Health Benefits

All of our member districts and charters offer a benefits package to eligible employees.  Benefits may differ by the number of hours worked, classification, and/or bargaining unit.   Health benefit selections are made for new hires during the hiring process and for active employees during open enrollment or due to a qualifying event.

Open Enrollment

Open Enrollment is the time during the year when you have the opportunity to change the medical, dental, and vision plans you are currently enrolled in.  If you anticipate having changes in your family in the upcoming plan year, open enrollment is the time to determine if your plan still meets your needs.

SISC Health Plans

Please see below for Open Enrollment information for all  Districts/ Charters enrolled on a SISC health plan


Open Enrollment forms are due to your district/charter school office no later than

August 14, 2020, for the 2020-21 plan year.

***2020-21 Open Enrollment Presentation***

Enrollment Forms, Annual Notices, and Information 

Anthem Enrollment Form
Kaiser Enrollment Form
Membership Change
HIPAA Notice of Privacy
Dependent Eligibility Requirements
Declination of Coverage-Less than FT
Declination of Coverage-Full Time
Qualifying Events


If you are an employee that would like to keep your current plan and make no changes, please complete your site-specific plan election form:

Enrollment Health Plan Election Form- (Site Specific)
If you are an employee that would like to enroll in a new plan,  please complete the enrollment health plan election for your site and one of the enrollment forms below.

Insurance Carrier's Enrollment- Anthem or Kaiser enrollment form

If you are an employee that needs to change your dependents please complete the enrollment health plan election form and the membership change form below:

Membership Change form-to add/delete dependents 

If you are an employee that would like to decline coverage please complete one of the declinations of coverage forms below:

Declination of Coverage- less than full time

Declination of Coverage  full-time (WABE)

Below are the 2020-2021  health benefit plan descriptions (SBC's)

Anthem PPO 100% Plan SBC 

Anthem PPO 90% Plan SBC 

Anthem PPO 80%-G Plan SBC 

Anthem PPO 80%-L Plan SBC 

Anthem PPO Minimum Value Plan SBC

Anthem PPO 2-Tier Anchor Bronze Plan SBC

Kaiser $10 Co-Pay Plan SBC 

When you enroll in one of the above medical plans (excluding the Anthem PPO 2-Tier Anchor Bronze Plan), you are automatically enrolled in the following Vision and Dental plans.

VSP Vision Dual Copay -  Signature Plan C 

Delta Dental Incentive  Plan $1,000

Use the Benefit Provider Contact List and contact the carrier if you have questions about a plan’s coverage and /or benefits.