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PSUSD
Benefits
Classified Employees
CLASSIFIED - ACTIVE
2025-2026 Teamster Benefits Guide
PSUSD BG TEAMSTERS 2025.pdf
2.35 MB
(Last Modified on April 9, 2025)
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2024-2025 Teamster Benefits Guide
00 PSUSD BG TEAMSTERS ACTIVE 10.01.2024.pdf
11.63 MB
(Last Modified on October 1, 2024)
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TEAMSTER/CLASSIFIED FORMS
Teamsters Life Insurance Beneficiary Designation Form
Teams Life Insurance Beneficiary Designation Form.pdf
82.94 KB
(Last Modified on August 25, 2017)
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Teamsters Change of Address Form
NWA Change of Address Form.pdf
42.76 KB
(Last Modified on August 25, 2017)
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DENTAL
PPO Incentive Plan Summary
Delta Dental PPO Incentive Plan Summary 2017.pdf
536.76 KB
(Last Modified on February 21, 2018)
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PPO Plan Summary
Delta Dental PPO Plan Summary 2017.pdf
531.58 KB
(Last Modified on February 21, 2018)
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HMO (DeltaCare USA) Plan Summary
DeltaCareUSA HMO Plan Summary 2017.PDF
372.31 KB
(Last Modified on February 21, 2018)
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LIFE
Statement of Health Form
01 New SOH 7.01.2022 - Fillable.pdf
260.98 KB
(Last Modified on April 9, 2025)
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COBRA
2024-2025 COBRA Rates
COBRA Rates Oct. 2024- Sept 2025.pdf
828.62 KB
(Last Modified on April 9, 2025)
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COBRA Vision Enrollment Form
Vision Enrollment Form - COBRA.pdf
44.85 KB
(Last Modified on October 17, 2017)
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COBRA Dental Enrollment Form
Delta Dental Enrollment Form COBRA.pdf
180.83 KB
(Last Modified on October 17, 2017)
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