Personnel Support Services - Benefits

For general inquiries and assistance email: benefits@powayusd.com
Phone: (858) 521-2800 ext. 2897, FAX: 858-485-1355

Carin Freitas, Insurance Benefits Specialist, email: cfreitas@powayusd.com
Christine Gold, Insurance Benefits Technician, email: cgold@powayusd.com
Shannon Wolff, Insurance Benefits Technician, email: swolff@powayusd.com

2020 INSURANCE INFORMATION


OPEN ENROLLMENT - BENEFITS ONLINE REGISTRATION!
Benefits Bridge Online Registration

2020 Insurance Benefits Guides and Forms


2020 INSURANCE FORMS
ACTIVE
Beneficiary Designation Form
Benefits Enrollment Form - ACTIVE EMPLOYEE
Dependent Day Care Provider Acknowledgement Form
Domestic Partner Affidavit
Flex Enrollment Form
Handicaped Child Attending Physicians Statement Form
Medical History Statement - The Standard Life Supplemental 
MES Claim Form
Optum RX Claim Reimbursement Form
Payroll Deduction Change
Request for Continuation of Medical Coverage
The Standard Life Insurance Enrollment Form
SENIORS/RETIREES
Benefits Enrollment Form - RETIREE
Kaiser Senior Advantage  [KPSA] Enrollment Form
Hyatt Election Form - Retiree
Benefit Bridge Tutorial
- Take 1

Benefit Bridge Tutorial
- Take 2

Benefits

CARRIER CONTACTS

AETNA: (800) 370-4526
GRP# 866283
www.aetna.com

OPTUM RX: (800) 797-9791
GRP# 610494
www.optumrx.com

KAISER: (800) 464-4000
GRP# 104206
www.kp.org

DELTA DENTAL: (866) 499-3001
GRP# 6779-0001 Active
GRP# 6779-0002 Retiree
www.deltadentalins.com

MetLife Dental HMO: (800) 880-1800
GRP# 216420 MET50
www.metlife.com

MES VISION: (800) 877-6372
GRP# 92-005
www.mesvision.com
 

The Poway Unified School District (PUSD) is an equal opportunity employer/program and is committed to an active Nondiscrimination Program. PUSD prohibits discrimination, harassment, intimidation, and bullying based on actual or perceived race, color, ancestry, national origin, nationality, immigration status, ethnicity, ethnic group identification, age, religion, marital or parental status, physical or mental ability, sex, sexual orientation, gender, gender identity, or gender expression or association with a person or a group with one or more of these actual or perceived characteristics. For more information, please contact: Title IX/Equity Compliance Officer, James Jimenez, Associate Superintendent of Personnel Support Services, Poway Unified School District, 15250 Avenue of Science, San Diego, CA 92128, 1-858-521-2800, extension 2761, jjimenez@powayusd.com

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POWAY UNIFIED SCHOOL DISTRICT | 15250 Avenue of Science, San Diego, CA 92128 | (858) 521-2800