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October 2024 Employee Health Benefits Open Enrollment
All Benefit Eligible Employees
Open Enrollment Dates: October 7 at 8:00am 鈥� November 1, 2024 at 5:00pm.
Effective Dates: January 1, 2025 鈥� December 31, 2025 Plan Year
Open Enrollment is your annual opportunity to review and make changes to your benefits. During Open Enrollment, you can:
Active Classified Employees Health Benefit Information
Enrollment Forms
Classified Benefits Enrollment Form
2024 Rate Sheet
Effective January 1, 2024 鈥� December 31, 2024
2024 SEIU/Teamsters Active Rate Sheet
2025 Rate Sheet
Effective January 1, 2025 鈥� December 31, 2025
2025 SEIU/Teamsters Active Rate Sheet
Summary of Benefits and Coverage
2025 Summary of Benefits and Coverage - Kaiser HMO
2025 Summary of Benefits and Coverage - Kaiser HSA SBC
2025 Summary of Benefits and Coverage - Western Health Employee Only
2025 Summary of Benefits and Coverage - Western Health Family
Classified Long-Term Disability Insurance
Classified Disability Insurance Booklet
Classified Disability Insurance Contract
Dental Plan
Retired Certificated Employees Health Benefit Information
Enrollment Forms
Enrollment Forms are now located under the Frequently Used Forms page.
2024 Rate Sheets
Effective January 1, 2024 鈥� December 31, 2024
2024 SCTA Early Retiree Rate Sheet
2025 Rate Sheet
Effective January 1, 2025 鈥� December 31, 2025
2025 SCTA Early Retiree Rate Sheet
Summary of Benefits and Coverages
2025 Summary of Benefits and Coverage - Health Net Seniority Plus
Active Certificated Employees Health Benefit Information
Enrollment Forms
Enrollment Forms are now located under the Frequently Used Forms page.
2024 Rate Sheet
Effective January 1, 2024 鈥� December 31, 2024
2025 Rate Sheet
Effective January 1, 2025 鈥� December 31, 2025
Summary of Benefits and Coverages
2025 Summary of Benefits and Coverage - Health Net
2025 Summary of Benefits and Coverage - Kaiser
Dental Plans
Active Mgmt-Unrep.Conf-Supv., UPE, TCS, Teamsters Employees Health Benefit Information
Enrollment Form
Classified Benefits Enrollment Form
2024 Rate Sheets
Effective January 1, 2024 鈥� December 31, 2024
2024 Active UnRep Management/Conf/Supv/UPE/TCS Rate Sheet
2024 SEIU/Teamsters Rate Sheet
2025 Rate Sheet
Effective January 1, 2025 鈥� December 31, 2025
2025 Active UnRep Management/Conf/Supv/UPE/TCS Rate Sheet
2025 SEIU/Teamsters Rate Sheet
Summary of Benefits and Coverage
2025 Summary of Benefits and Coverage - Kaiser HMO
2025 Summary of Benefits and Coverage - Kaiser HSA SBC
2025 Summary of Benefits and Coverage - Western Health Employee Only
2025 Summary of Benefits and Coverage - Western Health Family
Dental Plans
Premier Access Dental Information
Retired UPE/Mgmt/Supv/Conf/TCS and Teamsters Employees Health Benefit Information
Enrollment Forms
Enrollment Forms are now located under the Frequently Used Forms page.
2024 Rate Sheets
Effective January 1, 2024 鈥� December 31, 2024
2024 UnRep Management/Supervisor/Confidential/UPE/TCS Early Retiree Rate Sheet
2024 UnRep Management/Supervisor/Confidential/UPE/TCS Over 65 Retiree Rate Sheet
2024 SEIU/Teamsters Early Retiree Rate Sheet
2024 SEIU/Teamsters Early 50% Retiree Rate Sheet
2024 SEIU/Teamsters Over 65 Retiree Rate Sheet
2024 SEIU/Teamsters Over 65 Retiree 50% Rate Sheet
2025 Rate Sheet
Effective January 1, 2025 鈥� December 31, 2025
2025 UnRep Management/Supervisor/Confidential/UPE/TCS Early Retiree Rate Sheet
2025 UnRep Management/Supervisor/Confidential/UPE/TCS Over 65 Retiree Rate Sheet
Retired Classified Employees Health Benefit Information
Enrollment Forms
Enrollment Forms are now located under the Frequently Used Forms page.
Add dependents outside of Open Enrollment
Dependents must be added within 30 days of a qualifying event, such as marriage, birth, registered domestic partner or loss of coverage. Employee must complete a new enrollment along with required documentation.
2024 Rate Sheets
Effective January 1, 2024 鈥� December 31, 2024