Insurance Info & Documents: Active Employees

  • 2016-2017 Certificated, Management & Confidential Employee Benefits Guide

    by

     - This document provides important information for CERTIFICATED employees for the 2015-2016 plan year.

    CERT Lompoc EE Guide 2016-17.pdf 1.34 MB (Last Modified on June 22, 2016)
    Comments (-1)
  • 2016-2017 Classified Employees Benefits Guide

    by

     - This document provides important information for CLASSIFIED employees for the 2015-2016 plan year.

    CLASS Lompoc EE Guide 2016-17.pdf 3.82 MB (Last Modified on June 22, 2016)
    Comments (-1)
  • SISC Membership Change Form

    by
    - Use this form to change, add and/or delete dependents on your medical insurance only.
    - To add a dependent, you must provide a marriage certificate, birth certificate or adoption certificate.
    - To remove a dependent you must provide a divorce decree, death certificate or proof of other insurance.
    - You must provide a new Social Security card to change name(s) or Social Security number(s).
    SISC Membership Change Form - fillable.pdf 188.81 KB (Last Modified on May 8, 2012)
    Comments (-1)
  • Vision Service Plan (VSP) Enrollment

    by

    - Use this form to make changes to your Vision Service Plan.

    - No other documentation is required.

    VSP Enrollment.pdf 35.53 KB (Last Modified on March 26, 2015)
    Comments (-1)
  • Delta Dental Enrollment Form

    by

     - Use this form to make changes to your Dental plan.

    - Dental insurance enrollment is only available when you are hired, have a qualifying event or during Dental open enrollment.
    - Dental open enrollment is only available every 5 years.
    - The next Dental open enrollment is in June 2015.

    - No additional documentation is required.

    Delta Dental Enrollment 09-2007.pdf 115.59 KB (Last Modified on March 26, 2015)
    Comments (-1)
CLOSE