COBRA
DENTAL
LIFE
- Beneficiary Change
- Claim – Accidental Death & Dismemberment
- Claim – Proof of Death
- Enrollment – Basic Life – Interactive
- Enrollment – Voluntary Term Life – Interactive
- Conversion – Basic Life
- Portability - Voluntary Term Life
MEDICAL
- Enrollment – Interactive
- Kaiser Enrollment – Interactive
- Claim - Anthem Blue Cross
- Claim - Blue Shield of California
OTHER
- Declination of Coverage for Dependents
- Declination of Coverage for Less Than Full Time
- Domestic Partner Forms Link
- HIPAA Authorization
- Plan Election
- Instructions for Secure File Transfer
- SISC Web Portal Registration Form – Interactive
- Activity-Schedule 2013-2014
REPORTING DISTRICT ACTIVITY
- Address Change Form – Interactive
- Membership Change Form – Interactive
- MAR Changes and Transfers – Interactive
- MAR Terms – Interactive
- Notification of Plan Changes – Excel
RETIREES
- CompanionCare Application
- Kaiser Senior Advantage Election Blue
- Declination of Coverage for Retirees
- IRP Disenrollment – Interactive
- Shield 65 Plus Enrollment – Interactive
RX