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Insurance Plan Information, Rates and Forms

Insurance Premiums

2023 Health and Welfare Premiums

Insurance Plan Summaries

CalPERS Medical Benefits Summary

Delta HMO Dental Benefits Summary

Delta PPO Dental Benefits Summary

VSP Vision Care Benefits Summary

Cigna Employee Assistance Plan Informational Flyer

Insurance Forms

CalPERS Medical Insurance Enrollment Form

Delta Dental Insurance Enrollment Form

VSP Vision Insurance Enrollment Form

Discontinuation of Coverage Form

Pre-tax Deduction Authorization Form

Last revised 02/21/2023

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