Human Resources Forms

Please Note: We have moved forms more suitable only to staff/faculty to the wiki. If you don't see a form you are looking for, please check there.

For questions regarding benefits or leave of absence please contact Marcela Navarro at mnavarro@sbccd.edu or (909) 388-6945.

Health Benefits FAQ

Employee Assistance Program “EAP” FAQ

EAP Flyer

2024-2025 Benefits

• Anthem Blue Cross EAP
• Anthem California Care "Classic" HMO
• Beneficiary Designation
• Benefit Enrollment Form and Rates
• Anthem California Care “Premier” HMO
• Anthem Blue Cross PPO 100
• Anthem Blue Cross PPO 90
• Anthem PPO Part Time Faculty Plan Summary
• Delta Dental - PPO Plan Summary
• DeltaCare USA - Plan Summary
• Enrollment Guide
• EyeMed - Plan Summary
• Kaiser - $10 Plan Summary
• Kaiser - $30 Plan Summary
• Vol. Life & AD&D Insurance
• SBCCD Educational Partnerships
• Medical PPO cost-share information and estimates

American Fidelity

• American Fidelity - Accident Plan
• American Fidelity - Brochure
• American Fidelity - Cancer Plan
• American Fidelity - Disability Plan

Leave of Absence Information

• Leave of Absence Request Form