1. 2018 Active Benefits Information
2. Health Benefits Enrollment Form - Active Employees
3. Unit F and Unit G Benefits Overview
4. 2017 Health Benefits Enrollment Form - Half-Time Active Employees
5. Request for Change of Dependent Status - Active Employees
6. 2017 Domestic Partner Information, Declaration and Enrollment Form
7. Change of Address Form
8. Update Your Personal Information
9. Retirement Eligibility Verification Form
10. 2018 Medical Opt-Out Cash Back Attestation Form
11 2017 Medical Opt-Out Cash Back Attestation Form
12. 2018 Unit F - Benefits Opt-Out Cash Back Form
13. Mid Year Plan Changes
14. Application for Retiree Health Benefits HI-22 Form

 

1. 2018 Retiree Benefit Guide
2. Application for Retiree Health Benefits HI-22 Form
3. Request for Change of Dependent Status - Retirees
4. Change of Address Form
5. Out of Area Enrollment Form
6. 2017 Domestic Partner Information, Declaration, and Enrollment Form
7. Mid Year Plan Changes

 

 2017 Cobra Active Employees 2018 Cobra Active Employees
 2017 Cobra District Retirees 2018 Cobra District Retirees
 2017 Cal-Cobra 2018 Cal-Cobra
 2017 AB528 2018 AB528
 2016-17 Cobra Active Teacher Asst 2017-18 Cobra Active Teacher Asst & Unit G

 

1. Enrollment At A Glance Flyer
2. Enrollment Form 
3. Request for Beneficiary Change Form
4. Request for Coverage Change Form
5. Retiree Enrollment At A Glance Flyer
6. Voya Plan Guide

 

1. 403(b) Flyer
2. 403(b) List of Vendors
3. 403(b) Plan Information
4. 457(b) Flyer
5. 457(b) Enrollment Form
6. 457(b) Plan Information

 

1. 2018 FSA Newsletter
2. FSA Enrollment Form
3. FSA Request for Change Form
4. FSA Reimbursement Claim Instructions
5. Online Claim Submission Guide

 

 
 
1. 2017 CVS/CareMark Summary of Benefits for Anthem Blue Cross EPO
2. 2017 CVS/CareMark Summary of Benefits for Anthem Blue Cross HMO
3. CVS/CareMark Performance Drug List for Anthem Blue Cross Plans
4. CVS/CareMark Advanced Control Speciality Formulary for Anthem Blue Cross Plans
5. 2018 Prescription Drug Plan EOC for Anthem Blue Cross EPO - SilverScript Medicare
6. 2018 Prescription Drug Plan EOC for Anthem Blue Cross HMO - SilverScript Medicare
7. 2018 Prescription Drug Plan Formulary for Anthem Blue Cross  EPO - SilverScript
8. 2018 Prescription Drug Plan Fomulary for Anthem Blue Cross HMO - SilverScript
9. Health Net Active/Retirees Under 65 Drug Formulary
10. Health Net Retiree Over 65 Drug Formulary
11. Health Net Prescription Drug
12. 2017 UHC Comprehensive Drug Formulary
13. 2017 UHC Abridged Drug Formulary
14. SilverScript Employer Prescription Drug Provider Medicare Part D Plan

 

1. 2018 Prescription Drug Plan for Anthem Blue Cross EPO- SilverScript Medicare
2. 2018 Prescription Drug Plan for Anthem Blue Cross HMO - SilverScript Medicare
3. 2018 Prescription Drug Plan for Anthem Blue Cross EPO - CVS
4.  2018 Prescription Drug Plan for Anthem Blue Cross HMO - CVS
5.  2018 HealthNet HMO SBC - Actives
6.  2018 HealthNet HMO SBC - Early Retirees
7.  2018 Anthem Blue Cross EPO SBC - Actives CA Residents
8.  2018 Anthem Blue Cross EPO SBC - Actives Non CA Residents
9.  2018 Anthem Blue Cross EPO SBC - Retirees and AB528 CA Residents
10.  2018 Anthem Blue Cross EPO SBC - Retirees and AB528 Non CA Residents
11.  2018 Anthem Blue Cross Select HMO SBC - Actives
12. 2018 Anthem Blue Cross Select HMO SBC - Early Retirees
13. 2018 Kaiser HMO SBC - Actives
14. Sept 2017 - Aug 2018 Kaiser HMO SBC - Unit F and G
15.  2017 Kaiser HMO SBC - Early Retirees
16. 2017 Kaiser Senior Advantage HMO SBC - Hawaii
17. 2018 UHC SBC - Arizona
18. 2018 UHC SBC - California
19. 2018 UHC SBC - Colorado
20. 2018 UHC SBC - Neveda
21. 2018 UHC SBC - Oregon
22. 2018 UHC SBC - Texas
23. 2018 UHC SBC - Washington
24. 2018 United Concordia PPO Benefit Summary - Active
25. 2018 United Concordia PPO Benefit Summary - Retiree

 

1. 2018 Anthem Blue Cross EPO - Active CA
2. 2018 Anthem Blue Cross EPO - Active Non-CA
3. 2018 Anthem Blue Cross EPO - Retiree CA
4. 2018 Anthem Blue Cross EPO - Retiree Non-CA
5. 2018 Anthem Blue Cross HMO - Active
6. 2018 Anthem Blue Cross HMO - Retiree
7. 2017 Health Net HMO - Active
8. 2017 Health Net HMO - Early Retiree
9. 2017 Health Net Seniority Plus - Southern CA
10. 2017 Health Net Seniority Plus - Northern CA
11. 2018 Kaiser HMO EOC - Active
12. 2018 Kaiser HMO EOC - Early Retiree
13. Oct 2014 - Sept 2015 Kaiser HMO EOC - Student Body
14. 2018 Kaiser Senior Advantage EOC - Retiree Over 65 
15. 2016 Kaiser Senior Advantage EOC - Northwest
16. 2016 Kaiser Senior Advantage EOC - Hawaii
17. UHC EOC Arizona 2018
18. UHC EOC California 2018
19. UHC EOC Colorado 2018
20. UHC EOC Nevada 2018
21. UHC EOC Oregon 2018
22. UHC EOC Texas 2018
23. UHC EOC Washington 2018
24. 2017 United Concordia Dental - CA
25. 2017 United Concorida Dental - MS, MT, LA, and TX
26. Western Dental
27. EyeMed - Active
28. EyeMed - Retiree
29. VSP

 

1. Voya Funeral Planning Flyer
2. Voya Security When You Travel Flyer
3. Anthem Blue Cross Guest Member Brochure
4. Anthem Blue Cross Guest Membership Flyer