Open Enrollment Forms & Documents

arrow Health Plan Enrollment Form (for current employees)

arrow Health Insurance Opt-Out Form

arrow COBRA and Retiree Health Insurance Form (for former employees)

CHOOSE YOUR BARGAINING UNIT BELOW FOR INFORMATION ON:

arrow OPEN ENROLLMENT MEMOS - Provides an explanation of benefit changes for each bargaining unit.


arrow COMPARISON OF BENEFITS (COB) - Easy to read side-by-side comparison of available health plans and payroll deductions.


arrow SUMMARY OF BENEFITS AND COVERAGE (SBC) - Uniform summary of benefits for each health plan option as required by the Affordable Care Act. The SBC Uniform Glossary is available to explain terms used in the SBCs.

  1. AFSCME
  2. EPEA
  3. IAFF
  4. IAFF BC
  5. IATSE
  6. Non-Represented
  7. Mayor - Council Members