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A Division of the Cheif Executive Office


1010 10th Street
Modesto, CA 95354
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Phone: (209) 525-5710

Mon - Fri: 8am - 5pm
Closed Weekends & Holidays

Employee Benefits - Forms and Documents

Welcome to Employee Benefits Forms. Below is a list of online forms and documents for all Health Insurance, Deferred Comp, Flexible Spending Accounts, etc. Also the Employee Benefits Policy & Procedures Manual is located here. This manual will always be the most updated version for your use.

*New! At the bottom of this page is information regarding eBenefits Self Service.

Employee Benefits Policy & Procedures Manual

Health Insurance Forms and Documents



Health Insurance Information after Termination or Retirement

Medical Plan Information

Stanislaus County Partners in Health

Anthem Blue Cross

Health Savings Account- Wells Fargo

Dental Plan Information- Delta Dental

Vision Plan Information- VSP

Life Insurance and Long Term Disability- Voya/ReliaStar

Voluntary Benefits- Voya/ReliaStar

Accident Insurance

Critical Illness Insurance

Voluntary Benefits- Humana

Flexible Spending Accounts- Take Care by Wageworks

Deferred Compensation- Mass Mutual (Formerly Hartford)

PARS- Public Agency Retirement System


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