Benefits

2017-18 Open Enrollment - Active Employees

 

2017-18 Active Plan Comparison

 

Active Employees

Active Employee Plan Comparison

SISC III Change Form (dependents, addresses, etc)

Health Plan Election Form (Classified/Management)

Health Plan Election Form (Faculty/Certificated)

If you are changing from Blue Shield to Kaiser, also complete:

     Kaiser Enrollment form

If you are changing from Kaiser to Blue Shield, also complete:

     Blue Shield Enrollment form

Dental/Vision Election Form

POP Form (Required for Buy-Up Plans)

Life Insurance Beneficiary Change Form

Voluntary Life Enrollment Form and Voluntary Rate Sheet

 

 

General Health Plan Information

Kaiser Plan Information

Blue Shield 80-G Plan Information

Blue Shield 80-C Plan Information

Blue Shield 90-G Plan Information

Blue Shield 100-D Plan Information