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Medical Enrollment Forms

Eligibility and Enrollment

Employees

Eligibility is based on tenure and time base of your qualifying appointments.  You must work at least half-time or 20 hours per week or more and have a permanent appointment or a "limited term" appointment with a duration of more than six months.

Retirees

You are eligible to enroll in a CalPERS health plan if you meet all of the following criteria:

  • Your retirement date is within 120 days of separation from employment
  • you receive a monthly retirement allowance
  • you retire from the State, California State University (CSU) or an agency that currently contracts with CalPERS for health benefits

Family Members

The terms "family member" and "dependent" are used interchangeably.  Eligible family members include:

  • Spouse
  • Registered domestic partner
  • Children (natural, adopted, domestic partner's, or step) up to age 26
  • Children, up to age 26, if the employee or annuitant has assumed a parent-child relationship and is considered the primary care parent
  • Certified disabled dependent children over age 26

Contact

Zenobia N Keeton

Benefits Specialist

(707) 556-8921 x50016

E-mail zkeeton@vallejo.k12.ca.us

E-Fax (707) 638-0307

Medical Coverage Locker

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