2015 Contra Costa County Open Enrollment

September 15, 2014 through October 10, 2014

Information regarding CalPERS Open Enrollment, please click on this link, CalPERS Open Enrollment page.
 
Plan changes are effective 
    January 1, 2015


Open Enrollment is the time to:

*Note: If no changes are being made for the health and dental plans, you do not need to return the enrollment form. You will continue to keep your current health and dental plan for the 2014 plan year. Please refer to 2015 rate table for changes in the health and dental plan premiums.



 
For complete information about negotiated benefits, please see your applicable Memorandum of Understanding or Management Resolution.


2014 Benefit Statements, 2015 rates and enrollment forms were mailed to all County employees to the address on record as of August 1, 2014.  Benefit Statements include information on record as of August 1, 2014.

If you would like to make a plan change for 2015, please be sure Employee Benefits Service Unit receives your completed original enrollment forms no later than 5:00 PM on October 10, 2014 to the address below:

                        Employee Benefits Services Unit 
                        651 Pine Street, 5th Floor 
                        Martinez, CA 94553 
                        TEL: (925) 335-1746
                        FAX: (925) 335-1798
                        Email:  Benefits@hrd.cccounty.us


Flex Spending Accounts

Per IRS regulation, you must re-enroll in the Health Care Spending Account (HCSA) and/or Dependent Care Assistance Program (DCAP) each Plan Year.
 
In order to enroll in either HCSA or DCAP, you are required to submit the election form no later than 5:00 p.m. on October 10, 2014 to the Employee Benefits Services Unit.

Health Care Spending Account (HCSA): 
*Max 2013 annual contribution $2,500
        
 HCSA Handbook Worksheet for HCSA
Note: Handbook is slow to download. Please be patient. 
 2015 Enrollment Form 
 
Dependent Care Assistance Program (DCAP) 
 
DCAP Handbook Worksheet for DCAP
Note: Handbook is slow to download. Please be patient. 
 2015 Enrollment Form 
 
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MEDICAL

Age Limit: 26
Requirements: Include original certified birth certificate and dependent verification form with open enrollment form.

Reminder: Be sure to provide Social Security Number on the open enrollment form.
 Dependent Verification form
 
DENTAL

Age Limit: 19 - 24
Requirements: Must be a) full-time student, b) receive more than one-half of support from employee and c) unmarried. Include original certified birth certificate with open enrollment form and Dependent Verification form.

Reminder: Be sure to provide Social Security Number on the open enrollment form.

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Please read the following Domestic Partner Information to see what the  requirements and documentations are to add a domestic partner to your health and/or dental benefits.

Be sure to include the following forms with your Open Enrollment application. 
 

Declaration of Domestic Partners application
Imputed Income IRC Section 152 Form 
 
 
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