The 2023 Conference Health Benefits details for open enrollment are now available (as a single .zip file) for download on this Health Benefits page via the button below.
Please first carefully read the “2023 Cover Letter” document which contains pertinent details on the process this year.
To make changes for January 1, 2023, the deadline for submitting all forms to Rosa Garcia is December 12, 2022.
If you are waiving the Conference Health Benefits, complete the Health Benefits Waiver form found here. Once the declination form is fully completed and submitted it will be routed electronically to the Benefits Office and you will receive a copy.
For questions, contact Rosa Garcia (rgarcia@calpacumc.org; 626.568.7319), Health Benefits & Employment Administrator.
OR Download Each File
- 2023 Cover Letter (PDF)
- 2023 Medical, Dental and Vision Rates (PDF)
- 2023 Guidelines for Sponsoring the Conference Health Plan (PDF)
- Kaiser Enrollment/Change Form (PDF)
- Kaiser New Member (PDF)
- Kaiser Care Away from Home (PDF)
- Kaiser HMO Summary of Benefits (PDF)
- Kaiser Qualified High Deductible Health Plan (HDHP) HSA Summary of Benefits (PDF)
- Guardian Dental Enrollment/Change Form (PDF, updated 12/9/2022)
- 2023 Dental Side-by-Side Plan Comparison (PDF)
- DHMO Dental Guardian CoPay Schedule_1 (PDF)
- DHMO Dental Guardian CoPay Schedule_2 (PDF)
- VSP Membership Enrollment/Change Form (PDF)
- VSP Benefits Summary (PDF)
- VSP New Member Letter (PDF)
- Vision VSP: Search for a provider
- Dental Guardian: Find a dentist
- To waive the Conference health benefits during open enrollment or at any time of the year due to a qualifying event, please complete and submit the Declination form.