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CERTIFICATED - ACTIVE

2018 - 2019 BENEFIT GUIDE

0000 CERT-CONF-MGMT BG FINAL REVISION 3.12.2019.pdf 1.76 MB (Last Modified on March 15, 2019)

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2018 - 2019 CERTIFICATED RATES

CERT MGMT CONF RATES 6.14.18.pdf 102.29 KB (Last Modified on October 1, 2018)

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2018 - 2019 25% DISCOUNT RATES

25Percent Premium Discount Rate Sheets Certificated and Management.pdf 362.68 KB (Last Modified on October 1, 2018)

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CONFIDENTIAL / MANAGEMENT - ACTIVE

2018 - 2019 BENEFIT GUIDE

CERT MGMT CONF BG 18-19 6.14.2018.pdf 1.6 MB (Last Modified on October 1, 2018)

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2018 - 2019 CONFIDENTIAL & MANAGEMENT RATES

CERT MGMT CONF RATES 6.14.18.pdf 102.29 KB (Last Modified on October 1, 2018)

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2018 - 2019 25% DISCOUNT RATES

25Percent Premium Discount Rate Sheets Certificated and Management.pdf 362.68 KB (Last Modified on October 1, 2018)

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MEDICAL

SISC ENROLLMENT FORM

SISC III Enrollment Form - Active.pdf 196.47 KB (Last Modified on October 1, 2018)

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PLAN SELECTION FORM - CERTIFICATED

Plan Comparison and Election Form CERT.pdf 297.79 KB (Last Modified on October 1, 2018)

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PLAN SELECTION FORM - CONFIDENTIAL / MANAGEMENT

Palm Springs Plan Comparison and Election Form_Correction - CONF MGMT.pdf 509.56 KB (Last Modified on October 1, 2018)

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KAISER ENROLLMENT / CHANGE FORM

SISC III Kaiser Enrollment Form.pdf 214.67 KB (Last Modified on October 1, 2018)

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DENTAL

DELTA DENTAL PPO INCENTIVE PLAN SUMMARY

Delta Dental PPO Incentive Plan Summary 2017.pdf 536.76 KB (Last Modified on February 21, 2018)

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DELTA DENTAL PPO PLAN SUMMARY

Delta Dental PPO Plan Summary 2017.pdf 531.58 KB (Last Modified on February 21, 2018)

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DELTACARE USA HMO PLAN SUMMARY

DeltaCareUSA HMO Plan Summary 2017.PDF 372.31 KB (Last Modified on February 21, 2018)

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DELTA DENTAL ENROLLMENT/CHANGE FORM

Delta Dental Enrollment Form Active.pdf 212.24 KB (Last Modified on August 25, 2017)

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LIFE

METLIFE - DISTRICT PAID LIFE INSURANCE

District Basic Term Life - Beneficiary Form 3.28.17.pdf 230.62 KB (Last Modified on August 25, 2017)

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METLIFE - VOLUNTARY LIFE WORKSHEET

NEW Vol. Metlife Worksheet 2017.pdf 217.41 KB (Last Modified on August 25, 2017)

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METLIFE - VOLUNTARY LIFE INSURANCE ENROLLMENT

Vol. MetLife Insurance Enrollment -7.22.16.pdf 69.12 KB (Last Modified on August 25, 2017)

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METLIFE - STATEMENT OF HEALTH

MetLife-Statement of Health Form_7.22.16.pdf 55.28 KB (Last Modified on August 25, 2017)

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LEGAL

METLAW - ENROLLMENT FORM

MetLaw Enrollment Form 8.15.17.pdf 148.09 KB (Last Modified on August 25, 2017)

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COBRA

COBRA RATES

Cobra Rates

COBRA Rates.pdf 184.92 KB (Last Modified on January 9, 2019)

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COBRA VISION ENROLLMENT FORM

Vision Enrollment Form - COBRA.pdf 44.85 KB (Last Modified on October 17, 2017)

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COBRA DENTAL ENROLLMENT FORM

Delta Dental Enrollment Form COBRA.pdf 180.83 KB (Last Modified on October 17, 2017)

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