This page contains information on Open Enrollment for health insurance, dental insurance, vision insurance, pet insurance, and flexible spending.
Flexible Spending Open Enrollment for the 2023 plan year is October 31, 2022 - November 18, 2022, 4:30 pm.
To continue participation in Flexible Spending, a new enrollment through Employee Self Service (ESS) must be completed each year.
Eligible employees will receive paper packets of Flexible Spending Open Enrollment materials for the 2023 plan year from Human Resources and will be distributed by their departments beginning on October 31, 2022.
- Open Enrollment Memo
- Instructions for Submitting Flexible Spending Requests through Employee Self Service (ESS)
- Healthcare Flexible Spending Account Eligible Expenses
- Dependent Care Flexible Spending Account Eligible Expenses
- HIPAA Privacy Notice
- Open Enrollment Packet (Memo, Healthcare Flexible Spending Account Worksheet, Eligible Expense Lists FSA & DCAP, HIPAA notice)
2023 plan year Open Enrollment for health, dental, and vision insurance will be September 26, 2022 - October 21, 2022.
2023 plan year Open Enrollment for flexible spending will be October 31, 2022 - November 18, 2022.
Each year, typically in October and/or November, employees will have the opportunity to participate in open enrollment for health insurance, dental insurance, vision insurance, and flexible spending. Changes made during open enrollment are effective January 1st of the following year. Pet Insurance has year-round open enrollment.
To save paper, we encourage employees to use this site for reference rather than printing this material.
Please submit open enrollment requests online, using myETF Benefits for health insurance requests and Employee Self Service (ESS) for dental insurance, vision insurance, and flexible spending enrollments.
Health Insurance, Dental Insurance, Vision Insurance
Health, Dental, and Vision Insurance Open Enrollment for the 2023 plan year is September 26, 2022 - October 21, 2022. During this time, employees may enroll in health insurance, dental insurance, and/or vision insurance for the upcoming plan year, change health insurance carriers, change coverage levels, add or remove eligible dependents, or cancel coverage. Open Enrollment changes for these benefits take effect January 1, 2023.
Eligible employees will receive Open Enrollment materials in electronic format by email from Human Resources and/or as paper packets distributed by their departments beginning on September 26, 2022 for each of the benefits for which they are eligible for the 2023 plan year.
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. If necessary, paper Health Insurance Application/Change Forms may be printed and submitted to Human Resources (215 Martin Luther King Jr Blvd Ste 261, Madison, WI 53703) during business hours (Monday-Friday, 8:00 am - 4:30 pm); by inter-departmental mail, or faxed to 608-267-1115. If none of these options are available to you, you may choose to send in your paper application via USPS, or place it in the drop box located outside the Doty Street entrance to the Madison Municipal Building. (If using the drop box, please place your form inside an envelope addressed to City Human Resources MMB Ste 261.) Please note that the drop box is not maintained by the Human Resources Dept. and may not be checked daily. The form may also be submitted electronically to Human Resources at firstname.lastname@example.org; however, if you opt to use email, please encrypt your message (encrypt an email message and attachments sent from a City email account by typing #secure in the Subject line of your email message), as all City emails are subject to Open Records Requests. In all of these cases, the form must be received in the Human Resources office by 4:30pm on Friday, October 21, 2022 to be processed.
- ETF - It's Your Choice 2023
- ETF - It's Your Choice 2023 Decision Guide
- ETF - It's Your Choice Member Education - Health Insurance
- ETF - Health Plan Search (includes provider directories for available plans)
- ETF - Vaccinations available at in-network pharmacies at no cost. Click for more information
2023 Health Insurance Premium Rates
Employee contributions to health insurance premiums are deducted from the first paycheck of each month, for the following month's coverage. For example: The employee contribution to the premium for January 2023 coverage will be deducted from the 12/09/2022 paycheck.
Rates for Full-time Employees
Expanded rate sheets with prorated contribution amounts for Less-than-full-time Employees:
- General Employees, Police, and Fire (All Compensation Groups Except 41 and 42)
- Metro Transit (Compensation Groups 41 and 42 Only)
- Memo: Delta Dental Insurance Enrollment, Including Rates
- 2023 Dental Insurance Coverage Summary
- Instructions for Submitting Dental Insurance Open Enrollment Requests through Employee Self Service (ESS)
- Search for a Delta Dental in-network Provider
- Memo: DeltaVision Insurance Enrollment, Including Rates
- 2023 Vision Insurance Coverage Summary
- Instructions for Submitting Vision Insurance Open Enrollment Requests through Employee Self Service (ESS)
- Search for a DeltaVision in-network provider
Overview of 2023 Open Enrollment Process
- Memo: My Pet Protection pet insurance from Nationwide
- 2023 Pet Insurance Coverage Summary
- Learn more about pet insurance and get a fast, no-obligation quote. Please note that premiums for Pet Insurance are unable to be paid through payroll deduction. Nationwide will directly bill eligible employees who enroll in this coverage. Open enrollment for Pet Insurance is year-round.
- If you have questions about pet insurance, please contact Nationwide at 877-738-7874.