Enrollment

Type	File
PDF	Open Enrollment Form 2022-2023
PDF	Open Enrollment Guide 2022-2023
PDF	Qualifying Life Event Packet 2022-2023
PDF	Qualifying Life Event Packet 2021-2022
PDF	2022-23 New Hire Packet
PDF	2021-22 New Hire Packet
PDF	Online Enrollment Instructions
PDF	MBO Enrollment Form 2022-23
PDF	MBO Enrollment Form 2021-22
PDF	MBO Enrollment Form 2020-21
PDF	2022-23 MBO Cost Comparison
PDF	2021-22 MBO Cost Comparison
PDF	2020-21 MBO Cost Comparison

Blue Shield of CA

Learn More about Blue Shield of CA Benefits

To view your plan documents and more, visit blueshieldca.com/teamsters1932

Kaiser Permanente Plans

Type	File	Download or Email
PDF	2022-23 Benefit Summary $40 HMO Platinum
PDF	2022-23 Benefit Summary $10 HMO Platinum
PDF	Emergency Services Claim Form
PDF	Release of Information Unit
PDF	2021-22 Benefit Summary $40 HMO Gold SBC
PDF	2021-22 Benefit Summary $10 HMO Platinum
PDF	HMO Platinum Plan ($10 copay)
PDF	HMO Gold Plan ($40 copay)

Learn More about Kaiser Benefits

EyeMed

Type	File
PDF	EyeMed Member FAQs
PDF	How to Access & Use Member Web
PDF	How to use EyeMed Member App
PDF	Member Tools

Learn More about EyeMed Benefits

Delta Dental

To learn more, visit our Delta Dental Information page.

Type	File
PDF	PPO-DHMO-Your Smile Your Choice
PDF	Where's My ID Card
PDF	DHMO-8 Tips to Get the Most From Your Plan
PDF	PPO-7 Tips to Get the Most From Your Plan
PDF	PPO-Pre-Treatment Estimate
PDF	PPO-Diagnostic & Preventive Maximum Waiver
PDF	DHMO-Evidence of Coverage

Learn More about Delta Dental Benefits

General Unit

Type	File
PDF	MOU
PDF	2022-23 Cost Comparison (61-80 hours)
PDF	2022-23 Cost Comparison (40-60 hours)
PDF	2021-22 Cost Comparison
PDF	2020-21 Cost Comparison

Preschool Services Division

Type	File
PDF	2022-23 Cost Comparison (9 Month) updated MPS
PDF	2022-23 Cost Comparison (12 Month) updated MPS
PDF	2022-23 Cost Comparison (12 Month)
PDF	2022-23 Cost Comparison (9 Month)
PDF	2021-22 Cost Comparison (9 Month) updated MPS
PDF	2021-22 Cost Comparison (9 Month)
PDF	2021-22 Cost Comparison (12 Month) updated MPS
PDF	2021-22 Cost Comparison (12 Month)
PDF	2020-21 Cost Comparison (9 Month)
PDF	2020-21 Cost Comparison (12 Month)
PDF	MOU

Firefighters Auxiliary

Type	File
PDF	2022-23 Cost Comparison (61-80 hours)
PDF	2022-23 Cost Comparison (41-60 hours)
PDF	2021-22 Cost Comparison
PDF	2020-21 Cost Comparison
PDF	MOU

Part-Time and Recurrent

Type	File
PDF	Self-Payment Policy
PDF	2022-23 Part-Time and Recurrent Cost Comparison
PDF	2021-22 Part-Time and Recurrent Cost Comparison
PDF	2020-21 Part-Time and Recurrent Cost Comparison

Plan Comparisons

Type	File
PDF	2021-22 Plan Comparisons