2025 Information
What do I need to turn in to enroll in health benefits?
- Personalized Receipt Acknowledgement Form (required for newly health benefit eligible employees, which is provided by our department)
- Enrollment and Changes Form
- Copies of Supplemental Dependent Documents (if you are adding dependents to your coverage)
- We do not need to see original documents. Per board policy (1340a), if you bring an original document without a copy, we can make a copy for $0.25 per page (cash only).
- UNUM Group Life Beneficiary Form
I don't need to enroll in health through the district, what do I need to turn in to decline coverage?
- Personalized Receipt Acknowledgment Form
- UNUM Group Life Beneficiary Form
How do I turn in my completed documents?
- Documents that contain SS #'s cannot be sent via email.
- All documents can be turned in via fax (949-487-0671), district mail, US mail (CUSD ATTN: Insurance Department 33122 Valle Road, San Juan Capistrano, CA 92675), or in person.
- Our department is open Monday - Friday, 8am - 4:30pm.
- Have more questions? Contact someone in our department!
Mandatory Disclosures
