2017 - 2018 Employee Health Benefits

Employees Last Name beginning A-K: Karen Kettenhofen kkettenhofen@dcjesd.us / 916-770-8877

Employees Last Name beginning L-Z: Lorna LeBeau llebeau@dcjesd.us / 916-770-8878

Certificated (DCTA) Selection Form

Classified (CSEA) Selection Form

Confidential Employee Selection Form

Management/Board Members Selection Form

Transportation (ATU) Selection Form

KAISER PERMANENTE WEBSITE

Kaiser Service Area

PLAN INFORMATION:

Kaiser Plan 600559 (All employee groups)
Kaiser Permanente HSA-Qualified Deductible HMO Plan (All employee groups)
Kaiser Permanente 2018 Sample Fee List (High Deductible Plan)

SUMMARY OF BENEFITS AND COVERAGE:

Kaiser 20-10-25 ( All employee groups)
Kaiser High Deductible (All employee groups)

SUTTER HEALTH PLUS WEBSITE

Sutter Health Plus Service Area

PLAN INFORMATION (All employee groups):

Sutter Health Plus HMO
Sutter Health Plus High Deductible ($1,500/$3,000)
Sutter Health Plus High Deductible ($2,500/$5,000)
Sutter Health Plus 2018 Sample Fee List

SUMMARY OF BENEFITS AND COVERAGE (All employee groups):

Sutter Health Plus HMO
Sutter Health Plus High Deductible ($1,500/$3,000)
Sutter Health Plus High Deductible ($2,500/$5,000)

WESTERN HEALTH ADVANTAGE WEBSITE

Western Health Advantage Service Area

PLAN INFORMATION (All employee groups):

Western Health HMO Advantage
Western Health Advantage High Deductible ($1,800/$3,600)
Western Health Advantage High Deductible ($2,800/$5,600)
Western Health Advantage Medical Cost Estimator
Western Health Advantage Chiropractic and Acupuncture Coverage

SUMMARY OF BENEFITS AND COVERAGE (All employee groups):

Western Health HMO Advantage
Western Health Advantage High Deductible ($1,800/$3,600)
Western Health Advantage High Deductible ($2,800/$5,600)

Optum HSA Information (All employee groups)

Optum Bank Website

FORMS:

HSA user guide

HSA application

Optum HSA Salary Reduction Form

Request for Additional Debit Card- Authorized User

Withdrawal/Distribution Request Form

 

IRS Publication 502 Medical and Dental Expenses for 2016 returns

IRS Publication 969 Health Savings Accounts and Other Tax-Favored Health Plans for 2016 returns

PLAN INFORMATION:

Delta Dental Plan IB (ATU, DCTA, Management/Board Members)

Delta Dental Plan IIB (Confidential and CSEA Employees)

 

Delta Dental Mobile App

Diabetes and Your Mouth

Heart Disease & Your Oral Health

 

PLAN INFORMATION:

(All employee groups)

 

Freedom to Choose

Vision Benefits Summary

Extra 20% coupon

 

TruHearing (For VSP Vision Care members)