This website is for City employees.

Open Enrollment for 2025 Health Plan Changes

October 7 – October 31 (for changes effective January 1, 2025)

Open Enrollment Period Runs February 6 - April 28 | Shorewood School District

Any changes submitted during Open Enrollment will take effect January 1, 2025.
Premium and employer contribution changes will be reflected in your December paychecks.

 This is your once-a-year opportunity to make benefit elections/changes for the upcoming plan year without a qualifying life event.

We encourage you to walk through this enrollment process to review your benefits carefully and make changes as needed.

All Open Enrollment Change Forms must be submitted to HR no later than 5:00 pm on Thursday, October 31, 2024.  

For nearly all San Rafael employees, the City is excited to have parity among all groups for the City’s contribution toward your coverage in 2025.

Employee Only — $950/month City Contribution
Employee +1 — $1,900/month City Contribution
Employee +Family — $2,400/month City Contribution

*Exact contribution amounts may vary for some employees based on prorated FTE, employment status, and/or hire date.

Open Enrollment Forms

By October 11, 2024, you should have received an email with an individual Health Benefit Statement from Human Resources. Please complete the required fields on this form and send back to HR – you will need to indicate if you are not making any changes, or wish to make changes for 2025.

If you are continuing to WAIVE coverage for 2025 you must 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

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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 2025?  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:

  • 2025  CalPERS Health Plan Rates (please remember to use the zip code search to find plans in your area)
  • 2025 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.

 

United Concordia

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.

Vision Provider Locator

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 19, or age 25 if a full-time student).

Helping people act on their love | New York Life Insurance

NY Life Insurance – Make sure your Beneficiaries are up to date

Open Enrollment 2024: NY Life has extended to City employees a one-time open enrollment period to sign up for voluntary life insurance outside of the regular window following date of hire.

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.

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Flexible Spending Account (FSA) – NOT SUBJECT TO OPEN ENROLLMENT DEADLINE

A Flexible Spending Account (FSA) is a special account you put pre-tax money into that you use to pay for certain out-of-pocket health care costs. This means you’ll save an amount equal to the taxes you would have paid on the money you set aside. You can participate in a Health Care FSA to pay for eligible health and dental expenses for you, your spouse or dependents. A Dependent Care FSA is used to pay for eligible dependent care expenses, such as preschool, summer day camp, before or after school programs, and child (under age 13) or adult daycare.

Contribution limits for 2025 should be announced by the IRS in late October. HR will send a separate announcement and enrollment deadline for these plans.

The 2024 pre-tax limits are:

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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).

Take the time to understand your benefit choices so you can make sound decisions in choosing the right options for you and your family.  If you still have questions after visiting the links above, please contact the Human Resources Department via email at human.resources@cityofsanrafael.org. 

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