Benefit Resources

Frequently Asked Questions & Answers - 1095-C

2016-17 Employee Benefits Guide

Provider Contact Information

2016-17 Benefits at a Glance

Benefit Worksheet: Certificated

Benefit Worksheet: PSE 1 & Non Represented

Benefit Worksheet: PSE 2

Qualifying Event Form

Benefit Enrollment Election Form

Domestic Partnership Affidavit

Guide to Open Enrollment in Employee Access

403(b) New Hire Information Packet

Additional Resources

Department of Retirement Systems Website

PEBB Website

VEBA Website

Employee Assistance Program

Pet Insurance

Medical

KAISER            Kaiser Plan Website Kaiser Plan Resources Kaiser Enrollment Form Kaiser Summary of Benefits & Coverage Kaiser Plan Providers Out-of-Area Benefits Online Rx Refills Kaiser Domestic Partner Declaration Kaiser Waiver of Group Insurance Form Kaiser Enrollment Addendum (for additional dependents) Kaiser Discounts Link

PREMERA           Premera Plan Website Premera Plan Resources EasyChoice A Summary of Benefits & Coverage EasyChoice B Summary of Benefits & Coverage Basic Plan Summary of Benefits & Coverage QHDHP Summary of Benefits & Coverage Plan 2 Summary of Benefits & Coverage Plan 3 Summary of Benefits & Coverage Plan 5 Summary of Benefits & Coverage UNUM - Beneficiary Designation Form Premera Plan Providers Glossary of Health Coverage & Medical Terms

Dental

CIGNA (Classified) Cigna Website Cigna Dental Benefit Summary Cigna PPO Dental Plan Guide PPO Core Network Providers Cigna Claim Form Cigna ID Card Cigna Privacy Notice Agreement Regarding Electronic Documents

WASHINGTON DENTAL SERVICE (Certificated) Washington Dental Service Plan Website Washington Dental Service Plan Benefit Summary Plan Providers MySmile Personal Benefits Center

Vision

Vision Service Plan (VSP) Website

Vision Plan Benefit Summary

Vision Service Plan Card

Plan Providers

Life Insurance

SUN LIFE GROUP LIFE Group Life Insurance Summary Enrollment Form

SUN LIFE SUPPLEMENTAL LIFE (Voluntary) Voluntary Life Insurance Summary & Premium Rates Evidence of Insurability Form

Disability Insurance

SUN LIFE LONG TERM DISABILITY Long Term Disability Benefit Summary Long Term Disability Claim Form

SUN LIFE SHORT TERM DISABILITY (Voluntary) Voluntary Short Term Disability Benefit Summary Voluntary Short Term Disability Premium Rates SHORT TERM DISABILITY CLAIM PACKETS       1.  Employee/Claimant Packet       2.  Attending Physician Packet       3.  Employer Packet

American Fidelity Supplemental Insurance

American Fidelity Website

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Human Resources Department • 601 Crawford Street • Kelso, WA 98626
Phone: (360) 501-1924 • Fax: (360) 501-1950
human.resources@kelsosd.org