Benefits Enrollment Forms

• KCCD Plan Comparison Summary
• 100-A Anthem PPO Benefit Summary
• 90-G Anthem PPO Benefit Summary
• 80-G Anthem PPO Benefit Summary
• Kaiser Benefit Summary
• SISC Membership Change Form

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• Delta Dental Incentive - No Orthodontic - Plan Summary
• Delta Dental PPO - Orthodontic - Plan Summary  

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• VSP Benefit Summary

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• Basic Life Insurance Enrollment Form
• Voluntary Term Life Insurance Form
• ​Beneficiary Change Form

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For access to provider networks and other SISC resources, please visit Member Resources 

• SISC PPO Enrollment Guide
• Active & Fit Direct Program
• Silver & Fit Fitness Program
• Kaiser HMO Enrollment Guide
• Kaiser Active & Fit Direct Program
• Kaiser Silver & Fit Fitness Program

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• KCCD Plan Comparison Summary for Early Retirees
• KCCD Plan Comparison Summary for Retirees 65+

Classified, Management & Classified Confidential Retirees:

• Early Retiree Plan Election Form
• 65+ Retiree Plan Election Form
• Self Paid Plan Election Form

​Faculty Retirees:

• Early Retiree Plan Election Form
• 65+ Retiree Plan Election Form
• Self Paid Plan Election Form

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