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A Division of the Cheif Executive Office

Address:

1010 10th Street
Modesto, CA 95354
Get Directions

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.

Health Insurance Forms and Documents

Health Insurance Information after Termination or Retirement

Medical Plan Information

Prescription Pharmacy Network

Health Savings Account - OPTUM

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- P & A Group

Deferred Compensation- Mass Mutual

PARS- Public Agency Retirement System

eBenefits

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