Each October – 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 2017 calendar year is October 11, 2016 – November 11, 2016. To continue coverage, a new enrollment form must be completed each year.
- Open Enrollment Memo
- Enrollment Form
- Change of Election Form
- Direct Deposit Form
- TASC Card Request for Spouse/Dependent
- Medical Flex Spending Account Worksheet
Calculate health account contributions.
- HIPAA Privacy Notice
Health & Dental Insurance
Health and Dental Open Enrollment for the 2017 calendar year is October 11, 2016 – November 11, 2016. 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 2017
- ETF - It's Your Choice 2017 E-Learning
2017 Health Insurance Premium Rates
- General Employees
- Police, Fire and Transit
Compensation Groups 11, 13, 41 and 42
- Police Supervisors
Compensation Group 12
- Memo: Delta Dental Insurance Enrollment, Including Rates
- 2017 Dental Coverage Summary
- Delta Dental Application
This form must be printed and submitted to Human Resources.