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Insurance Forms & Flyers

Form Information

Forms are subject to change without notice and may only be accepted under specific guidelines. For additional information or to request a form not available on this page, please contact the District Insurance Office. (Some forms are only available from the carrier.)

 

Please visit www.benefitbridge.com/oceanside to view Summary Plan Descriptions or Summaries of Benefits of the current plans.

Forms

MEDICAL
 

Medical Plans

Description: Employees participating in the OUSD-sponsored medical plans
Eligible Employees: Permanent (50%+ Certificated / 4.0+ Classified / Full-Time Leadership)

Enroll/Change: Open Enrollment / Qualifying Event

Medical Waivers

Description: For employees not participating in the OUSD-sponsored medical plans
Eligible Employees: Permanent (50%+ Certificated / 4.0+ Classified / Full-Time Leadership)
Enroll/Change: Open Enrollment / Qualifying Event


DENTAL
 

Dental Plans

Description: Employees participating in the OUSD-sponsored dental plans
Eligible Employees: Permanent (50%+ Certificated / 4.0+ Classified / Full-Time Leadership)
Enroll/Change: Open Enrollment / Qualifying Event

Dental Waivers

Description:For employees not participating in the OUSD-sponsored dental plans
Eligible Employees:Permanent (50%+ Certificated / 4.0+ Classified / Full-Time Leadership)
Enroll/Change: Open Enrollment / Qualifying Event


VOLUNTARY VISION


Vision Plan

Description: Employee-Paid Voluntary Vision Plan
Eligible Employees: Permanent (50%+ Certificated / 4.0+ Classified / Full-Time Leadership)
Enroll/Change: During Open Enrollment / Qualifying Event


LIFE
 

Accidental Death & Dismemberment (AD&D)

Description: Employee-Paid Accidental Death & Dismemberment Plan
Eligible Employees: Permanent (50%+ Certificated / 4.0+ Classified / Full-Time Leadership)
Enroll/Change: Any Time

Group Term Life

Description: District-Provided Group Term Life / Accidental Death & Dismemberment
Eligible Employees: Permanent (50%+ Certificated / 4.0+ Classified / Full-Time Leadership)
Enroll: Within first 30 days of hire date or return from Unpaid Leave of Absence

Change: Beneficiary Designation can be changed at any time

Voluntary Term Life

Description: Employee-Paid Voluntary Term Life Plan
Eligible Employees: Permanent (50%+ Certificated / 4.0+ Classified / Full-Time Leadership)
Enroll: Within first 31 days of hire date or return from Unpaid Leave of Absence without medical review / Any time with medical review


TAX-SHELTERED ACCOUNTS/ANNUITIES
 

Flexible Spending Accounts

Description: Employees' pretax money put aside for eligible healthcare or daycare expenses
Eligible Employees: Permanent (50%+ Certificated / 4.0-Hr+ Classified / Leadership)
Enroll/Change: FSA Open Enrollment / Qualifying Event

Tax-Sheltered Annuities

Description: Employees' pretax & post-tax money put in an additional, voluntary retirement account
Eligible Employees: All (including substitutes and hourly)
Enroll/Change: Any time


OTHER

HIPAA Authorization

Description: For assistance with claim / billing / service resolution
Eligible Employees: Any benefitted employee and/or their covered dependents

Pre-Enrollment Questionnaire

Description: Basic questionnaire for newly hired employees
Eligible Employees: Permanent (50%+ Certificated / 1.85-Hr+ Classified / Leadership)

Legal Services Plan

Description: Employee-paid voluntary legal services plan
Eligible Employees: Permanent (50%+ Certificated / 4.0-Hr+ Classified / Leadership)

Enroll: During Open Enrollment

Voluntary Plans

Description: Employee-paid voluntary plans
Eligible Employees: Please see Insurance Benefits Packet for eligibility requirements
Enroll: Varies

Gym Membership Discounts

The District is a corporate member with 24 Hour Fitness and LA Fitness, which gives our employees and their families discounted membership if they join. Information about this wellness program is included in the Insurance Benefit Packets distributed to employees each year and in the flyers below: