Health Benefits

City of Santa Rosa Benefits Guide

Medical Plan Information 

Medical Plan Documents

  1. EPO - City (Anthem Blue Cross)
  2. HMO - City (Kaiser)
  3. HMO - Teamsters (Kaiser)
  4. PPO - City (Anthem Blue Cross)
  5. PPO - Teamsters (Direct Pay)
  6. PPO/EPO - City - Prescription Changes for 2020 (Express Scripts)

Medical Plan Rates

  1. 2020 CalPERS Fire (Unit 2) Medical Plan Rates
  2. 2020 CalPERS Fire (Unit 2) Medical Plan Rates - Additional City Contribution
  3. 2020 CalPERS Fire Management (Unit 9) and Fire Executive (Unit 10) Medical Plan Rates
  4. 2020 CalPERS Police Medical Plan Rates
  5. 2020 City Medical Plan Rates
  6. 2020 Teamsters Medical Plan Rates

Dental and Vision Plan Information

Dental Plan Documents

  1. Delta Dental PPO Transit (Unit 8 Only) Buy-Up Plan
  2. Delta Dental PPO (All Units EXCEPT 8-Transit)
  3. Delta Dental PPO (Unit 8-Transit) Core Plan

Vision Plan Documents

  1. Vision - VSP

Dental and Vision Rates

  1. City Medical, Dental and Vision COBRA Rates
  2. Dental and Vision Rates

Enrollment and Change Forms


  1. CalPERS HBD-12 Health Benefits Enrollment Form (Safety Employees)
  2. City COBRA and Retiree Medical Universal Enrollment Form
  3. City Universal Benefits Enrollment Form (City Medical or Dental/Vision)
  4. Teamsters Enrollment Form
  5. Teamsters Retiree Medical Enrollment Form