Welcome to the 2022 Open Enrollment Page for Public Safety Employees

This is your once-a-year opportunity (outside of a qualifying event) to make coverage and plan changes. Changes made during Open Enrollment take effect January 1, 2022.  

Discover your options using the resources and information provided on this page by clicking on the plan or vendor tabs below.


  1. Anthem
  2. Blue Shield
  3. Delta Dental
  4. EAP
  5. Health Net
  6. Kaiser
  7. OptumRx
  8. Standard Life Insurance
  9. United Healthcare
  10. VSP Vision
  11. Western Health


Visit Anthem's CalPERS plan site for information and resources.The site offers quick links to: 

- Plan overview

- Pharmacy benefits

- Programs and services


Click on one of the links below to learn more about your health plan options.

Interactive Open Enrollment Brochure

Search for a doctor online

PERS Gold (Previously PERS Select)

PERS Platinum (Previously PERS Choice/ PERSCare)

PORAC Safety Health Plan

Select HMO Benefit Guide

Traditional HMO Benefit Guide

CalPERS Open Enrollment Guide

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ACTIONS TO TAKE DURING OPEN ENROLLMENT

  1. Learn about your health benefit options by watching the above Open Enrollment video guide.
  2. CalPERS plans are changing. CalPERS three PPO plans, PERSCare, PERS Choice, and PERS Select, will transition to two plans: PERS Platinum, PERS Gold and CalPERS Blue Shield Access+ HMO will be available in Sonoma County. If you are enrolled in PERSCare PPO or PERS Choice PPO you will be automatically transferred to the PERS Platinum PPO plan, and if you are enrolled in PERS Select PPO you will be automatically transferred to the PERS Gold PPO, unless you make another election during Open Enrollment. Review these changes and if you wish to make a plan change for 2022, complete the appropriate enrollment forms. All forms are available in the Forms tab below.
  3. If you plan to enroll in a Flexible Spending Account (Health and/or Dependent Care), you must submit an enrollment form for 2022. Enrollments from 2021 do not automatically enroll you in the 2022 plan year. Health FSA contributions are limited by the IRS to $2,750 per person in 2022 and DCAP contributions to $5,000 per year per eligible family. • New for 2022: The rollover option will replace the Grace Period option. The rollover option allows FSA participants to rollover up to $550 of unused health FSA funds into the 2023 plan year. This rollover option will replace the grace period.
  4. If you would like to increase your supplemental life and/or AD&D coverage without providing Evidence of Insurability (EOI), complete the required enrollment form. All forms are available in the Forms tab below.
  5. Submit all required forms and documentation to Human Resources by the deadline of 5:00pm Friday, October 15, 2021.
  6. Forms not received or postmarked by Human Resources by the deadline will not be processed, no exceptions.
  7. Forms should be e-mailed from your Santa Rosa issued email address to benefits@srcity.org using the “Encrypt” feature under the Options menu in Outlook. WARNING: We do not recommend emailing forms from a personal email. Emailing forms from your personal email could result in a potential security breach of your private information. Forms can also be faxed to (707) 543-3064 or mailed to the following address: Attn: Human Resources Department - Benefits, 100 Santa Rosa Avenue, Room 1, Santa Rosa, CA 95404.
  8. If you do not plan to have an FSA account and do not plan on making any other benefit changes for 2022, no action is needed. Your 2021 medical plan elections will continue into the 2022 plan year (except for FSA elections).
  9. Questions? Contact the Human Resources Department at Benefits@srcity.org or 707-543-3060.

Declining Health Coverage?

Safety employees wishing to waive health coverage because they have other coverage may do so at any time.

Fire -  You may receive the current allotted amount for dependent care, if eligible. Please note that in order to received the allotted amount you MUST have a qualifying dependent and enroll in the Dependent Care Plan for 2022.

Police - 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 2022.

Please provide proof of coverage and complete the following:
  1. Complete the CalPERS Health Benefit Plan Enrollment Form declining coverage 
  2. Complete the Waiver of Health Insurance Form (from the forms tab below)
  3. Provide proof of coverage
  4. Return completed forms and proof of coverage to Human Resources at City Hall, Room 1 no later than 5:00 p.m. Friday, October 23, 2020
  5. Forms not received by Human Resources by the deadline will not be processed, no exceptions. This includes forms mailed but not delivered to Human Resources by the deadline.
  1. 2022 Rates
  2. 2021 Rates
  1. FAQ's & More!
  2. Forms
  3. Summary of Benefits & Coverage