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Qualifying Life Events

ACTIVE CLASSIFIED ENROLLMENT CHANGES

Navigate this page to find important information on how to make changes mid-year. 

Qualifying Events & Demographic Information Changes:

Demographic information, such as legal names and addresses must be updated by Human Resources.  Please contact HR directly for name change procedures.  If you wish to update your address, please complete an Emergency Card.

 

Classified Emergency Card link


If you are experiencing a qualifying life event, please complete the required forms and submit them to our department with required supporting documents.  Forms and documents may be delivered to the Benefits Department via mail/interoffice/in-person or emailed to [email protected].

 

If you are making a change due to a Qualifying Life Event, you must do so within 30 days of the event date!  

 

Enrollment changes may require forms to be filled out and supporting documents to be provided to the Benefits Services Department.  They will submit the change to SISC, who will then process the changes with your insurance plan carriers.  For further questions or inquiries, feel free to contact our Benefits Helpdesk by emailing [email protected] or calling (661) 789-6525.

 

SUPPORTING DOCUMENTS

Use this form to change from Kaiser to Blue Shield. If you are changing to Kaiser, please fill out the Kaiser form.
Use this form to change from Blue Shield to Kaiser.  If you are changing to PPO, please fill out the SISC Enrollment form.
Please use this form to make any changes to your Name, Address, Telephone Number, Social Security Number, Date of Birth (Correction), and to Add/Remove Dependents (Supporting Documents will be required).

SISC FORMS

The Plan Matrix provides an overview of the different plan options available.