Welcome to SISC Open Enrollment for the 2025-2026 Benefit Year!
Open Enrollment Period: July 1, 2025 - August 8, 2025
Open Enrollment is your annual opportunity to review, update, or make changes to your health benefit elections for the upcoming plan year, October 1, 2025 – September 30, 2026. All Open Enrollment changes will be effective October 1, 2025, and the first payroll deduction will be processed on the September payroll.
Outside of the open enrollment period, changes to an election plan can only be made if an employee experiences a qualifying life event. The employee must notify the Benefits Department at HRbenefits@mtsac.edu within 30 days of the life event date.
HOW TO ENROLL:
- Meet with an American Fidelity Representative one-on-one.
- To make an appointment with an American Fidelity Representative, click the following link below to locate a specific date and time that will work for you, , or you may call 1-800-365-9180, ext. 0.
KEY ENROLLMENT INFORMATION:
- If you take no action during open enrollment period, your current 2024-25 medical, dental, and vision plans will remain in effect; however, the 2025-26 premium rates will apply.
- Section 125 Flexible Spending Account (FSA) is an employer sponsored plan that allows you to set aside pre-tax funds for qualified medical, dental, and vision. If you would like to enroll or re-enroll you are required to meet with an American Fidelity benefit counselor.
- You are eligible to set aside pre-tax funds for dependent care expenses (DFSA). If you would like to enroll or re-enroll you are required to meet with an American Fidelity benefit counselor.
KEY DEPENDENT VERIFICATION INFORMATION:
- To continue coverage for your covered dependents, you are required to meet with an American Fidelity benefit counselor and provide the necessary eligibility documents for each covered dependent during the open enrollment period.
- Failure to provide the required documentation during the open enrollment period may result in your dependents being dropped from your coverage, effective October 1, 2025.
DEPENDENT DOCUMENTS:
- SISC Dependent Eligibility Document List
- If you and your spouse file taxes separately, the eligibility documents would be a combination of your marriage certificate and the SISC Affidavit of Marraige.
- SISC Affidavit of Marriage
MEDICAL OPT-OUT RECERTIFICATION:
If you currently opt out of medical coverage, your HR Benefits team will contact you directly via email with instructions to re-certify your opt-out status for the new plan year. This will occur after the conclusion of open enrollment.
Changes to other benefits can be made directly through the online Open Enrollment platform.
QUESTIONS:
If you have questions about the dependent verification recertification or plan designs for your medical, dental, or vision coverage options, please contact the Benefits Department at HRbenefits@mtsac.edu.
To view the open enrollment benefit options for the 2025-2026 plan year,
please click the corresponding employee group icon below.
-
- Classified CSEA 262
Cost of Coverage
Medical Benefit Summaries
HMO Plans
- Blue Shield Access Plus (Full Network) HMO $10-0 RX 5-20 (2025-26)
- Blue Shield Trio HMO - $10 office visit; RX $5-20 (2025-26)
- Kaiser HMO - $0 office visit; RX $5 (2025-26)
- Kaiser HMO - $15 office visit; RX $5-20 (2025-26)
PPO Plans
- Blue Shield 90G - $20 office visit; RX $5-20 (2025-26)
- Blue Shield 100A - $10 office visit; RX $5-20 (2025-26)
- Blue Shield 2-Tier HSA (2025-26)
Dental Benefit Summaries
HMO Plan
PPO Plans
Vision Benefit Summaries
Programs and Services
Available to all Enrollees:
Prescription Coverage - Navitus Customer Care
- Navitus - Vaccinations
- Costco Pharmacy
- Costco Pharmacy - Instacart
- Costco - Flu Shots
Available to Kaiser Enrollees:
- Kaiser Additional Resources and SISC Member Benefits Overview
- Kaiser Care Away From Home - Travel Benefit
- Kaiser Emotional Support - Ginger App
- Kaiser Hearing Aid Benefit
- Kaiser Mobile App
Available to Blue Shield Enrollees:
- Blue Shield Mobile App
- Blue Shield Plan Features and Member Benefits
- Blue Shield Print ID Card
- Carrum Health - Surgery Benefit (PPO only)
- Eden Health - Virtual Healthcare Team (PPO only)
- Hinge Health - Back and Joint Pain Benefit (PPO only)
- Lantern - Cancer Support
- Maven - Virtual Maternity & Postpartum Support (PPO only)
- MDLive - Virtual Office Visits
- Midi - Menopause Care (PPO only)
- Quest Diagnostic Kit (PPO only)
- Vida - Digital Health Coaching
Supplemental Life Insurance
- MetLife Plan Benefits and Supplemental Rates
- MetLife Supplemental Enrollment Form - Send to HRbenefits@mtsac.edu.
- MetLife Statement of Health - Send to MetLife
- MetLife Beneficiary Form - Send to HRbenefits@mtsac.edu.
American Fidelity Supplemental Benefits
Mt. San Antonio Community College District has partnered with American Fidelity Assurance Company to provide supplemental health insurance benefits and financial services to our employees*.
Services
Section 125 Cafeteria Plan offers: Section 125, a program available, to help employees save money on taxes. An employee is allowed to deduct needed benefits from gross earnings before taxes are computed. This means that current after-tax expenses such as insurance products and benefits, can now be paid for with pre-tax dollars.
- Dependent Day Care Flexible Spending Account (FSA)
- Health FSA (Unreimbursed Medical Expenses)
Retirement/Annuities
- 403(b) Tax-Deferred Annuity
- Roth IRA
- After-Tax Annuity
Supplemental Insurance
- Classified CSEA 651
Cost of Coverage
Medical Benefit Summaries
HMO Plans
- Blue Shield Access Plus (Full Network) HMO $10-0 RX 5-20 (2025-26)
- Blue Shield Trio HMO - $10 office visit; RX $5-20 (2025-26)
- Kaiser HMO - $0 office visit; RX $5 (2025-26)
- Kaiser HMO - $15 office visit; RX $5-20 (2025-26)
PPO Plans
- Blue Shield 90G - $20 office visit; RX $5-20 (2025-26)
- Blue Shield 100A - $10 office visit; RX $5-20 (2025-26)
- Blue Shield 2-Tier HSA (2025-26)
Dental Benefit Summaries
HMO Plan
PPO Plans
Vision Benefit Summaries
Programs and Services
Available to all Enrollees:
Prescription Coverage - Navitus Customer Care
- Navitus - Vaccinations
- Costco Pharmacy
- Costco Pharmacy - Instacart
- Costco - Flu Shots
Available to Kaiser Enrollees:
- Kaiser Additional Resources and SISC Member Benefits Overview
- Kaiser Care Away From Home - Travel Benefit
- Kaiser Emotional Support - Ginger App
- Kaiser Hearing Aid Benefit
- Kaiser Mobile App
Available to Blue Shield Enrollees:
- Blue Shield Mobile App
- Blue Shield Plan Features and Member Benefits
- Blue Shield Print ID Card
- Carrum Health - Surgery Benefit (PPO only)
- Eden Health - Virtual Healthcare Team (PPO only)
- Hinge Health - Back and Joint Pain Benefit (PPO only)
- Lantern - Cancer Support
- Maven - Virtual Maternity & Postpartum Support (PPO only)
- MDLive - Virtual Office Visits
- Midi - Menopause Care (PPO only)
- Quest Diagnostic Kit (PPO only)
- Vida - Digital Health Coaching
Supplemental Life Insurance
- MetLife Plan Benefits and Supplemental Rates
- MetLife Supplemental Enrollment Form - Send to HRbenefits@mtsac.edu.
- MetLife Statement of Health - Send to MetLife
- MetLife Beneficiary Form - Send to HRbenefits@mtsac.edu.
Supplemental Benefits
Mt. San Antonio Community College District has partnered with American Fidelity Assurance Company to provide supplemental health insurance benefits and financial services to our employees*.
Services
Section 125 Cafeteria Plan offers: Section 125, a program available, to help employees save money on taxes. An employee is allowed to deduct needed benefits from gross earnings before taxes are computed. This means that current after-tax expenses such as insurance products and benefits, can now be paid for with pre-tax dollars.
- Dependent Day Care Flexible Spending Account (FSA)
- Health FSA (Unreimbursed Medical Expenses)
Retirement/Annuities
- 403(b) Tax-Deferred Annuity
- Roth IRA
- After-Tax Annuity
American Fidelity Supplemental Insurance
- Confidential
Cost of Coverage
Medical Benefit Summaries
HMO Plans
- Blue Shield Access Plus (Full Network) HMO $10-0 RX 5-20 (2025-26)
- Blue Shield Trio HMO - $10 office visit; RX $5-20 (2025-26)
- Kaiser HMO - $15 office visit; RX $5-20 (2025-26)
PPO Plans
- Blue Shield 90G - $20 office visit; RX $5-20 (2025-26)
- Blue Shield 100A - $10 office visit; RX $5-20 (2025-26)
- Blue Shield 2-Tier HSA (2025-26)
Dental Benefit Summaries
HMO Plan
PPO Plans
Vision Benefit Summaries
Programs and Services
Available to all Enrollees:
Prescription Coverage - Navitus Customer Care
- Navitus - Vaccinations
- Costco Pharmacy
- Costco Pharmacy - Instacart
- Costco - Flu Shots
Available to Kaiser Enrollees:
- Kaiser Additional Resources and SISC Member Benefits Overview
- Kaiser Care Away From Home - Travel Benefit
- Kaiser Emotional Support - Ginger App
- Kaiser Hearing Aid Benefit
- Kaiser Mobile App
Available to Blue Shield Enrollees:
- Blue Shield Mobile App
- Blue Shield Plan Features and Member Benefits
- Blue Shield Print ID Card
- Carrum Health - Surgery Benefit (PPO only)
- Eden Health - Virtual Healthcare Team (PPO only)
- Hinge Health - Back and Joint Pain Benefit (PPO only)
- Lantern - Cancer Support
- Maven - Virtual Maternity & Postpartum Support (PPO only)
- MDLive - Virtual Office Visits
- Midi - Menopause Care (PPO only)
- Quest Diagnostic Kit (PPO only)
- Vida - Digital Health Coaching
Supplemental Life Insurance
- MetLife Plan Benefits and Supplemental Rates
- MetLife Supplemental Enrollment Form - Send to HRbenefits@mtsac.edu.
- MetLife Statement of Health - Send to MetLife
- MetLife Beneficiary Form - Send to HRbenefits@mtsac.edu.
American Fidelity Supplemental Benefits
Mt. San Antonio Community College District has partnered with American Fidelity Assurance Company to provide supplemental health insurance benefits and financial services to our employees*.
Services
Section 125 Cafeteria Plan offers: Section 125, a program available, to help employees save money on taxes. An employee is allowed to deduct needed benefits from gross earnings before taxes are computed. This means that current after-tax expenses such as insurance products and benefits, can now be paid for with pre-tax dollars.
- Dependent Day Care Flexible Spending Account (FSA)
- Health FSA (Unreimbursed Medical Expenses)
Retirement/Annuities
- 403(b) Tax-Deferred Annuity
- Roth IRA
- After-Tax Annuity
Supplemental Insurance
- Management
Cost of Coverage
- 2025-26 Plan Premiums & District Contributions (Management)
- 2025-26 Plan Premiums & District Contributions (Executive Management)
Medical Benefit Summaries
HMO Plans
- Blue Shield Access Plus (Full Network) HMO $10-0 RX 5-20 (2025-26)
- Blue Shield Trio HMO - $10 office visit; RX $5-20 (2025-26)
- Kaiser HMO - $15 office visit; RX $5-20 (2025-26)
PPO Plans
- Blue Shield 80G - $20 office visit; RX $5-20 (2025-26)
- Blue Shield 90G - $20 office visit; RX $5-20 (2025-26)
- Blue Shield 100A - $10 office visit; RX $5-20 (2025-26)
- Blue Shield 2-Tier HSA (2025-26)
Dental Benefit Summaries
HMO Plan
PPO Plans
Vision Benefit Summaries
Programs and Services
Available to all Enrollees:
Prescription Coverage - Navitus Customer Care
- Navitus - Vaccinations
- Costco Pharmacy
- Costco Pharmacy - Instacart
- Costco - Flu Shots
Available to Kaiser Enrollees:
- Kaiser Additional Resources and SISC Member Benefits Overview
- Kaiser Care Away From Home - Travel Benefit
- Kaiser Emotional Support - Ginger App
- Kaiser Hearing Aid Benefit
- Kaiser Mobile App
Available to Blue Shield Enrollees:
- Blue Shield Mobile App
- Blue Shield Plan Features and Member Benefits
- Blue Shield Print ID Card
- Carrum Health - Surgery Benefit (PPO only)
- Eden Health - Virtual Healthcare Team (PPO only)
- Hinge Health - Back and Joint Pain Benefit (PPO only)
- Lantern - Cancer Support
- Maven - Virtual Maternity & Postpartum Support (PPO only)
- MDLive - Virtual Office Visits
- Midi - Menopause Care (PPO only)
- Quest Diagnostic Kit (PPO only)
- Vida - Digital Health Coaching
Supplemental Life Insurance
- MetLife Plan Benefits and Supplemental Rates
- MetLife Supplemental Enrollment Form - Send to HRbenefits@mtsac.edu.
- MetLife Statement of Health - Send to MetLife
- MetLife Beneficiary Form - Send to HRbenefits@mtsac.edu.
American Fidelity Supplemental Benefits
Mt. San Antonio Community College District has partnered with American Fidelity Assurance Company to provide supplemental health insurance benefits and financial services to our employees*.
Services
Section 125 Cafeteria Plan offers: Section 125, a program available, to help employees save money on taxes. An employee is allowed to deduct needed benefits from gross earnings before taxes are computed. This means that current after-tax expenses such as insurance products and benefits, can now be paid for with pre-tax dollars.
- Dependent Day Care Flexible Spending Account (FSA)
- Health FSA (Unreimbursed Medical Expenses)
Retirement/Annuities
- 403(b) Tax-Deferred Annuity
- Roth IRA
- After-Tax Annuity
Supplemental Insurance Benefits
- Classified CSEA 262
To view the current plan year (2024-2025) information, please visit www.mtsac.edu/hr/benefits.