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Insurance Premium Rates and Employee Cost

Monthly Employee Insurance Premium Rates 7/1/22 to 6/30/23

27J Schools Premium rate sheet for 07-01-22 to 06-30-23 Final.pdf 204.64 KB (Last Modified on April 19, 2022)

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Monthly Employee Insurance Premium Rates 7/1/21 to 6/30/22

27J Schools Premium rate sheet for 07-01-21 to 06-30-22 Final.pdf 199.66 KB (Last Modified on April 28, 2021)

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Medical Insurance

Insurance Enrollment and Change Form

27J Schools Insurance Enrollment and Change Form - Modified May 2021.pdf 264.73 KB (Last Modified on April 15, 2021)

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Waiver of Group Insurance Benefits Form

Waiver of Group Insurance Benefits Form 20190211.pdf 121.41 KB (Last Modified on February 11, 2019)

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Kaiser HDHP Summary of Benefits

27J Schools HDHP 6000 EMB 2022-2023.pdf 696.6 KB (Last Modified on April 11, 2022)

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Kaiser DHMO Summary of Benefits

27J Schools DHMO 2500 2022-2023.pdf 657.81 KB (Last Modified on April 11, 2022)

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Get Registered on KP.org

Kaiser Registration Flyer.pdf 427.6 KB (Last Modified on June 21, 2019)

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Age-appropriate Preventive Screening Guidelines for men and women

Kaiser Age Related Preventive Guidelines.pdf 71.9 KB (Last Modified on March 1, 2022)

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A little prevention goes a long way

A_little_prevention_goes_a_long_way.pdf 2131210 (Last Modified on November 11, 2021)

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Understanding Preventive Care

Understanding Preventive Visits.pdf 45.3 KB (Last Modified on February 7, 2019)

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Kaiser Manage Your Care Online

Kaiser Manage Your Care Online.pdf 213.17 KB (Last Modified on November 7, 2017)

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Kaiser Care Options

Kaiser Care Options Guide 2021.pdf 1.2 MB (Last Modified on April 7, 2021)

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Kaiser Permanente 2022 Sample Fee List

Kaiser 2022 Sample Fee List.pdf 1.47 MB (Last Modified on February 28, 2022)

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Medicare Creditable Non-Creditable Coverage

Medicare Creditable Coverage Notice for SD27J - August 2021.pdf 480.2 KB (Last Modified on August 25, 2021)

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Kaiser Chat with a Mental Health Specialist

Kaiser chat with a mental health specialist.pdf 73.89 KB (Last Modified on October 22, 2021)

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Kaiser Complaint Form

2022-23 Complaint Form for 27J employees to use when they have issues with Kaiser.pdf 190.63 KB (Last Modified on February 2, 2022)

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IRS Publication 502

2021 IRS 502 Publication.pdf 1.28 MB (Last Modified on April 11, 2022)

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Dental and Vision

Dental Claim form front page

Dental Claim Form - Front side.pdf 61.25 KB (Last Modified on July 25, 2014)

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Dental Claim form back page

Dental Claim Form - Back side.pdf 10.30 KB (Last Modified on July 25, 2014)

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Dental Plan Summary of Benefits

27J Schools Dental Plan Summary of Benefits 2021-222.pdf 568.3 KB (Last Modified on June 3, 2021)

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Dental Plan Booklet

SD27J Dental Plan Doc_FINALDRAFT July 2015.pdf 358.00 KB (Last Modified on April 13, 2015)

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Vision Plan Summary

27J Schools Vision Plan Summary of Benefits 2021-2022.pdf 1.31 MB (Last Modified on June 3, 2021)

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Life/AD&D Insurance with The Standard Insurance Company

Life Insurance Enrollment Form for The Standard

Life Insurance Enrollment Form for The Standard - 2019 .pdf 175.57 KB (Last Modified on February 11, 2019)

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Life Services Tool Kit

Life Services Tool Kit Employee FLyer Aug 2021.pdf 336.99 KB (Last Modified on April 20, 2022)

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Travel Assistance

Travel Assistance flyer 7.2020.pdf 975.15 KB (Last Modified on April 20, 2022)

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Flexible Spending Accounts

Flex Enrollment Form 2022-2023

27J Schools 22-23 Flex Enrollment Form.pdf 399.4 KB (Last Modified on April 19, 2022)

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Flex Enrollment Booklet 2021-2022

27J Schools 21-22 Flex Enrollment Guide.pdf 1.21 MB (Last Modified on April 29, 2021)

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HealthSmart Self-Service Portal

HealthSmart FSA Participant Self-Service Portal Login Instructions.pdf 653.44 KB (Last Modified on April 29, 2021)

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HealthSmart Mobile App

HealthSmart My Flex Spending Mobile App.pdf 617.48 KB (Last Modified on April 29, 2021)

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IRS Publication 502

2021 IRS 502 Publication.pdf 1.28 MB (Last Modified on April 11, 2022)

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Health Savings Account - HSA Bank

Health Savings Accounts Frequently Asked Questions

27J Schools Health Savings Accounts - Frequently Asked Questions.pdf 538.37 KB (Last Modified on April 20, 2022)

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HSA Building a Stronger Retirement

HSA Building a Stronger Retirement Ebook.pdf 3.4 MB (Last Modified on April 20, 2022)

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Health Savings Account Paycheck Contribution Form

27J Schools Health Savings Account Paycheck Contribution Form - 2022-2023.pdf 319.14 KB (Last Modified on April 6, 2022)

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HSA Expense Eligibility

HSA Expense Eligibility.pdf 206.82 KB (Last Modified on April 20, 2022)

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H S A Beneficiary

HSA Designation of Beneficiary Form.pdf 431.26 KB (Last Modified on April 20, 2022)

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27J Schools Retirement Programs

Retirement Plans - 401K/403B

Retirement Plans 2022 2023.pdf 116.99 KB (Last Modified on March 28, 2022)

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OMNI Updates

Inside_Edge-4th-Qtr-2020_72.pdf 1.79 MB (Last Modified on November 4, 2020)

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403B UA Notice

403B UA Notice 573.pdf 292.6 KB (Last Modified on February 2, 2022)

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