SISC Retiree Benefits

Auxiliary and Classified (non-medicare)

Welcome to the retiree benefits page for auxiliary and classified employees under the age of 65. Here you will find information about the health and wellness benefits available to you in retirement. Our goal is to help you understand your options and make the best choices for your needs as you enter this new stage of life.

Medical Plans and Forms

District-Required Election Form

All benefit enrollment changes begin with the completion of the District-required Retiree Election Form. This form initiates your request. Depending on the type of change, you may also be required to complete the applicable insurance carrier enrollment form before your request can be processed.

2026-2027 Retiree Election Form: Classified and Auxiliary (Non-Medicare Eligible)

HMO Medical Plans

Benefit Plan Summary	Enrollment Form
Kaiser Permanente $15 - $15 OV; Rx $5-20 (30 Day) (2026-27)	Kaiser Permanente Enrollment Form
Kaiser Permanente $0 - $0; Rx $5-20 (30 Day) (2026-27)	Kaiser Permanente Enrollment Form
Blue Shield Trio (Limited Network) - Rx 5-20 (2026-27)	SISC III Enrollment Form for Blue Shield
Blue Shield Access+ (Full Network) - Rx 5-20 (2026-27)	SISC III Enrollment Form for Blue Shield

PPO Medical Plan

Benefit Plan Summary	Enrollment Forms
Blue Shield 90G - $20 OV; Rx $5-20 (30 Day) (2026-27)	SISC III Enrollment Form for Blue Shield
Blue Shield 100A - $10 OV; Rx $5-20 (30 Day) (2026-27)	SISC III Enrollment Form for Blue Shield

Prescription Coverage

Navitus Medicare Rx Information

HIPAA Privacy Notice

HIPAA Notice of Privacy Practices

Dental Plans (Optional)
HMO Dental Plan
- Delta Care USA
PPO Dental Plans
- Delta Dental 1500
- Delta Dental Incentive Unlimited
Vision Plan (Optional)
- VSP Signature Plan C $0
Additional Forms
- Declination of Coverage for Retirees Form
- Dependent Eligibility Documentation Checklist