• Online Benefits Calculator
• Employee Benefit Brochure
• Retiree Benefit Rate 2011-2012

• Spring Newsletter 2012
• Winter Newsletter 2011
• Fall Newsletter 2011
• Spring Newsletter 2011
• Winter Newsletter 2010
• Fall Newsletter 2010
• Summer Newsletter 2010
• Spring Newsletter 2010

• SISC-80-G-SUMMARY OF BENEFITS
• Medco 80% PPO Plan
• Blue Shield PPO 80% Evidence of Coverage
• SISC-90-E-SUMMARY OF BENEFITS
• Medco 90% PPO Plan
• Blue Shield OPT PPO 90% Evidence of Coverage
• Life Referrals 24/7 and behavioral health benefits - SISC PPO
• Prescription Drug Benefit Handbook
• Blue Shield PPO Pharmacy Benefits Enhancement - Diabetes Supplies - RX Lancets, Syringe and Test Strips
• Blue Shield PPO / Costco Program Flyer

• Benefit Summary Blue Shield HMO
• Blue Shield HMO Evidence of Coverage - Full Version
• Blue Shield HMO amendment EOC
• Benefit Summary Blue Shield HMO Rx

• Benefit Summary Kaiser HMO
• Kaiser Evidence of Coverage - Full Version
• Kaiser-Chiropractic Care
• Kaiser Guidebook
• Health Topic Stress
• OC Facilities Guide
• Health Topic Diabetes
• Manage your health online

• Benefit Summary Delta Dental PPO
• Delta Dental PPO EOC
• Benefit Summary DeltaCare Dental PMI

• Benefit Summary VSP Vision
• Benefit Summary MES Vision

• Brochure
• Mail Order Form
• Reimbursement Form

• Blue Shield Preventive Services
• Kaiser Preventive Services

• Basic Life Insurance Enrollment Form
  Fill out form and print
• Schedule of Benefits
• Summary of Coverage

• HIPAA Statement

• Contact Sheet and Web Addresses for Benefits

• Medical Eye Services Claim Form
• VSP out-of-network claim form

• Benefit Open Enrollment Form
• Blue Shield HMO & PPO Enrollment Form
  Fill out form and print
• Blue Shield Change/Add Form
  Fill out form and print
• Kaiser Enrollment-Change Form
• Notice of Cobra Qualifying Event

• American Fidelity Medical Reimbursement Form
• Flexguide
• Dependent Day Care Reimbursement Form / Acknowledgment Form

Please Note: All forms should be sent to:

WESTMINSTER SCHOOL DISTRICT
ATTN: Insurance
14121 Cedarwood Avenue
Westminster, CA 92683-4499