Each year, typically in October and/or November, employees will have the opportunity to participate in open enrollment. Changes made during open enrollment are effective January 1st of the following year.
To save paper, we encourage employees to use this site for reference rather than printing this material. Flex Spending and Delta Dental forms are the only items that need to be printed and returned to Human Resources.
Flexible Spending Open Enrollment for the 2019 plan year is October 1, 2018 - October 26, 2018. To continue coverage, a new enrollment form must be completed each year.
***On November 15, 2018, it was announced by the Internal Revenue Service that the Healthcare Flexible Spending Account (FSA) limit will increase to $2,700 for the 2019 plan year. This announcement followed the close of the City's FSA open enrollment period for the 2019 plan year, but employees who elected $2,650 for the 2019 plan year will be contacted and provided the opportunity to increase their election to as much as $2,700.***
- Open Enrollment Memo
- Enrollment Form
- Change of Election Form
- Healthcare Flex Spending Account Worksheet
Calculate health account contributions.
- Healthcare Flexible Spending Account Eligible Expenses
- Dependent Care Flexible Spending Account Eligible Expenses
- HIPAA Privacy Notice
Health & Dental Insurance
Health and Dental Open Enrollment for the 2019 calendar year is October 1, 2018 – October 26, 2018. During this time, employees may enroll in health and dental insurance for the upcoming plan year, change carriers, or change between single and family plans.
Health Insurance - "It's Your Choice"
- Memo: It's Your Choice Open Enrollment for Health Insurance
- Health Insurance Application/Change Form
You do not need to complete this paper application if you have submitted an online change request.
- ETF - It's Your Choice 2019
- ETF - It's Your Choice 2019 E-Learning
- ETF - Health Plan Map (includes provider directories for available plans)
2019 Health Insurance Premium Rates
- Memo: Delta Dental Insurance Enrollment, Including Rates
- 2019 Dental Coverage Summary
- Delta Dental Application
This form must be printed and submitted to Human Resources.