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Human Resources

Benefits Forms and Documents

Below you will find links that will take you to various Benefits forms and documents. You may also browse a complete alphabetical listing of forms and documents.

Benefits Documents
New Content
Document Title
File(s)
Notes
  Academic Employees Benefits Highlights PDF 2008-2009
  Academic Employees Open Enrollment Overview PDF Open Enrollment 5/19/18 to 6/6/08.
  AFT and Management Plan Coverage Contributions PDF  
  Anthem Blue Cross PPO Benefits PDF Academic; 2007-2008.
  Anthem Blue Cross PPO Benefits PDF Classified and Management; 2007-2008.
  Blue Cross Prescription Drug Benefits PDF Classified and Management; 2007-2008.
  CCA Benefits Election Form PDF Effective 7/1/08-6/30/09
  Classified and Management Employees Benefits Highlights PDF 2008-2009
  Classified and Management Team Benefits Election Form PDF Effective 7/1/08-6/30/09
  Classified and Management Team Retirees Open Enrollment Overview PDF Open Enrollment 6/2/2008 to 6/20/2008
  Delta Dental PPO Highlights PDF LBCCD group benefits.
  Insurance Continuation Rights PDF COBRA Notification.
  Kaiser Permanente Benefits PDF Full-Time Faculty, Classified, and Management; 2007-2008.
  Life Insurance Announcement PDF Effective 10/01/05
  Managed Health Network (MHN) PDF Instructions to log in.
  Vision Service Plan Summary PDF  

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Forms External Link(s):
Classification Study (JIQ)

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Human Resources
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