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Open Enrollment

Name Contact Responsibilities
Ron Owen
Senior Benefits Analyst
415.883.2211 ext. 8159
Benefits Administration
Peggy Isozaki
Fiscal Services Director
415.883.2211 ext. 8160
Fiscal Services Administration

Tuesday, May 10, 2016 – Thursday, August 25, 2016
Deadline: Thursday, August 25, 2016, 5 pm to the Benefits Office at Indian Valley Campus


We are pleased to announce the 2016-2017 Annual Open Enrollment for all benefit eligible employees, beginning Tuesday, May 10, 2016.

Any enrollment changes for you or your dependents will go into effect on October 1, 2016, with any employee premium contributions beginning on the September 2016 payroll. The district caps remain unchanged.

If you are satisfied with your current coverage, there will be no action needed.

Open Enrollment Memo and Instructions

SISC Program Features

To Enroll or Change enrollment, you must complete:

Medical Plan Election Form


Kaiser Enrollment Form


Blue Shield Enrollment Form

Flex Week Open Enrollment Sessions for Health Benefits

Thursday, August 18, 2016 – TBD KTD
Thursday, August 18, 2016 – TBD KTD
Friday, August 19, 2016 – TBD KTD
Friday, August 19, 2016 - TBD KTD

Plan Documents


Traditional Plan - Summary of Benefits and Coverage

Traditional Plan - Benefit Summary

Open Enrollment Guide for Traditional Kaiser Permanente plans

Deductible HMO Plan - Summary of Benefits and Coverage

Deductible HMO Plan - Benefit Summary

Open Enrollment Guide for Deductible HMO Kaiser Permanente plans

Kaiser Permanente Service Areas

Kaiser Chiropractic Care Benefit

Beginning February 1, 2015 a chiropractic benefit was added to both the Kaiser Traditional HMO and the Kaiser Deductible HMO Plans.

Chiropractic Care Benefit

Find a Chiropractic Provider

Blue Shield PPO

Blue Shield of California 100% Plan A - Summary of Benefits

SISC Blue Shield of California 100% Plan A / $20.00 Copayment (update pending)

Blue Shield of California 80% Plan K - Summary of Benefits

SISC Blue Shield of California 80% Plan K / $30.00 Copayment (update pending)

SISC Blue Shield of California: Minimum Value Plan - Summary of Benefits

Open Enrollment Guide for Blue Shield PPO plans (2015-2016 Enrollment Guide - update pending)

Free Generic Medications at Costco and Through Mail Order

Free Identity Protection Services for Blue Shield Members

Delta Dental

Active Employees
Retired Employees


The following benefit enhancements will be added effective October 1, 2016:

Diabetic Eye Care Program Plus - This program is being added to all VSP plans with no impact to the rates. It provides supplemental eye care for patients with diabetic eye disease, glaucoma, or macular degeneration. Coverage includes glaucoma testing, fundus photography, retinol screening, visual field exams, and medical exams for a $20 co-pay per visit.

VSP Vision Benefit Summary

Open Enrollment Forms

Step 1: Complete Medical Plan Election Form

Step 2: Complete Enrollment Forms

Step 3:  Dependent Eligibility – Required Documents: If you are adding an eligible dependent the following documents are required by SISC:

Spouse, Domestic Partner (AB205), or Domestic Partner (Non-AB205): In addition to the documentation listed below, a copy of the first page of the previous calendar year’s IRS Federal Tax Return for spouse (financial information and first five digits of the Social Security number may be blacked out). If taxes were filed separately, a copy of both returns is required.

Dependent Child: Photocopy of the legal birth certificate, hospital certificate, adoption paperwork, or guardianship paperwork issued by a court (documentation must include both child and parents’ names and the dependent relationship to the employee). Grandchildren are only eligible if they are the employee/retiree’s dependent through adoption or legal guardianship.

As a large public entity purchasing pool of educational agencies, SISC requires dependent eligibility documentation to validate each dependent’s legal relationship to the employee.  If you do not have copies of the required documents, you may contact the county recorder’s office in which the marriage or birth occurred.

Enrollment information submitted with incomplete forms or missing documents will cause a delay in access to benefits.

Domestic Partnerships

Pre-Tax Your Share of Premium: 

If you have any out of pocket share toward the premium, you may consider having the deductions taken on a pre-tax basis.  By signing up for this option your federal, state and social security deductions will decrease.  Please visit the Open Enrollment webpage for the Salary Reduction Agreement. Please submit by August 25, 2016 to the Benefits Office.

Open Enrollment for Pre-Tax Benefit Enrollment - Aflac and WageWorks

Dependent Terminations

What are the employee and district responsibilities regarding spouse/domestic partner and/or dependent children terminations?

It is the employee’s responsibility to notify the district of any changes in eligibility status for their spouse/domestic partner or dependent(s). The district is required to notify SISC in a timely manner of these changes. Paid claims on a non-eligible spouse/domestic partner or dependent(s) will be recovered.

Open Enrollment for Pre-Tax Benefit Enrollment – TDS and Guardian

Flexible Spending Account (FSA) and Guardian Voluntary Plans - For Eligible Employees

Now is the time to enroll for an effective date of October 1, 2016.

TDS Open Enrollment Flyer

The College of Marin provides you with several benefits options that allow you can use pre-tax money to increase your spending power and protect you when unforeseen events put you at risk with loss of income, unanticipated medical expenses and more.

You pick the coverage that best suits you and your family. Supplemental Insurance Programs Offered to College of Marin Employees:

You can have up to $2,550 withheld annually on a pre-tax basis to pay for any out of pocket medical/dental expenses (Medical FSA) and an additional $5,000 withheld annually for dependent care expenses (Dependent Care FSA) may also be withheld.  Click here to start your enrollment.

Commuter Benefits/Transportation Program: This benefit allows you to set aside pre-tax funds, up to $130 per month, to pay for qualified workplace mass transit or van pooling expenses. Transportation Plan Flyer.

It’s quick and simple, with online education videos and decision support tools to help you make the right choices for you and your family.

Need help? If you have any questions or need assistance, please call 1-800-934-0161. Benefit Counselors are standing by Monday – Thursday 10:30am to 7:30pm and Saturday 8:30am – 12pm.

Click to Register for the 2016-2017 Annual Open Enrollment for the Section 125 Cafeteria Plan

After you watch the TDS Overview Video, click “Return to Website” on the lower right corner.

Look for the Enroll Now in the upper left corner. Next look for: Enrollment - Step 1: Select Enrollment. Follow the prompts.

At the end of the enrollment process, you will see an Enrollment Summary. You can edit any of your selections from this page. If everything is correct, click the button on the lower right corner: “Save Enrollment”.

Note: You may bypass the videos by clicking on the “Return to Website” on the lower right corner. You will be taken back to a webpage titled:  “Enrollment - Step 3: Benefit Selection”. If you do not wish to take the coverage, enter “No Contribution” or $0.00.

Resources and Contact Information

Kaiser Permanente

Customer Service: (800) 464-4000.

Blue Shield

Customer Service: (855) 256-9404.

Navitus Pharmacy Services: (866) 333-2757

Delta Dental

Customer Service: 800-765-6003


Member Services: 800.877.7195

Self-Insured Schools of California (SISC)

Visit web site:

Benefits Office

For specific questions please contact Ron Owen, Sr. Benefits Analyst at extension 8159 or (415) 884-3159.

Fiscal Services Website
Content Responsible: Peggy Isozaki, Director of Fiscal Services, 415.883.2211 ext. 8160
Technical Contact: Katy Bauer, Executive Assistant to the Vice President of Finance and College Operations, 415.883.2211 ext. 8101