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2025-2026 Benefits Information and Open Enrollment for Active Employees

The annual open enrollment period, starting Friday, May 2 through Friday, May 30, 2025, allows you to review your benefits and ensure the best plan for you and your family.

If you want to make changes to your medical or dental, please complete the plan enrollment form of your choosing, attach any required documentation, and return it to the Payroll/Benefits Office by Friday, May 30, 2025.

You do not need to do anything to keep your current plans.

Section 125 Health Savings Account (HSA)

If you wish to enroll or make changes to an existing medical plan with HSA, you need to contact American Fidelity, the District administrator for HSA.

click here to schedule an appointment with an American Fidelity representative.
Or call 1-800-365-8306, option 7

Forms for Active Employees

(2025-2026 Documents will be updated when available)

2025-2026 Insurance Rate Sheet

Kaiser HMO Enrollment Form

Kaiser HSA Enrollment Form

Dental and Vision Plans Election Form

Pre-Tax Authorization Form

Anthem HMO PPO Enrollment Form

Anthem HSA Enrollment Form

SISC III Membership Change Form

Links to Plan Benefit Summaries

HMO PPO Summary of Benefits

Kaiser Traditional Plan Benefit Summary

Anthem HMO Premier 10 Benefit Summary

Anthem HMO Classic Benefit Summary

Anthem PPO 90-20 Plan Benefit Summary

Anthem PPO 80-20 Plan Benefit Summary

Delta Dental Base Plan Benefit Summary

Delta Dental Enhanced Plan Summary

HSA Summary of Benefits

Kaiser HSA Plan Benefit Summary

Anthem HSA Benefit Summary

SISC Platinum + Benefit Summary

Vision Enhanced Plan Benefit Summary

Useful Links:

Kaiser Enrolllment Guide
Anthem HMO Enrollment Guide
Anthem PPO Enrollment Guide
SISC Value Added Services (Employee Assistance Program)
Dependent Eligibility Chart