Talent Acquisition & Employee Services / District Medical Insurance

Enrollment Form

Enrollment Form Casa Grande Fillable.pdf 452.08 KB (Last Modified on May 13, 2021)

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Affordable Care Act (ACA)

Grandfather Status Information

Notice for Exchange (www.healthcare.gov)

1095C Form FAQ

ACA Grandfathered Plan Information2.pdf 24.52 KB (Last Modified on September 3, 2020)

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Required Health Care Notices

Miscellaneous Health Care Notices. Midyear Changes to the Medical Plan, Reminder to provide Social Security Numbers of each enrollee to the Health Plan, Declining Medical Coverage, Privacy Notice Reminder, Women’s Health and Cancer Rights Act, Medicare Notice of Creditable Coverage, Notice of Grandfather Status, Family and Medical Leave Act (FMLA) Reminder, COBRA Coverage Reminder Medicare Part D, HIPAA Privacy, Health Insurance Marketplace.

COMPLY 1100 Casa Grande Elem. SD_ 2021 Important Plan Notices.pdf 644.3 KB (Last Modified on July 1, 2021)

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Summary of Benefits and Coverage

CGESD - Summary of Benefits and Coverage - SBC - 07 01 2021 through 06 30 2022.PDF 117.6 KB (Last Modified on July 1, 2021)

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Summary Plan Document

Casa Grande ESD4EBT_ July2020 Plan Document_SPD.PDF 2.19 MB (Last Modified on December 15, 2020)

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Talent Acquisition & Employee Services