Benefits Summaries and Forms

HSD Employee Benefits Guide

HSD Benefits Enrollment Form

EASE Online Benefits System Reference Sheet

EASE Online Benefits User Guide 

Dental, Vision, Life, and Disability Benefits Summaries

Delta Dental

United Concordia Dental

MES Vision

MES Vision Buy-Up

Lincoln Financial Voluntary Life

Lincoln Financial Short-Term Disability

Lincoln Financial Long-Term Disability

Health Benefits Summaries through October 31, 2020

Kaiser HMO

Anthem Blue Cross Select HMO

Anthem Blue Cross Vivity HMO

Anthem Blue Cross PPO

Anthem Blue Cross HMO Prescription Plan

Anthem Blue Cross PPO Prescription Plan

Health Summary of Benefits and Coverages through October 31, 2020 (in accordance with the Affordable Care Act)

Kaiser HMO

Anthem Blue Cross Select HMO

Anthem Blue Cross Vivity HMO

Anthem Blue Cross PPO

Health Benefits Summaries as of November 1, 2020 (Proposed)

Kaiser HMO

Anthem Blue Cross Select HMO

Anthem Blue Cross Vivity HMO

Anthem Blue Cross PPO

Health Summary of Benefits and Coverages as of November 1, 2020 (in accordance with the Affordable Care Act) (Proposed)

Kaiser HMO

Anthem Blue Cross Select HMO

Anthem Blue Cross Vivity HMO

Anthem Blue Cross PPO

Forms
Kaiser Application

Delta Dental Application

United Concordia Dental Application

MES Vision Application

Lincoln Financial Application

Blue Cross Application

Blue Cross Change Form

FSA Enrollment Form

Health Care FSA Claim Form

Dependent Care FSA Claim Form