CA LAUSD Health Benefits Enrollment Form 2022 free printable template

Los Angeles Unified School District Benefits AdministrationHEALTH BENEFITS ENROLLMENT FORM ACTIVE EMPLOYEES Employee Numberless NameAddressFirst Name City. I. Statesman AddressClassified Certificated

How to fill out health benefits enrollment form

How to fill out CA LAUSD Health Benefits Enrollment Form

1. Obtain the CA LAUSD Health Benefits Enrollment Form from the official district website or human resources department.
2. Provide personal information, including your full name, address, and employee ID number.
3. Indicate your employment status and date of hire.
4. Select the appropriate health benefit plan options available to you.
5. List any dependents you wish to enroll, including their names and relationship to you.
6. Review any additional sections for optional benefits or coverage.
7. Check for any required signatures and date the form.
8. Submit the completed form by the specified deadline to your HR department or through the designated method.

Who needs CA LAUSD Health Benefits Enrollment Form?

1. The CA LAUSD Health Benefits Enrollment Form is needed by all newly hired employees, current employees enrolling in new health plans or making changes to their existing plans, and those adding or removing dependents.

People Also Ask about

Who is eligible for lausd lifetime health benefits?

For employees hired on or after June 1, 1992, years of qualifying service and age must total at least eighty (80) in order to qualify for retiree health benefits. For employees who have a break in service, this must include at least ten (10) consecutive years immediately prior to retirement.

What is the phone number for lausd medical benefits?

For information on medical insurance benefits after retirement, please contact the Los Angeles Unified School District Employee Benefits Administration at (213) 241-4262.

What is the employee discount program?

Employee discounts refer to the discount given on the original price of the goods or services by the company to their employees. Generally an employee discount is given as one of the fringe benefits.

Do LA County employees get discounts?

The Employee Discount Program offers discounts to LA County employees for theme parks, sporting events, entertainment, dining, and various other activities throughout the County.

Do lausd employees get discounts?

Get LAUSD Employee Discounts As a member, you will find employee discounts on travel, insurance, car rentals, prescriptions, cell phones, tires, movies, theme parks, and more. Just sign up to become a member and get instant access!

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What is CA LAUSD Health Benefits Enrollment Form?

The CA LAUSD Health Benefits Enrollment Form is a document used by employees of the Los Angeles Unified School District to enroll in or make changes to their health benefits plans.

Who is required to file CA LAUSD Health Benefits Enrollment Form?

All new employees of LAUSD, existing employees wishing to change their current health benefits, and those experiencing qualifying life events are required to file the CA LAUSD Health Benefits Enrollment Form.

How to fill out CA LAUSD Health Benefits Enrollment Form?

To fill out the CA LAUSD Health Benefits Enrollment Form, employees should carefully read the instructions provided, enter their personal information, select their desired health benefits plan, indicate any dependents to be covered, and sign and date the form before submitting it.

What is the purpose of CA LAUSD Health Benefits Enrollment Form?

The purpose of the CA LAUSD Health Benefits Enrollment Form is to facilitate the enrollment process for health benefits, ensuring that eligible employees have access to necessary health care options and coverage.

What information must be reported on CA LAUSD Health Benefits Enrollment Form?

The information that must be reported on the CA LAUSD Health Benefits Enrollment Form includes the employee's personal details (name, address, employee ID), choice of health benefits plan, information about any dependents to be covered, and the employee's signature.