Medical
GYM MEMBERSHIP FLIERS
One Pass select Affinity Fitness plan (Only applicable for Kaiser members)
CURRENT MEDICAL PLAN RATE SHEETS 2024-2025
2025 CalPERS Health Benefit Summary Booklet
2025 SUMMARY OF BENEFITS AND COVERAGE
2025 Anthem Blue Cross Select HMO
2025 Anthem Blue Cross Traditional HMO
2025 Blue Shield PERS Platinum PPO
2025 Blue Shield PERS Gold PPO
2025 United Healthcare SignatureValue Alliance HMO
2025 United Healthcare SignatureValue Harmony HMO
MEDICAL FORMS AND INFORMATION
Medical Enrollment or Changes - CalPERS HBD-12 Form
Pre-Tax Election & Waiver Form for Medical Insurance Premium Payroll Deduction
Glossary of Health Coverage and Medical Terms
SELF PAY 2025 (Unpaid Leave)
Self Pay Medical, Dental and Vision Rate Sheet (If on Unpaid Leave)
COBRA 2025
COBRA Medical, Dental and Vision Packet for Employees and Dependents
COBRA Medical, Dental and Vision Packet for Non-Employees
OTHER
John Muir Behavioral Health Center, Outpatient Services