2016-2017 Benefits

• Beneficiary Designation/Change Card
• Benefit Rates
• Delta Dental - PPO Plan Summary
• DeltaCare USA - Plan Summary
• Enrollment Guide
• EyeMed - Plan Summary
• Health Advocate EAP
• Kaiser - $20 Plan Summary
• Kaiser - $40 Plan Summary
• Pharmacy Mail Order Form
• Vol. AD&D Brochure
• Vol. Life Insurance

American Fidelity

• American Fidelity - Accident Plan
• American Fidelity - Brochure
• American Fidelity - Cancer Plan
• American Fidelity - Disability Plan

Anthem Blue Cross

• Anthem Blue Cross - Guest Membership Program
• Anthem Blue Cross - HMO Chiropratic Plan Summary
• Anthem Blue Cross - HMO Medical Provider Finder
• Anthem Blue Cross - HMO Rx Plan Summary
• Anthem Blue Cross - HMO Summary of Benefits
• Anthem Blue Cross - HMO Summary of Benefits and Coverage
• Anthem Blue Cross - PPO CA Medical Provider Finder
• Anthem Blue Cross - PPO Outside of CA Medical Provider Finder
• Anthem Blue Cross - PPO Summary of Benefits
• Anthem Blue Cross - PPO Summary of Benefits and Coverage

Leave of Absence Forms

• Certificatation of Health Care Provider
• Leave of Absence Application
• Leave of Absence Instructions

Leave of Absence Information

• Employee Leave of Absence Instructions
• Family Care - CSEA
• Family Care - CTA
• Medical Disability - CSEA
• Pregnancy - CSEA
• Pregnancy - CTA

Workers Compensation - Employee

• Covered Employee Notification
• Instructions for Injured Worker

Workers Compensation - Providers

• FOX Occupational
• LOMA LINDA UNIVERSITY

Workers Compensation - Supervisor

• DWC-1
• Employee Statement
• Medical Authorization
• Supervisor Instructions
• Supervisor Statement
• Witness Statements