Welcome! Please review all plan information and rates when making a selection. Check out our Benefit Cost Calculator for assistance.
Highlighted below are the required forms to enroll. Benefits are effective the first of the month following the date of hire.
All documents are DUE: 30-days from your date of hire
1. Medical Election Form
MEDICAL PLAN ELECTION FORM
==========================================
2. Medical Plan Enrollment Form
(Kaiser and United Health Care Plans use the Universal Enrollment Form)
See below for plan descriptions
MEDICAL ENROLLMENT FORM
WAIVER FORM
==========================================
3. Dental Enrollment Form (if enrolling)
See below for plan descriptions
Delta Dental - ENROLLMENT FORM
==========================================
4. Vision Enrollment Form (if enrolling)
See below for plan description
MES ENROLLMENT FORM
==========================================
5. Minnesota Life Enrollment and Beneficiary Form (District-paid)
BENEFICIARY FORM
Minnesota Life Plan Summary and Rates
Minnesota Life Enrollment Form
Minnesota Life Evidence of Insurability Form
(Evidence of Insurability is required if electing above the guaranteed issued amount)
==========================================
6. Disability Acknowledgement Form
Disability Acknowledgement Form
==========================================
IMPORTANT: If enrolling dependents, you must provide proof of dependent relationship. Please see dependent verification requirements: Dependent Verification Documents
Spouse: First page of the previous year Federal tax return showing the married filing status.
Child(ren): Birth Certificate naming employee or spouse as a parent.
Additional Information
Plan Comparison
Benefit Guide
2022 PLAN RATES
Medical Plan Descriptions
KAISER $20 PLAN
KAISER $30 PLAN
UHC NETWORK 1
UHC NETWORK 2
UHC NETWORK 3
UHC SIGNATURE VALUE HMO
Find out which medical group is covered in the UHC Networks 1, 2, and 3 by clicking here DIRECTORY or check online at UHC Provider Finder
OptumHealth Chiropractic
Kaiser Members: 800-428-6337
UHC Members: 800-624-8822
VEBA Advocacy Programs
Contact VEBA at: 888-276-0250
Best Doctors
Expert Medical Second Opinion; Ask the Expert; Find a Best Doctor; Critical Care Support
Contact at 866.904.0910 | members.bestdoctors.com
Dental Plan Descriptions
Vision Plan Descriptions
MES VISION PLAN SUMMARY
Please visit the MES website for provider directory, benefits, and claim forms: mesvision.com