculty: Most instructors' benefits will begin the first of the month of their semester start date (August 1st or January 1st). Some exceptions apply.
If you have questions as to when your benefits will start, please feel free to contact the Benefits Office at (209) 575-6547.
New Hire Benefits Forms:
1) New Hire Benefits Checklist
Medical Plan Information: Medical Plan Comparison with Rates (effective 10/01/2022)
2) Active Plan Election Form: Election Form for All Employees
3a) Blue Shield: SISC Enrollment
Premium Only Plan (POP) Form - (required for 80%-C, 90%-G, or 100%-D plan choices)
3b) Kaiser: Kaiser Enrollment
IMPORTANT NOTE FOR KAISER: You must live or work in an approved Kaiser Service Area. Columbia College employees are not eligible unless they live in one of these service areas. To see if you qualify, you can access Kaiser's directory at: https://healthplans.kaiserpermanente.org/federalemployees/wp-content/uploads/sites/2/2013/11/Service-Areas-v2.pdf
YOU MUST include Marriage Certificate/Legal Partnership forms and page one of your most recent tax return showing same address if enrolling spouse/domestic partner. If enrolling children, include a copy of each child's birth certificate as well as a copy of their social security number.
4) Premium Only Plan (POP) Form
5) Basic Life Beneficiary/Enrollment Form
6) Voluntary Life Enrollment Form (optional) -> Voluntary Life Rates and Information
7) 2022-23 Health Plan Comparison
ACA - Affordable Care Act Notice and Marketplace Coverage Employee FAQs (Please Read)
New employees are eligible to enroll in the FLEX Savings Accounts through Navia at the time of hire!
8) SISC/Navia Flex - Benefits Guide
9) SISC/Navia Flex - Enrollment Form