Benefits and Insurance

Personnel Support Services - Benefits

Carin Freitas, Benefits Specialist, email: cfreitas@powayusd.com
Christine Gold, Insurance Benefits Technician, email: cgold@powayusd.com
Lauren Brookshire, Insurance Benefits Technician, email: lbrookshire@powayusd.com

Phone: (858) 521-2800 ext. 2897, FAX: 858-485-1355

2017 INSURANCE INFORMATION

Are you a current benefited employee thinking about retirement in the next year? If so, join us at our RETIREMENT BENEFITS SEMINAR on May 18, 2017 from 4:00pm - 6:00pm located at the District Office - Community Room.


2017 INSURANCE FORMS

INSURANCE GUIDES/FORMS GROUP TYPE
2017 EMPLOYEE BENEFITS INFORMATION GUIDE ACTIVE MEDICAL
2017 COBRA BENEFITS INFORMATION GUIDE ALL MEDICAL
2017 RETIREE BENEFITS INFORMATION GUIDE RETIREE MEDICAL
2017 BENEFITS ENROLLMENT FORM - ACTIVE EMPLOYEE ACTIVE MEDICAL
2017 BENEFITS ENROLLMENT FORM - RETIREE RETIREE MEDICAL
2017 FLEX ENROLLMENT FORM ACTIVE FLEX
OPT OUT OPTION FORM ACTIVE  
OPT OUT WAIVER FORM ACTIVE  
2017 PUSD DELTA DENTAL BENEFIT SUMMARY ALL DENTAL
2017 PUSD MES VISION SUMMARY ACTIVE VISION
THE STANDARD LIFE INSURANCE ENROLLMENT FORM ACTIVE LIFE
2017 PUSD AETNA AVN HMO SBC (Summary of Basic Coverage) ACTIVE MEDICAL
2017 PUSD AENTA AVN HMO SUPPLEMENTAL INFO ACTIVE MEDICAL
2017 PUSD AETNA AVN HMO SUMMARY (AETNA VALUE NETWORK) ACTIVE MEDICAL
2017 PUSD AETNA EPO SUMMARY (ELECT CHOICE) ACTIVE MEDICAL
2017 PUSD AETNA FULL NETWORK SBC ACTIVE MEDICAL
2017 PUSD AETNA FULL NETWORK SUPPLEMENTAL INFO ACTIVE MEDICAL
2017 PUSD AETNA FULL NETWORK HMO SUMMARY ACTIVE MEDICAL
2017 PUSD AETNA OAMC SBC ACTIVE MEDICAL
2017 PUSD AETNA OAMC SBC SUPPLEMENTAL INFO ACTIVE MEDICAL
2017 PUSD AETNA OAMC SUMMARY (OPEN ACCESS MANAGED CHOICE) ACTIVE MEDICAL
2017 PUSD KAISER PRINCIPAL BENEFITS SUMMARY ACTIVE MEDICAL
2017 PUSD KAISER CHIRO RIDER ACTIVE MEDICAL
2017 PUSD KAISER TRANDITIONAL PLAN SBC (Summary of Benefits & Coverage) ACTIVE MEDICAL
2017 PUSD KAISER SENIOR ADVANTAGE [KPSA] ENROLLMENT FORM SENIORS MEDICAL
2017 PUSD KAISER SENIOR ADVANTAGE [KPSA] BENEFIT SUMMARY SENIORS MEDICAL
2017 PUSD KAISER SENIOR ADVANTAGE [KPSA] DENTAL SUMMARY SENIORS DENTAL
DOMESTIC PARTNER FIDAVIAFT ACTIVE  
PAYROLL DEDUCTION CHANGE ACTIVE  
MES Claim Form ACTIVE EYE
Handicaped Child Attending Physicians Statement Form ACTIVE  
Request for Continuation of Medical Coverage ACTIVE  
MHS HO ACTIVE LIFE
Domestic Partner Agreement Form ACTIVE  
Dependent Day Care Provider Acknowledgement Form ACTIVE  
Optum RX Claim Reimbursement Form ACTIVE RX
Beneficiary Designation Form ACTIVE  
     
     
     

 

The Poway Unified School District (PUSD) is an equal opportunity employer/program and is committed to an active Nondiscrimination Program. PUSD prohibits discrimination, harassment, intimidation, and bullying based on actual or perceived ancestry, age, color, disability, gender, gender identity, gender expression, nationality, race or ethnicity, religion, sex, sexual orientation, or association with a person or a group with one or more of these actual or perceived characteristics. For more information, please contact the Title IX/Equity Compliance Officer, Associate Superintendent of Personnel Support Services, Poway Unified School District, 15250 Avenue of Science, San Diego, CA 92128-3406, 858-521-2800, extension 2761. View Annual Notification of Parents’/Students’ Rights | Annual Notification of Employees’ Rights

POWAY UNIFIED SCHOOL DISTRICT | 15250 Avenue of Science, San Diego, CA 92128 | (858) 521-2800