Health and Welfare

Required Documents for Enrollment

To Insure Dependent Children

  • Birth Certificate
  • Social Security Card

To Insure Spouse

  • Marriage License
  • ID (Drivers License)
  • Social Security Card

 

Enrollment & Cancellation Information

You can request cancellation of coverage at anytime.

To begin coverage outside of open enrollment you must have a loss of coverage letter, to add dependent coverage if you have a permitting event, such as marriage, birth of child etc.

To enroll, add dependent/s, spouse or cancel coverage you must fill out the forms below for your employment classification.

To insure dependent children

  • Birth Certificate
  • Social Security Card

To insure spouse

  • Marriage License
  • ID (Drivers License)
  • Social Security Card

If you have questions regarding health plans, use this link to the CalPERS web page.

 

Enrollment forms for medical and dental are below

March 15th is the last day to purchase your Cap & Gown for Graduation!