Benefits

Petaluma City Schools offers employees a comprehensive benefits package including District-paid contributions for medical, dental, vision, and life insurance. Access the District's benefit eligibility chart, benefit summaries, and rate information by clicking on the links below. District-paid contributions are pro-rated based on FTE or hours per day.

Rate Pricing


Kaiser Permanente, Blue Shield (except for Anchor Bronze), Delta Dental and Vision Service Plan are based on composite rate pricing. Composite Rate Pricing means that the monthly premium is the same for every employee regardless of the number of family members covered by the plan.

Blue Shield Anchor Bronze is based on tiered rate pricing. Tiered Rate Pricing means that the monthly premium is based on the specific number of family members covered by the plan (single, double, or family).

The rate chart is based on the District-paid contribution for a full-time employee that is 100% benefit eligible. Part-time employees receive a pro-rated amount of all District-paid contributions for medical, dental and vision. To determine the over cap amount for a part-time employee, deducted the pro-rated cap amount from the cost per month as listed on the charts below.

Monthly Premiums


2022-23 Active Employee Monthly Premiums

2023-24 Active CSEA Employee Monthly Premiums

2023-24 Active NON-CSEA Employee Monthly Premiums

Eligibility & Verification


Benefits Eligibility Chart

Required Verification Documentation

Benefit Enrollment Forms


SISC Membership Change Form

CSEA Employees Benefit Election Form 2023-24

NON-CSEA Benefit Election Form 2023-24

Kaiser Enrollment Form

Blue Shield Enrollment Form

Delta Dental Enrollment Form

VSP Enrollment Form

Medical Enrollment Change Form

MetLife Insurance - Enrollment Form

MetLife Insurance - Beneficiary Change Form

Affidavit of Marriage

Kaiser Permanente Information


2023-24 Kaiser Side-by-Side Comparison Chart

High Package Summary of Benefits & Coverage 2023-24

Mid Package Summary of Benefits & Coverage 2023-24

Low Package Summary of Benefits & Coverage 2023-24

Blue Shield Information


2023-24 Blue Shield Side-by-Side Comparison Chart

90% Summary of Benefits & Coverage 2023-24

80% Summary of Benefits & Coverage 2023-24

High Deductible Summary of Benefits & Coverage 2023-24

Anchor Bronze Summary of Benefits & Coverage 2023-24

Delta Dental Information


Delta Dental Disclosures: 2023-24

Vision Services Plan Information


VSP Benefits Summary

Wellness Information


Employee Assistance Program Flyer

Value Added Services

Kaiser Choose Healthy

24 Hour Fitness

Advance Medical

Carrum Health

Costco Rx Flyer

Detailed Costco Mail Order Brochure

MD Live

Solar4me Diabetes Prevention Program

VIDA Health App