Archived Forms & Documents

• 2016-peralta-community-college-kaiser-hmo-sbc-10 (Managers, and PFT, Trustees)
• 2016-peralta-community-college-kaiser-hmo-sbc-15 (Local 1021, Confidentials and Local 39)
• 2016-peralta-community-college-kaiser-hmo-sbc-0
• Handbook with Enrollment form – 2016
• Pre-Tax Commuter SPD: peralta-132-doc
• Claim-form
• Direct-deposit-authorization

Fall 2014 Part Time and Hourly Faculty Members Benefits Enrollment!!!
As a temporary or part-time faculty member you may be eligible for participation in the District’s medical, dental, flexible benefit plans enrollment based on your past part-time teaching load. Please download and print the following documents in PDF format which are required for enrollment/re-enrollment in the benefit plans.

• Current coverage is due to end Sunday, August 31, 2014.
• For continuous, uninterrupted coverage, enrollment is REQUIRED for all Part Time and Hourly Faculty employees by Tuesday, September 23, 2014.
• New Enrollees – Enroll by Tuesday, September 23, 2014or within 30 days of loss of coverage under another plan.

Enrollment Downloads:

Fall 2014 Part-Time & Hourly Faculty Open Enrollment Announcement
Fall 2014 Part-Time & Hourly Faculty Open Enrollment Forms Packet

• Benefits Enrollment Checklist
• Part-Time & Hourly Faculty Enrollment Form
• Eligibility Affidavit
• Required Documentation Matrix
• FAQ – Benefits & What to Expect After Enrollment

(ALL PAGES contained in this document MUST be completed and submitted to the District Benefits Office no later than Tuesday, September 23, 2014)

2014 Flexible Spending Accounts Enrollment Form
2014 Commuter/Parking Expense Plan Enrollment Packet
2014 Peralta/PFT Successor Agreement