Benefits How-To Information

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As an employee, you may have questions regarding your benefits. The information herein will assist you with answers to commonly asked questions.


HOW TO INFORMATION


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Health & Dental Benefits Enrollment Worksheet

Who: Eligible Employee

When: Use this form to enroll in the health and dental insurance plans. You have 60 days from the date of the eligible appointment to enroll in a health and dental plan. 

How: Use this form to enroll in the health and dental insurance plans

Form: Health & Dental Benefits Enrollment Worksheet

Related Information:


To find out more, go to: Employee Benefits

Declaration of Health Coverage (HBD-12a)

Who: Eligible Employee

When: Use this form to enroll in the CalPERS Health Benefits Program, in the event you or your dependents lose health insurance coverage. You must request enrollment within 60 days from the date you lose coverage.

How: Complete the form and return completed form to the Benefits Coordinator.

Form: Declaration of Health Coverage (HBD-12a)

Related Information:


To find out more, go to: Employee Benefits