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Open Enrollment Information-Public Safety
Welcome to the 2017 Public Safety Open Enrollment Page!
THIS
YEAR'S OPEN ENROLLMENT FOR SAFETY EMPLOYEES IS SEPTEMBER 11, 2017 - OCTOBER 6, 2017
Update: Due to the current state of affairs, Flex Medical Spending and Dependent Care Account enrollment was extended from October 6th to November 20th.
Open Enrollment starts September 11 and ends October 6. This is your once-a-year opportunity (outside of a qualifying event) to make medical, dental and vision plan changes. Changes made during Open Enrollment take effect January 1, 2018. During Open Enrollment, you can:
- Add eligible dependents to your health coverage.
- Change your CalPERS health plan.
- Delete dependents from your health coverage.
- Discontinue your existing CalPERS health coverage.
- Enroll in a CalPERS health plan, if you are not currently enrolled in CalPERS health coverage.
- For more detailed information about the health plans offered by CalPERS, please visit their website at www.calpers.ca.gov.
- Enroll in the City's Flexible Spending Account (FSA) and/or Dependent Care Assistance Plan (DCAP) for 2018.
- NOTE: These accounts do not automatically roll over from year-to-year. YOU MUST COMPLETE AND SUBMIT NEW ENROLLMENT FORMS FOR BOTH THE FSA & DCAP PLANS EACH YEAR.
- FSA MAXIMUM ANNUAL AMOUNT HAS INCREASED FROM $2,550 TO $2,600.
- DCAP MAXIMUM ANNUAL AMOUNT REMAINS AT $5,000.
- MINIMUM ANNUAL ENROLLMENT AMOUNT FOR EITHER FSA OR DCAP REMAINS AT $520.
- All changes and enrollments must be completed and received in Human Resources no later than October 6, 2017. For additional questions about open enrollment or your benefits, please contact Michelle Capella by email or by telephone at 543-3062.
ALERT:
Prior to turning in your CalPERS Health Enrollment Form you must verify your current zip code qualifies under the plan you are selecting. Please visit CalPERS Health Plan Search by Zip Code to do so.
CalPERS requires that we capture Social Security numbers for all family members every time a Health Change Form is submitted. When completing your enrollment form, please make sure to include Social Security numbers.
DECLINING HEALTH COVERAGE
Safety employees wishing to waive health coverage because they have other coverage may do so at any time. Please provide proof of coverage and complete the following: (1) Waiver of Health Insurance Form, and (2) CalPERS Health Benefit Plan Enrollment Form declining coverage and return the completed forms to Human Resources at City Hall, Room 1 no later than October 6, 2017. Links to these forms can be found below:
Fire Waiver of Health Insurance Form - You may receive the current allotted amount for dependent care, if elgibile. Please note that in order to received the allotted amount you MUST have a qualifying dependent and enroll in the Dependent Care Plan for 2018.
Police Waiver of Health Insurance Form - You may choose to receive an additional taxed $200 per month OR the current allotted amount for dependent care. Please note that in order to receive the allotted amount for dependent care, you MUST have a qualifying dependent and enroll in the Dependent Care Plan for 2018.
LIFE INSURANCE
Although employees may apply for supplemental life insurance at any time, open enrollment is an excellent time to assess your current supplemental coverage levels. Please note that all units have a City paid basic life insurance policy. Amounts are are follows:
- Unit 2 (Fire)-$12,000
- Unit 5 (Police)-$10,000
- Unit 9 (Safety Management)-$30,000
If you would like to apply for additional supplemental life insurance, please complete the Evidence of Insurability (EOI) Form and send direct to VOYA (previously ING).
Informational Materials
CalPERS 2017 Open Enrollment Newsletter
Health Plan Rate & Benefits Changes
2018 Health Benefit Summary
2018 Find a Medical Plan
2018 Health Program Guide
Understanding Your Health Plan Statement
FAQ's - Open Enrollment
CalPERS Medicare Changes Information
Current PEMHCA Employer Contribution Amounts
Flexible Spending (FSA) and Dependent Care DCAP) Account Forms
DCAP Provider Form
FSA/DCAP Enrollment Form
FSA FAQ's
Health Care Reform-OTC FAQ
*Return completed forms to
HR by 10/06/2017
Forms
CalPERS Health Change Form (complete sections 1-21)
Universal Benefits Enrollment Form (to change dental/vision only)
Police Health Insurance Waiver
Fire Health Insurance Waiver
Supplemental Life Insurance Evidence of Insurability Application
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Human Resources
Physical Address
100 Santa Rosa Avenue
Room 1
Santa Rosa, CA 95404
Phone: 707-543-3060Fax: 707-543-3064
TDD: 707-543-3063
Jobs: 707-543-3076
Hours
Monday - Friday
8 a.m. - 5 p.m.