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Current Benefits for Active Employees

DENTAL, VISION & MEDICAL

Important Benefit Contact Information

Eligibility Rules for Dental, Vision and Medical Plans

 

DENTAL BENEFITS

Delta Dental Evidence of Coverage Booklet

Dental & Vision - Change in Enrollment

Delta Dental - Keep Smiling and Benefit Coverage Information

Delta Dental App - Stay Connected

Delta Dentist Estimate your Costs

Delta Dental Website Tool

Delta PPO Dentist Information Flyer

 

VISION BENEFITS

Vision Service Plan (VSP) Evidence of Coverage

Eyewear Protection Program Flyer

VSP Extra Savings Flyer

TruHearing VSP Flyer

VSP Out-Of-Network Reimbursement Form

 

MEDICAL BENEFITS

Medical Enrollment or Changes - CalPERS HBD-12 Form

HBD-12 Form Instruction Sheet

Pre-Tax Election & Waiver Form for Medical Insurance Premium Payroll Deduction 

Cash-In-Lieu of Medical Benefits

2019 CalPERS Health Benefit Summary Booklet

CalPERS Health Program Guide

Summary of Benefits and Coverage Notice

Glossary of Health Coverage and Medical Terms

 

2019 Summary of Benefits and Coverage

OptumRx Pharmacy Benefits Information

OptumRX Pharmacy Frequently Asked Questions

2018-19 MEDICAL PLAN RATE SHEETS

SELF PAY (Unpaid Leave)

Self Pay Dental & Vision Rate Sheet (If on Unpaid Leave)

Self Pay Medical Rate Sheet (If on Unpaid Leave)

Self Pay Instructions

Self-Pay Agreement Dental & Vision (Unpaid Leave)

Self-Pay Agreement Medical CalPERS (Unpaid Leave)

 

OTHER

Employee Assistance Program

John Muir Behavioral Health Center, Outpatient Services

In-Shape Health Club Membership Flyer 

Discovery Transportation Benefits

Long-Term Care Coverage