Benefit Information
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Open Enrollment

Open Enrollment is the only time during the year you have the opportunity to change the medical, dental, and vision plans you are currently enrolled in.  Open Enrollment takes place June 1st through August 24th  each year.  Changes made take effect October 1st. If you are going to have any changes in your family in the upcoming plan year, Open Enrollment is the time to determine if your plan still meets your needs.

Open Enrollment forms are due to your district/charter school office no later than August 24, 2018 for the 2018-2019 plan year.

***Register Here for Open Enrollment Workshops for Active & Retired Employees*** 


If you are an employee that would like to keep your current plan and make no changes, please complete your site specific plan election form:

  • Enrollment Health Plan Election Form- (Site Specific)

If you are an employee that would like to enroll in a new plan,  please complete the enrollment health plan election for your site and  one of the enrollment forms below:

  • Insurance Carrier's Enrollment- Anthem or Kaiser enrollment form (below)

If you are an employee that would like to decline coverage please complete one of the declination of coverage forms below:

  • Declination of Coverage- less than full time and full time employees (below)      


Enrollment Forms, Annual Notices, and Information 

Anthem Enrollment Form        2018-19 Annual Health Benefit Notices                   

2018-19 Plan Comparison

 
 
Kaiser Enrollment Form   HIPPA Notice of Privacy   Dependent Eligibility Requirements  
Declination of Coverage-Less than FT    Declination of Coverage-Full Time   Qualifying Events  

2018-2019 Health Benefit Renewal Information Packet

***The 2018-2019 plan descriptions will be provided as soon as they become available***


Below are the 2017-2018 health benefit plan descriptions (SBC's)


Anthem PPO 100% Plan SBC 10/1/17 thru 9/30/18

Anthem PPO 90% Plan SBC 10/1/17 thru 9/30/18

Anthem PPO 80%-G Plan SBC 10/1/17 thru 9/30/18

Anthem PPO 80%-L Plan SBC 10/1/17 thru 9/30/18

Anthem PPO Minimum Value Plan SBC

Anthem PPO 2-Tier Anchor Bronze Plan SBC 10/1/17 thru 9/30/18

Kaiser $10 Co-Pay Plan SBC 10/1/17 thru 9/30/18

When you enroll in one of the above medical plans (excluding the Anthem PPO 2-Tier Anchor Bronze Plan), you are automatically enrolled in the following Vision and Dental plans.


VSP Vision Dual Co-Pay - Plan B
Delta Dental Incentive Plan


Use the Contact Benefits list and contact the carrier if you have questions about a plan’s drug coverage or to see if your medication is covered.


Annual Health Benefit Notices

2018-19 Annual Health Benefit Notice

2017 -18 Annual Health Benefit Notice 

 


Announcements
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July 26, 2018

Employee Open Enrollment Workshop

10 am & 1 PM

@ VCSBSA