OPEN ENROLLMENT (FULL-TIME EMPLOYEES)

It is important to review the details of your medical plan and understand what your plan offers for you and your family for medical coverage. CalPERS offers a variety of medical plans in Region 1- which is comprised of many Bay Area counties. If you live outside of Region 1, your plan options and premiums may change. If you would like to see which plans are available at your home zip code, or if you would like to see if your Primary Care Physician/Doctor is available under a certain plan, use this link to get started. You can also login to your MyCalPERS account to access Open Enrollment information/resources, view your Health Benefit Statement, and can use the "Search Health Plans" tool in your MyCalPERS account to see your plan options. While in your MyCalPERS account, you can access the Health Benefits Enrollment Form (HBD-12) which will have most of your information pre-populated- you will just need to finish completing/reviewing the form based on the change(s) you would like to make, if you are making changes for the 2025 plan year.

If you are making changes for the 2025 plan year, please note that you may need to submit applicable forms/dependent documents (if applicable) to Human Resources and not to CalPERS. If you are not making changes to your medical plan for the 2025 plan year, no action is necessary as your medical coverage will carry over to 2025 as you are currently enrolled.  

Eligible employees pay a monthly employee contribution to be enrolled in a CalPERS medical plan. Your monthly employee contribution is based on a number of factors such as which plan you choose to enroll in, the tier/level of enrollment (i.e. employee only, employee + 1 dependent, family), and your Bargaining Unit's MOU language. Please refer to the 2025 Memo for Health Benefits for further information on plan options and to view the employer vs. employee monthly contribution. It is important to note that most plans have has an increase in cost for the 2025 plan year, so be sure to review your current plan selection. Additionally, CalPERS has announced the following medical plan changes for the 2025 plan year: 

• PERS Gold & Platinum PPO plans- Blue Shield of California will be the new administrator (currently, Anthem Blue Cross is the administrator) 
• Anthem Blue Cross Del Norte (EPO) exits the CalPERS Medical Program- unless employees and their dependents change their medical plan during Open Enrollment, those currently enrolled in this plan will be automatically enrolled in the Blue Shield Access+ plan, effective January 1, 2025. 

Please note, to enroll eligible dependent children, a spouse or a registered domestic partner in medical coverage, the following documentation is required to be submitted with your Health Benefits Enrollment Form (HBD-12): 

• Dependent Child(ren): copy of their Social Security Card and Birth Certificate 
• Spouse or Registered Domestic Partner: copy of their Social Security Card and Marriage Certificate or Declaration of Domestic Partnership 

To view all medical plan Summary of Coverage and Evidence of Coverage documents, please visit this CalPERS Forms & Publications page. 

Additional information and resources can be found in the documents below or by visiting the CalPERS Open Enrollment for active members page 

CalPERS Health Benefits Enrollment-Change Form (HBD-12)
CalPERS Open Enrollment Newsletter
CalPERS Health Program Guide
CalPERS Health Benefit Summary Guide
CalPERS Guide to Choosing a Health Plan
CalPERS Guide to Understanding Your Health Plan Statement
CalPERS Medicare Enrollment Guide
CalPERS Health Benefit Enrollment Form (HBD-12) Instructions
City of Petaluma Cash-in-Lieu Enrollment/Cancellation Form 

Important Update: The City is switching from Delta to MetLife for dental benefits/coverage, effective January 1, 2025.  Please note that this is simply a change in the insurance carrier and this change will offer a wider network of providers. All dental plan benefits will remain the same. Those currently enrolled in the City’s group dental plan with Delta will be automatically enrolled in the MetLife plan. Further information & educational resources will be shared with employees later this year, via city email and will be posted on the City’s website here. 

The City provides dental benefits for you and your eligible dependents, which are paid for by the City if you are a regular, 100% full-time employee. Regular, full-time equivalent employees who work less than 100% full-time, receive a pro-rated City contribution. 

If you are not making changes to your dental coverage, no action is necessary as your dental coverage will carry over to 2025 as you are currently enrolled. If you are making changes to your dental coverage, you will need to submit a completed MetLife Enrollment/Change Form.

Please note, to enroll eligible dependent children, a spouse or a registered domestic partner in dental coverage, the following documentation is required to be submitted with your Enrollment/Change Form: 

• Dependent Child(ren): copy of their Social Security Card and Birth Certificate 
• Spouse or Registered Domestic Partner: copy of their Social Security Card and Marriage Certificate or Declaration of Domestic Partnership 

Additional information and resources can be found in the documents below. 

2025 Dental Benefits Summary
2025 MetLife Dental Coverage Summary
MetLife Enrollment/Change Form
MetLife How to Register for MyBenefits
MetLife How to Find a Dental Provider
MetLife Generic PPO Dental ID Card (with City’s Group#)

The City provides vision benefits for you and your eligible dependents, which are paid for by the City if you are a regular, 100% full-time employee. Regular, full-time equivalent employees who work less than 100% full-time, receive a pro-rated City contribution.  

If you are not making any changes to your vision coverage, no action is necessary as your vision coverage will carry over to 2025 as you are currently enrolled. If you are making changes to your vision coverage, you will need to submit a completed MetLife Enrollment/Change Form.

Please note, to enroll eligible dependent children, a spouse or a registered domestic partner in vision coverage, the following documentation is required to be submitted with your Enrollment/Change Form: 

• Dependent Child(ren): copy of their Social Security Card and Birth Certificate 
• Spouse or Registered Domestic Partner: copy of their Social Security Card and Marriage Certificate or Declaration of Domestic Partnership 

Additional information and resources can be found in the documents below. 

2025 Vision Benefits Summary
2025 MetLife Vision Coverage Summary (units 1,2,3,4,8,9,11)
2025 MetLife Vision Coverage Summary (units 6,7,10,Council)
MetLife Enrollment/Change Form
MetLife How to Register for MyBenefits
MetLife How to Find a Vision Provider 

What is a Flex Spending Account? A Flexible Spending Account (FSA) allows an employee to set aside a portion of their pre-tax earnings to pay for “out-of-pocket” Health Care expenses, Dependent Care expenses, and/or Commuter expenses every calendar year. It is important to take some time to figure out how much money you should contribute for the plan year, based on how much you think you will incur for covered expenses. If you are unsure if enrolling in a FSA plan is the right choice for you, the Navia benefit tax calculator can help you estimate your potential savings. It is also recommended to review what your FSA contributions are eligible for to make sure you get the most out of the plan. 

Enrollment: For those employees who are currently participating in a 2024 FSA, you must complete a new enrollment form to elect contributions for the 2025 plan year (your current enrollment does not automatically renew for the 2025 plan year). To enroll/re-enroll for a Health Care and/or Dependent Care FSA, you will need to submit a completed Navia FSA Enrollment Form. FSA Enrollments will be effective January 1, 2025.  

2025 Plan Contribution Limits (please note that the amounts below are the amounts for the 2024 plan year as the IRS has yet to announce the 2025 limits. As soon as the IRS makes that announcement, any employee who elected the 2024 plan year maximum will be provided notification and the opportunity to increase their contribution(s) later this Fall): 

• Health Care FSA: $3,200 per calendar year 
• Dependent Care FSA: $5,000 per calendar year ($2,500 if you’re married and filing taxes separately) 
• Commuter Benefit FSA: $315 per month for transit, eligible vanpools and for qualified parking 

Additional information and resources can be found in the documents below. 

2025 Navia FSA Enrollment Form
Navia Health Care FSA Brochure
Navia Dependent Care FSA Brochure
Navia FSA Estimator Worksheet
Navia FSA Eligible & Ineligible Expenses
Navia FSA Store Brochure
Navia Benefit Education Resources
Navia Participant Tools & Resources
Navia FSA Debit Card Overview
Navia FSA Debit Card FAQ
GoNavia Commuter Benefits Brochure
GoNavia Parking Benefits
GoNavia Commuter Benefits Sign-Up Instructions
Navia FSA Contact Information