Benefits
If you need to review a summary of the Open Enrollment options:
You will find the appropriate PDF forms below. Please download, fill, print and mail or fax the items. It is necessary to have the free Adobe Acrobat Reader to open and view these items. If you do not have the Adobe Acrobat Reader installed on your computer, you can obtain it free of charge at https://get.adobe.com/reader/
Select a category below:
Kaiser Permanente HMO
Anthem Blue Cross PPO (SMART Medical Plan)
United Healthcare Harmony HMO
- UHC Harmony Benefit Summary Part-time 2024
- UHC Harmony Benefit Summary Full-time 2024
- UHC Chiropractic Benefit Summary 2024 (Full-time only)
- UHC RX Benefit Summary 2024 (Full-time only)
- Express Scripts Benefit Overview (Part-time only)
- Express Scripts Benefit Summary (Part-time only)
- Express Scripts Mail Order Form (Part-time only)
- Enrollment Card 2024
- UHC Enrollment/Change Form
United Healthcare Value HMO
- UHC Value Benefit Summary Part-time 2024
- UHC Value Benefit Summery Full-time 2024
- UHC Chiropractic Benefit Summary (Full-time only)
- UHC Rx Benefit Summary (Full-time only)
- Express Scripts Benefit Overview (Part-time only)
- Express Scripts Benefit Summary (Part-time only)
- Express Scripts Mail Order Form (Part-time only)
- Enrollment Card 2024
- UHC Enrollment/Change Form
VSP Vision Coverage