Welcome to Employee Benefits

Empire Union School District provides a comprehensive benefits package for employees who meet the minimum requirements for coverage including...

Medical, Dental, Vision, Disability and Basic Life Insurance Plans Participation in CalSTRS or CalPERS retirement systems Employee Assistance Programs Optional supplemental Life & AD&D insurance plan Optional participation in 403(b) & 457(b) Tax-Sheltered Investments Optional participation in critical illness & other supplemental insurances Optional participation in Flexible Spending Account programs

Questions regarding Benefits? Contact: C.W. Smith - Human Resources (209) 521-2800 x2219 CSmith@empire.k12.ca.us

Certificated Employees

Certificated Employees (CVT)

Benefits

Open Enrollment is NOW through August 25, 2019 

Certificated Employees are eligible to make changes to and/or enroll in the following benefits:

  • CVT health Plan

  • Delta & United Healthcare Dental Plans

  • Vision Service Plan (VSP)

No plan cost Changes for Dental & Vision

See sections below for Plan Documents, Rates & Enrollment Forms 

Plan Cost Adjustment effective September 2020 Payroll

Coverage Changes Effective October 1, 2020

Required documents when enrolling in any available health benefit:

Spouse

  • Marriage Certificate 

    Child(ren)

  • Birth Certificate(s)

All documents are due to C.W Smith at the District Office no later than Monday, August 25, 2019

Affordable Care Act
ACA Notice - Benefits Eligible
ACA Notice - Benefits Ineligible

COBRA Rights
General Notice of COBRA Rights

CVT HIPPA
CVT Notice of Privacy Practices

DID YOU KNOW ... 

  • MyCVT can be your one-stop-shop resource for your health benefit needs!

  • If you are not registered with MyCVT you can do so by going to https://mycvt.cvtrust.org/  ... Click Here for Instructions

  • That you can connect directly to CVT benefit partners from MyCVT without having to sign into multiple sites? Even print replacement cards!

  • MyCVT also connects you to special programs?  Need counseling, legal or financial advice? Employee Assistance Program EAP could help.  Bad cold getting worse and Dr. offices are closed? MDLIVE 24/7/365 Anytime, Anywhere!

  • You can update your Name/Address/Phone # - Documentation may be required.

  • You can Enroll/Dis-enroll dependents and/or change plans as a Qualifying Event or during Open Enrollment - Documentation maybe required.

Health Plans, Forms & Rates (CVT)

Health Plan Side by Side Comparison Summaries
20/21 CVT PPO Plans 3A 4B 6B & 10C
20/21 CVT PPO Wellness & Bronze Plans
20/21 CVT Kaiser Plans

Forms
CVT Enrollment Form

Rates
20/21 Certificated Full Time
20/21 Certificated 80%
20/21 Certificated 50%

Dental Plans & Forms

Dental Plan Summaries
Delta Dental Premier
Delta Dental Preferred
United Healthcare Dental
United Healthcare Dental Full Summary

Forms
Delta Dental Enrollment Form
United Healthcare Dental Enrollment Form

Vison Plan & Forms

VIsion Service Plan (VSP) Plan Summary
VSP Plan Summary

Forms
VSP Enrollment Form
VSP Enrollment Change Form

CVT Anthem Blue Cross PPO 

Benefit Booklets
For a more in-depth look at Anthem Blue Cross PPO plans follow the links below. 

CVT Kaiser HMO Benefit Booklets
For a more in-depth look at Kaiser HMO plans follow the links below. 

CEC Classified, Classified Confidential, Board & Management Employees (SISC)

Open

Open Enrollment is NOW through August 25, 2020 

CEC Classified, Confidential, Board & Management Employees are eligible to make changes to and/or enroll in the following benefits:

  • SISC health Plan

  • Delta & United Healthcare Dental Plans (No Plan Cost Change)

  • Vision Service Plan (VSP) (no plan cost change)  

See sections below for Plan Updates, Documents, Rates & Enrollment Forms 

Plan Cost Adjustment effective September 2020 Payroll

Coverage Changes Effective October 1, 2020

Required documents when enrolling in any available health benefit:

Spouse

  • Marriage Certificate &

  • 1st Page of 2019 Federal Tax Return showing married filing status

Child(ren)

  • Birth Certificate(s)

All documents are due to C.W. Smith at the District Office no later than Tuesday, August 25, 2020

Affordable Care Act
ACA Notice - Benefits Eligible
ACA Notice - Benefits Ineligible

COBRA Rights
General Notice of COBRA Rights

SISC HIPAA
SISC HIPAA  Notice of Privacy Practices

CEC Classified Health Plans & Forms (SISC)

Health Plan Comparison Summaries
20/21 All SISC Plans

Forms
SISC PPO Enrollment Form
SISC Kaiser Enrollment Form
SISC WABE Election Form
SISC Name Address Dependent Coverage Change Form

Dental Plans & Forms

Dental Plan Summaries
Delta Dental Premier
Delta Dental Preferred
United Healthcare Dental
United Healthcare Dental Full Summary

Forms
Delta Dental Enrollment Form
United Healthcare Dental Enrollment Form

Vison Plan & Forms

Vision Service Plan (VSP) Plan Summary
VSP Plan Summary

Forms
VSP Enrollment Form
VSP Enrollment Change Form

CEC Classified Rates
20/21 8 hr Classified Rates
20/21 
7.5 hr Classified Rates
20/21 7 hr Classified Rates
20/21 6.5 hr Classified Rates
20/21 6 hr Classified Rates
20/21 5.5 hr Classified Rates
20/21 5 hr Classified Rates
20/21 4.5 hr Classified Rates
20/21 4 hr Classified Rates

CEC Classified Confidential, Board & Management Rates
20/21  8 hr Confidential, Board & Managment Rates
20/21 80% Confidential, Board & Management Rates
20/21 50% Confidential, Board & Management Rates

Paraprofessional Rates
20/21 8 hr Paraprofessional 
20/21 7.5 hr Paraprofessional 
20/21 7 hr Paraprofessional 
20/21 6.5 hr Paraprofessional 
20/21 6 hr Paraprofessional 
20/21 5.75 hr Paraprofessional 
20/21 5.5 hr Paraprofessional
20/21 5.25 hr Paraprofessional
20/21 5 hr Paraprofessional
20/21 4.75 hr Paraprofessional
20/21 4.5 hr Paraprofessional
20/21 4 hr Paraprofessional
20/21 24 hr/wk Paraprofessional

SISC Plan Summary of Benefits & Coverage (SBC)
19/20 100C
19/20 80G
19/20 80M
19/20 HSA B
19/20 Anchor Bronze
19/20 Kaiser

Blue Shield Enrollment Guide 
Kaiser Enrollment Guide
Find a Provider Blue Shield PPO

SISC Plan Summaries 
20/21 100C
20/21 80G
20/21 80M
20/21 HSA-B
20/21 Anchor Bronze
20/21 Kaiser

CSEA Classified Employees (CalPERS)

Enrollment

Open Enrollment for CalPERS health Benefits is September 21 - October 16, 2020

CSEA Employees are now eligible to make changes to:

  • CalPERS Health Plans

Open Enrollment for Dental & Vision Benefits August 3 - 25, 2020

See sections below for Plan Documents, Rates & Enrollment Forms 

Plan Cost Adjustment for Dental & Vision effective September 2020 Payroll

Plan Cost Adjustment for CalPERS Health Plans effective December 2020 Payroll

Dental & Vision Coverage Changes Effective October 1, 2020

CalPERS Health Plan Changes Effective January 1, 2021

Required documents when enrolling in any available health benefit:

Spouse

  • Marriage Certificate &
    Child(ren)

  • Birth Certificate(s)

All required dental & vision documents are due to Sarah Evers at the District Office no later than Tuesday, August 25, 2020 

All required CalPERS health documents are due to Sarah Evers at the District Office no later than Friday, October 16, 2020 

Affordable Care Act
ACA Notice - Benefits Eligible
ACA Notice - Benefits Ineligible

COBRA Rights
General Notice of COBRA Rights

CalPERS HIPPA
CalPERS Notice of Privacy Practices

CSEA Classified Health Plans & Rates (CalPERS)

Health Plans Comparison Summaries
2020 CalPERs All Plans

Forms
CalPERs Health Enrollment Form

Rates
2021 Full Time Employee Cost Increase/Decrease
2021 Full Time CSEA CalPERS Rates
2021 7.5 hr CSEA CalPERS Rates
2021 7 hr CSEA CalPERS Rates
2021 6.5 hr CSEA CalPERS Rates
2021 6 hr CSEA CalPERS Rates
2021 5.5 hr CSEA CalPERS Rates
2021 5 hr CSEA CalPERS Rates
2021 4.5 hr CSEA CalPERS Rates
2021 4 hr CSEA CalPERS Rates

Dental Plans & Forms

Dental Plan Summaries
Delta Dental Premier
Delta Dental Preferred
United Healthcare Dental
United Healthcare Dental Full Summary

Forms
Delta Dental Enrollment Form
United Healthcare Dental Enrollment Form

Delta Dental
(866) 499-3001
www.deltadentalins.com

United Healthcare Dental
(877) 816-3596
www.myuhc.com 

Vison Plan & Forms


VIsion Service Plan (VSP) Plan Summary
VSP Plan Summary

Forms
VSP Enrollment Form
VSP Enrollment Change Form

Vision Service Plan
(800) 877-7195
www.vsp.com.

For a More Comprehensive Look at CalPERS Health Plan Coverage View Documents Below

CalPERS Health Plan Summaries of Benefits & Coverage (SBCs)

Information is from 2020 and will be updated once 2021 materials become available

CalPERS Health Plan Evidence of Coverage (EOCs)

Information is from 2020 and will be updated once 2021 materials become available


Anthem Blue Cross HMO
(855) 839-524
 www.anthem.com/ca/calpers

Blue Shield of California
(800)334-5847 
www.blueshieldca.com/calpers

Kaiser Permanente
(800) 464-4000 
www.kp.org/calpers

PERS Select/Choice/Care 
(877) 737-7776
www.anthem.com/ca/calpers