2017 - 2018 Employee Health Benefits
For More Information Contact:
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
Selection Forms
Kaiser Permanente
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
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
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)
Health Savings Account
Optum HSA Information (All employee groups)
FORMS:
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
Delta Dental Information
PLAN INFORMATION:
Delta Dental Plan IB (ATU, DCTA, Management/Board Members)
Delta Dental Plan IIB (Confidential and CSEA Employees)
Heart Disease & Your Oral Health