2023 Open Enrollment Information & Forms

Open Enrollment Information (PDF)

2023 Open Enrollment Information

Employee Benefit Record Form (enrollment form) (PDF)

Virtual Benefits Fair (PDF)

2023 Medical Plan Rates Full-Time & Sworn (PDF)

2023 Health Plan Rates - Permanent Part-Time (PDF)

2023 Medical Plan Comparison Chart (PDF)

2023 CalPERS Medical Plan Comparison Chart

2023 Summary of Benefit and Coverage Notice (PDF)

2023 DeltaCare USA HMO Summary (PDF)

2023 Delta Dental PPO Summary (PDF)

FSA Program Highlights (PDF)

FSA program highlights.

FSA Online Enrollment Instructions (PDF)

Voluntary Life Insurance Form - Non-Sworn (PDF)