Weaver Union School District

Open Enrollment

Thursday, August 1st  through Friday, August 15th, 2024.

PLEASE NOTE: Plan changes will impact September payroll and coverage as of October 1st, 2024.

*** 75%* plan***

When married spouses/qualified domestic partners both work for a participating SISC district and are both covered by a composite rated SISC medical plan each district will be billed 75% of the composite rate for the eligible employee. The discount applies to medical products only. Members enrolled on the 75% premium will be still required to participate at 100% of the cost for dental, and vision through SISC and must continue to participate according to SISC Participation guidelines.         

• 2-Tier Anchor Bronze (No Spouse, No Dental, No Vision, high deductible, Prescriptions subject to high deductible)

•  As before, regarding the 3rd dental option (Anthem Dental 4D002A 65862BA /Narrow Network) Please be sure to research this option prior to making any changes.  

•  You can search for Delta PPO providers at www.deltadental.com to see if your current provider, or a provider you’d like to use is listed.

• You can search for VSP providers at www.vsp.com to see if your current provider, or a provider you’d like to use is listed. 

• We cannot advise you regarding the impact of potential plan changes. If you have questions regarding the various plan options, please contact SISC Customer Service at (800) 322-5709.

•  This is your opportunity to add or remove dependents to your plan with a qualifying life event. (birth, marriage, etc.) 

•  If your CAP is prorated (part-time staff), please contact Esmeralda to provide updated rates.

For the 2024-2025 Enrollment Year, we need all employees to complete the Medical Options Election Form. 

If you HAVE changes to your plan this year:

1. Print the Medical Options Election Form to your classification

2. Make your selection change, by adding your initials in box below the new plan premium

3. Print your name

4. Sign your name

5. Date the form

6. Return to Esmeralda Villa at Human Resources

If you do not have changes to your plan this year

1. Print the Medical Options Election Form to your classification

2. Print your name

3. Sign your name

4. Date the form

5. Select the box: NO CHANGE IN CURRENT PLAN

6. Return to Esmeralda Villa at Human Resources

ALL forms must be received at the Human Resource Office No later than 4:00 p.m. on Friday, August 16,2024 in order to meet SISC’s deadline.  

ANY FORMS RECEIVED AFTER THIS TIME WILL NOT BE PROCESSED.