Open Enrollment for 2026 Health Plan Changes
We encourage you to walk through this enrollment process to review your benefits carefully and make changes as needed.
Any changes submitted during Open Enrollment will take effect January 1, 2026.
Premium and employer contribution changes will be reflected in your December paychecks.
Scroll down for Drop In dates with Human Resources or to schedule 1:1 meeting to review your options and questions!
Open Enrollment Forms and Process
- By September 19, 2025, you will have received an email with your individual Health Benefit Statement from Human Resources. This will go to your official City of San Rafael email – please check it and contact with HR if you do not receive it.
- You will need to indicate if you are not making any changes or if you do want to make changes for 2026.
- Complete the required fields on this form and email it to hrforms@cityofsanrafael.org, no later than 5:00 pm on Friday, October 10, 2025.
- If you are continuing or starting to WAIVE coverage for 2026:
- You must ALSO sign the Annual Opt-Out Waiver attestation form and provide proof of other group coverage. You must turn in a new waiver each year to receive the cash-in-lieu (“cash back”).
CalPERS Medical Plans
The City is excited to have parity among employee groups for the City’s contribution toward employee* Medical coverage in 2026.
Employee Only — $998/month City Contribution
Employee +1 — $1,995/month City Contribution
Employee +Family — $2,520/month City Contribution
*Exact contribution amounts may vary for some employees based on prorated FTE, employment status, and/or hire date.
CalPERS has developed a member-focused Step by Step Guide for open enrollment, to walk active members through the process of searching for a doctor and completing the HBD-12 form. The Open Enrollment for Active Members webpage provides additional guides and resources to assist you during Open Enrollment.
Thinking of changing your health plan (or enrolling) for 2026? Not all CalPERS plans are available in all areas/zip codes. Be sure to use the Search Health Plans tool to research the health plan coverage and benefits most important to you and your family.
CalPERS Health Plan Information:
- 2026 CalPERS Health Plan Rates (please remember to use the zip code search to find plans in your area)
- 2026 Health Plan Benefit Summary (comparison chart of plans starts on page 16)
- CalPERS Videos
- Dropping Dependents at Age 26 Limit: REMEMBER that if your dependent is dropped by CalPERS for reaching age 26 and that reduces your plan tier, you MUST notify HR to change to the lower tier/deduction on your paycheck. CalPERS does not automatically notify HR.
Dental – United Concordia (UCCI)
This benefit is fully paid by the City of San Rafael (pro-rated for part-time employees) and includes any eligible dependents up to age 26. Employees can log-in to the United Concordia website to view their coverage You can print an ID card once you’re logged on to the website.
The Summary of Benefits below provides information about your deductibles and services covered.
- United Concordia Enrollment Form
- United Concordia Dental Benefits Summary (Advantage Plus PPO Network)
Vision – EyeMed
Members in certain bargaining groups are eligible for vision coverage through EyeMed. This benefit is fully paid by the City for “Employee Only” coverage (pro-rated for part-time employees). Employees may enroll all eligible dependents for an out-of-pocket cost of $7.39/month. The City covers the cost to enroll all eligible dependents for Executive and Mid-Management employees. Employees can log-in to the EyeMed website to view their coverage details, covered dependents, search providers, and print an ID card.
The Summary of Benefits below provides information about your coverage and copays.
Complete the EyeMed Enrollment Form to sign up or add eligible dependents (up to age 26).
Life Insurance – New York Life
All employees are automatically enrolled in the city-paid Basic Life insurance benefit, as designated in the appropriate MOU, upon hire. Employees should maintain an updated Basic Life Beneficiary Designation form on file.
There is no formal open enrollment period to purchase Voluntary Life insurance for yourself and/or your eligible dependents, however enrollments requested more than 30-days from your initial hire date will require medical review. Please note that in order to purchase life insurance for your spouse and/or child(ren) you must purchase voluntary life insurance for yourself. This optional benefit is fully paid for by the employee.
- Voluntary Life Insurance Application
- Voluntary Life Insurance brochure
- Voluntary Life Insurance Sample Rate Sheet
- HOT TIP: Make sure your Beneficiaries are up to date Beneficiary Designation Change Form (for Basic and Voluntary life insurance)
Flexible Spending Account (FSA)
Contribution limits for 2026 should be announced by the IRS in late 2025; please enroll in FSA at the annual amount that makes most sense for your needs. We will reach out to individuals who have signed up to notify them of the updated IRS maximum and allow them to increase their election.
The 2025 pre-tax limits are:
- Flexible Spending – $3,300.00 max election per year
- Dependent Care- $5,000.00 max election per household
**Dependent care maximum increases to $7,500 per year in 2026**
Employee Commute Program
All regular full-time and part-time employees are eligible to participate in the program, which includes incentives for carpooling or walking/biking to work. Visit the Commuter Program page to sign up.
Employees interested in setting aside pre-tax funds for public transit expenses are encouraged to purchase clipper card value online with My Commuter Check. Orders must be placed by the 10th of each month for passes/value to be added for the following month (e.g. ECO pass/clipper value for January must be purchased by December 10th).
