Please find below a quick reference for your Health Benefits needs.
Adding a Dependent
If you need to add a dependent to your health benefits, please complete and return this form: Supplemental Application
Computer Glasses
If you need glasses to work on your computer, please complete and return this form: Certification of VDT Use
Life Insurance
If you need to enroll or purchase additional coverage, please complete the Cigna Application.
If you need to designate a beneficiary, please complete the Cigna Beneficiary Designation Form.
Retirement Benefits
Are you an active employee thinking about retiring? Please complete and return the Application for Retiree Health Benefits form.
Health Benefits for New Retirees
Are you a new retiree? Health Benefits for New Retirees.
Additional Retiree forms and information can be found on the Retiree Forms page.
Retirees and Survivors Enroll/Change
Are you a Retiree or a Survivor who needs to enroll or change your vision or dental benefits? Please complete and return the Retiree Enrollment/Change Form.
For additional resources, please visit this page: http://laccd.edu/Departments/HumanResources/healthbenefits/Pages/Survivors.aspx
COBRA Health Benefits Information
If you need to extend your COBRA health benefits please visit the COBRA Participants page for information