Enrollment Forms

Classified Benefits Enrollment Form

2024 Rate Sheet

Effective January 1, 2024 – December 31, 2024

2024 SEIU/Teamsters Active Rate Sheet

2025 Rate Sheet

Effective January 1, 2025 – December 31, 2025

2025 SEIU/Teamsters Active Rate Sheet

Summary of Benefits and Coverage

2025 Employee Benefits Guide – Active Employees & Early Retirees

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

Delta Dental Information

Premier Access Dental Information

2024 Dental Comparison Sheet