peralta benefits everyone

 

SISC Medical Open Enrollment

 

October 14 - November 21, 2022

All employees are required to re-enroll for coverage effective January 1, 2023

 

Open Enrollment Important Documents

Please use the link below to upload your forms/documents securely to the Benefits Office for processing no later than November 21, 2022.

Secure Upload Link: https://forms.office.com/r/4ieRYqEsne

 

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Medical Plans

SISC Kaiser Traditional HMO Plan

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SISC Kaiser Traditional HMO Summary of Benefits & Coverage
SISC Kaiser Traditional HMO Document Summary & Plan Description
SISC Kaiser Traditional HMO Enrollment Form

Please download the form and sign with a digital signature before submitting.

You can submit your form in person or via mail to the PCCD Benefits office at 333 East 8th St, Oakland, CA 94606.

SISC Anthem PPO Plan

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SISC Anthem PPO Summary of Benefits & Coverage
SISC Anthem PPO Document Summary & Plan Description
SISC Anthem PPO Enrollment Form

Please download the form and sign with a digital signature before submitting.

SISC Evidence of Coverage Pharmacy Benefit

For assistance with your benefits questions,
please contact the District Benefits Office at 510.466.7229
Mon – Fri, 8:30 AM – 5:00 PM, PST or email benefits@peralta.edu