
2017-2018 Open Enrollment - Retiree
NOTE! If you are not making any changes, you do not need to do anything.
Benefits will mail letters mid-September confirming your elected plan(s) and rate(s).
Retired Employees
SISC III Change Form (addresses, dependents)
Retire Beyond YCCD Contribution Rate Sheet
Retiree Health Plan Rate Sheet
Retiree Health Plan Election Form (If changing plans, see notes below.)
If you are changing from Blue Shield to Kaiser, also complete:
If you are changing from Kaiser to Blue Shield, also complete:
Retiree Vision/Dental Enrollment Form
Other Retiree Information
How to set up Automatic Payments
Retiree Dental/Vision Rate Sheet - Only for retirees with current Dental/Vision benefits
General Health Plan Information
Kaiser Senior Advantage Information (over 65)
Blue Shield 80-G Plan Information
Blue Shield 80-C Plan Information
Blue Shield 90-G Plan Information
Blue Shield 100-D Plan Information
Blue Shield Companion Care Plan Information