Documents and Forms

FORMS FOR CURRENT EMPLOYEES

KAISER PERMANENTE (KP)

 SUTTER HEALTH PLUS (SHP)

WESTERN HEALTH ADVANTAGE (WHA) 

VISION SERVICE PLAN (VSP) 

HEALTH SAVINGS ACCOUNTS (HSA)

FLEXIBLE SPENDING ACCOUNTS (FSA)

DELTA DENTAL (DENTAL)

LIFE INSURANCE

CRITICAL ILLNESS

RETIREE HEALTH SAVINGS PLAN (RHSP)

LONG-TERM CARE

FORMS FOR RETIREES

Medicare Enrollment Forms

(Required in addition to the County form when enrolling in or switching between a Medicare plan)

Medicare Disenrollment Forms

(Required in addition to the County form when dis-enrolling from or switching between a Medicare plan) 

KAISER PERMANENTE (KP)

SUTTER HEALTH PLUS (SHP)

UNITED HEALTHCARE (UHC)

WESTERN HEALTH ADVANTAGE (WHA)

VISION SERVICE PLAN (VSP) 

PRINCIPAL FINANCIAL (DENTAL)

RETIREE HEALTH SAVINGS PLAN (RHSP)

LONG-TERM CARE

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