Employee Benefits

To add a newborn, newly married spouse or to remove a spouse, submit a membership change form to payroll. A copy of the hospital birth announcement, marriage certificate or final court divorce paperwork must accompany the membership change form. A newborn or spouse must be added within 30 days of the event or will have to wait until open enrollment. 

If you have a question regarding a claim, please call the provider/carrier. Blue Cross will provide medical cards, but you will not receive a Delta Dental or VSP card. Additional or lost cards can be replaced by calling 800-322-5709.

Federal and state tax withholding documents can be found under the Tax Forms tabs. Send or drop off  to payroll when complete.

2025 federal w-4

2025 state de-4

• 2025-2026 How to Enroll Flyer
• 2025-2026 SISC Medical Plan Comparisons
• 2025-2026 SISC Insurance Plan Contribution Summary

• Anthem Blue Cross Summary of Benefits - PPO 80-C
• Anthem Blue Cross Summary of Benefits - PPO 90-C
• Anthem Blue Cross Summary of Benefits - PPO 80-E
• Anthem Blue Cross Summary of Benefits - PPO 80-G
• Anthem Blue Cross Sydney App - Digital Card
• Kaiser HMO Summary of Benefits

• Delta Dental PPO Incentive Plan
• Delta Dental App - Digital Card

• VSP Vision Care Benefit Information
• VSP Vision App
• VSP Exclusives 
• XP Health Vision Care Benefit Information
  • Locate Your Provider by Zipcode

• Pharmacy Benefit Schedule Rx 7-25 PPO 80-C
• Pharmacy Benefit Schedule Rx 7-25 PPO 90-C
• Pharmacy Benefit Schedule Rx 9-35 PPO 80-E
• Pharmacy Benefit Schedule Rx 9-35 PPO 80-G
• Pharmacy Benefit Booklet
• Navitus FAQ Booklet
• Navitus Customer Care 24-7
• Kaiser Pharmacy Benefit Schedule Rx 10-30 HMO

• Lincoln Financial Group
• Lincoln Financial Group - Basic Life Summary 40K
• Lincoln Financial Group - Basic Life Summary 50K
• Lincoln Financial Group - Voluntary Life Summary 

• Flex Plan Enrollment Form 2025
• Flex Plan Enrollment Guide 2025
• Flex Plan Participant FAQ-2025
• Flex Benefits Card FAQ-2025

• Added Value Services offered by SISC 2025-2026
• SISC Employee Assistance Program
• Centivo Care
• MDLive
• Teledoc Medical Experts
• Vida Health
• Hinge Health
• Maven
• Midi Health
• Carrum Health
• Lantern Cancer Care
• Rula
• Airbo
• Costco $0 Generic

SISC Membership Change Form 

• SISC Anthem Blue Cross PPO 80-C
• SISC Anthem Blue Cross PPO 80-E
• SISC Anthem Blue Cross PPO 90-C
• SISC Evidence of Coverage Pharmacy Benefit 

• Certificated Retirement (STRS) - FAQ
• CalSTRS - Your Retirement Plan 
• CalSTRS - Express Benefit Report 
• CalSTRS - Service Retirement Application 

• Classified Retirement (PERS) – FAQ
• CalPERS Benefits - Planning Your Service Retirement 
• CalPERS Service Retirement Election Application

In addition to CalSTRS, CalPERS, and SISC Defined Benefits retirement plans, the Panama-Buena Vista Union School District offers employees the ability to contribute additional money towards their retirement in the form of a tax-sheltered annuity plan. The types of plans are 403b, 403b Roth, 457b and 457b Roth. PBVUSD does not match or contribute anything to any of these types of plans.

The third-party administrator (TPA) that PBVUSD is contracted with to handle our tax-sheltered annuity plans is OMNI TSACG.

U.S. OMNI & TSACG Compliance Services 

https://www.tsacg.com/individual/plan-sponsor/california/panama-buena-vista-union-school-district/

To start, change, or stop a 403b or 457b payroll deduction, please fill out an electronic Salary Reduction Agreement form: https://sra.tsacg.com/index.php

https://www.tsacg.com/TSA/media/TSA/content-files/forms/Instructions-for-Online-SRA-Processing-3-7-19.pdf

** Please note that a Salary Reduction Agreement form cannot be submitted to begin a payroll deduction until you have verified with your chosen vendor that your account is open and active.

WHAT IS THE DIFFERENCE BETWEEN A 403B AND A 457B?

• A 403b offers a narrower range of investment options vs a 457b which offers a broader range of investment options.
• A 403b allows for additional catch-up contributions for employees who have been with their employer for at least 15 years, whereas a 457b allows for extra contributions for employees within 3 years of retirement age.
• Both 403b and 457b plans have the same withdrawal rule that you can only access your money without penalty once you reach the age of 59 1/2. However, if you leave the employer sponsoring your 457b plan, you may withdraw your money penalty-free at any age.

What is the difference between a regular 403b or 457b plan and a Roth plan?

• A 403b or 457b plan is pre-taxed, and the Roth plans are post-tax.

What is the maximum contribution amount?

• This amount changes annually. For 2025 the maximum contribution amount is $23,500 for individuals under 50. For people 50 years and older, the maximum is $31,000.

What is the catch up amount?

• For 403b plans, employees who have been with their employer for at least 15 years may contribute up to $3,000 per year. However, there is a $15,000 lifetime maximum on these catch-up contributions. For 457b plans, employees who are within three years of the normal retirement age (as specified by their plan) may contribute up to twice the annual base 457b contribution limit. 

Are contribution maximums based on the fiscal year or the calendar year?

• Contribution maximums are based on the calendar year, January 1 - December 31.

CAN YOU CONTRIBUTE TO BOTH A 403B AND A 457B PLAN?

• Yes, you can. You may contribute up to the annual maximum on each plan.

When do I need to submit a Salary Reduction Agreement form in order to see the changes reflected on my paycheck?

• OMNI must receive your electronic SRA no later than the 10th of the month in order for changes to be made for the end of month payroll.