Cafeteria Plan Forms for 2021 Health Plan Changes
Region 1- to see a full list of counties visit CalPERS. Please submit Cafeteria Plan forms ONLY if you are making changes to your enrollment or if you are enrolling for the first time. Flex dollar allowances and premium rates are for 2021, however since CalPERS requires prepayment of premiums, the scheduled rate increases go into effect in December of 2020 (for January 2021 coverage).
Executives, Mid-Mgmt & Electeds
San Rafael Fire Chief Officers’ Association
San Rafael Firefighters’ Association
San Rafael Police Mid-Mgmt Association
San Rafael Police Association
Public Employees Local-1 Confidential Unit
SEIU- Local 1021
SEIU- Child Care
Western Council of Engineers
Additional resources: CalPERS website.