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Insurance

CAPISTRANO UNIFIED SCHOOL DISTRICT

An unwavering commitment to student success

New Enrollment Packet

 

2025 Information

    • Voluntary Life Insurance
      • Employee Non-Medical Maximum
        • $200,000 (up to age 59)
        • $100,000 (age 60 to age 69)
        • Employees age 70 and older, evidence of insurability required for all amounts (underwriting process)
      • Spouse Non-Medical Maximum
        • $50,000 (up to age 59)
        • Spouse age 60 and older, evidence of insurability required for all amounts (underwriting process)
      • Child(ren) 
        • Must be under the age of 26 years old 
        • Increments of $2,000 to $10,000 
 

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