Open Enrollment for Associate Faculty

The August Open Enrollment is ONLY for those already enrolled in the Associate Faculty Medical Benefits Program.

Please note, if you want to enroll for the first time, you'll need to wait until September for the Associate Faculty Eligibility/Enrollment Period, where you can enroll at that time, and coverage will start October 1.

If you aren't making any changes to your current coverage during Open Enrollment, then no action is required.

Open Enrollment is from August 1 to August 31, 2025. Any change you make during Open Enrollment goes into effect October 1, 2025. This is your opportunity to review current benefit elections and make changes such as:

  • Change medical plans
  • Add or drop dependents
  • Drop your plan

After Open Enrollment ends, you cannot change your benefit elections until the next Open Enrollment in 2026, unless you have a ‘qualified status change’ like a change in your marital status, the birth of a baby or loss of other coverage, etc.

 

  • Medical benefit summaries and rates

    The District offers a choice of five medical plans through our membership in Self-Insured Schools of California (SISC). 

    Monthly Premium Rates

    These rates are for Associate Faculty and are effective October 1, 2025.

     

    Please click on the links below to view the Benefit Summaries of the five medical plans:

    Kaiser Permanente HMO

    Kaiser Permanente Deductible plan with a Health Savings Account (HSA). This is a HMO deductible plan.

    Blue Shield of California HMO

    Blue Shield of California PPO

    Blue Shield of California PPO Deductible plan with a Health Savings Account (HSA). This is a PPO deductible plan.

     

    Blue Shield drug formulary and doctor search

     

    There are limitations depending on where you live:

    ·         If you live outside of California, the Blue Shield PPO plans are the only plans you’d be eligible to enroll in since they are available in every state.

    ·         Kaiser operates by region, so if you live outside of the San Francisco Bay Area, then you are not eligible to be enrolled in the District’s Kaiser plans. SRJC is part of the Kaiser Bay Area/Northern California region and is not part of the Southern California Kaiser region. SRJC is also not a part of the Kaiser regions in other states.

    ·         Blue Shield HMO is only available in California.

     

  • Enrollment Forms

    All enrollment forms should be submitted to Christie Colón in Human Resources

    Don't forget to provide the dependent eligibility documentation if you're adding a dependent. 

     

    These forms are fillable and signable. Once you've opened the form, please click "Download" to download the signable version:

     

    MEMBERSHIP CHANGE FORM

    Making changes to your current medical plan (like adding or deleting a dependent)? Please fill out the Membership Change form.

    KAISER ENROLLMENT FORM

    Use this Kaiser enrollment form to enroll for the first time and follow these instructions: 

                             * Be sure to check "HMO" or "Deductible plan" in Section A on the enrollment form

    BLUE SHIELD ENROLLMENT FORM

    Use this Blue Shield enrollment form to enroll for the first time and follow these instructions:

    Blue Shield PPO or HSA – you must write HSA or PPO in the top margin on the form Blue Shield HMO – you must select a doctor when enrolling in this plan and include the doctor's IPA & PCP information on the enrollment form:
    • IPA is the Group Name
    • PCP is the Primary Care Physician #
    • Here’s how to search on Blue Shield's website for the IPA and PCP information and to select a Blue Shield HMO doctor in your area
      •  Click on “Primary Care Physician”
      • Type in your location
      • Select Specialty, like “Family Practice”, “Internal Medicine”, etc.

    HSA form

    If you are enrolling in Kaiser Deductible or Blue Shield Deductible, please fill this HSA form out in addition to your Kaiser or Blue Shield enrollment form.

WHAT'S NEW FOR 2025-2026?

Blue Shield

  • MDLive copay changes from $10 to $0, effective October 1, 2025.
  • Midi Health: Virtual Menopause Clinic available as a contracted provider.
  • PPO Plan – members 45+ are eligible for a free, at-home FIT colorectal cancer screening kit. Request a kit by creating an account at My.QuestForHealth.com.
  • Costco pharmacy prescriptions are delivered for free with Instacart. Once a prescription is filled, a text is sent to you with the link to access Instacart for free.

 

Kaiser Permanente

  • Kaiser's discounted gym membership program changed from Active & Fit to One Pass.