Human Resources » Benefits

Benefits

2021/2022 Affordable Health Care

 
 
CERTIFICATED - Rates Effective 10/1/2021 to 9/30/2022
CVT Plan Selection Form:  (Required for all new and changes)
 
 
CLASSIFIED - Rates Effective 10/1/2021 to 9/30/2022
CLASSIFIED  
Plan Selection Form: Classified: 2021-22 SISC-Plan Selection Form (Required for all new and changes)

Letter: SISC- Open Enrollment Letter for 2021-22
 

Forms:


 
SISC III Enrollment Form
SISC III Membership Change Form
Kaiser- California Region Group Enrollment Form
Declination of Coverage Form - (only for Part-Time staff)
WABE Option Form
 
Medical 

Dental   Vision  
 SISC -  Anthem PPO  SISC - Kaiser SISC - WABE   MES Kaiser 
Rate Sheet: Medical Health Plan   Rate Sheet: Dental Plan Rate Sheet: MES Vision Plan Included in Health Plan 
Flyers with information
Employee Assistance Program (EAP)
WABE Value Added     Kaiser-Vision Benefits 
Anthem Blue Distinction Plus Healthy LifeStyle Programs        
Anthem PPO 1st Three Visit $0 Co-pay Mental Health and Wellness         
Anthem Sydney App Digital Tools for Emotional Wellness        
Benefits of Health Savings Account(HSA) Kaiser SISC Plan Features and Member Benefits        
Carrum Health-The Smart Surgery Benefit          
Contigo Health Cancer Benefit          
Costco Free Generic Medications          
Hinge Health          
MDLive - $0 Co-pay          
Navitus Customer Care 24-7          
Value Based Site-of-Care Benefit          
VIDA Health          
Anthem SISC Plan Features and Member Benefits          
Blue Shields SISC Plan Features and Member Benefits          
Other information:
HIPAA Notice of Privacy Practices
SISC Exchange Notification
 
 
MANAGEMENT - Rates Effective 10/1/2021 to 9/30/2022
NON-CAP EMPLOYEES - Rates Effective 10/1/2021 to 9/30/2022