BSSP What's New? Frequently Asked Questions Board of Directors Meetings and Agendas Our Partners Anthem Blue Cross Medco Delta Dental Vision Service Plan Sun Life Wellness Health Screenings and Flu Shot Clinics Mammograms Other Wellness Topics Medicare HIPPA Employee / Member Forms Just for Kids Employee Benefits Advisory Committee Property and Liability Financial Documents Governance Documents
"Where children come first."
Member Forms
Healthy Employees Supported by Quality, Well-Managed Programs
BSSP
Application for Enrollment - Fill In and Print
Application for Enrollment - Print and Fill In
Certification of Overage Dependents
Certification of Dependents and Coordination of Benefits
Anthem Blue Cross
Medical Claim Form
Medco
Prescription Claim Reimbursement Form - to request reimbursement for a claim already paid
Medco by Mail Order Form - to request a prescription be filled by mail
Benefit Coverage / Appeal Request
Delta Dental
Dental Claim Form
Vision Service Plan (VSP)
Vision Claim Form
Sun Life Financial
Optional Life and Voluntary AD&D Enrollment Form - fill and print
Optional Life and Voluntary AD&D Enrollment Form - print and fill
Beneficiary Designation
Designación de Beneficiario
Death Claim Packet
Life Benefits Claim Packet
For more information
Christy R. Patterson, Executive Director Phone: (530) 532-5837 Email: cpatters@bcoe.org Cathy Ramirez, Administrative Assistant Phone: (530) 532-5838 Email: cramirez@bcoe.org Fax: (530) 532-5836
Christy R. Patterson, Executive Director Phone: (530) 532-5837 Email: cpatters@bcoe.org
Cathy Ramirez, Administrative Assistant Phone: (530) 532-5838 Email: cramirez@bcoe.org Fax: (530) 532-5836
Butte County Office of Education
