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Open Enrollment 9/21 - 10/16/20


Cash-in-lieu of medical coverage

MUST BE RENEWED during Open Enrollment to receive 2021 Benefit

2-page Waiver of Coverage form AND Proof of Coverage are to be submitted together, please.

AFFORDABILITY and Covered California Subsidy information

1)  If you work 6 or more hours per day and the employee cost of the PERS Select PPO plan is less than 9.83% of your monthly income the plan meets the definition of "Affordable".  

2)  If the PERS Select PPO plan is "Affordable" You no longer qualify to receive premium assistance or Advanced Tax Credits as of January 2021 and should enroll in a medical plan offered below.  

3)  To determine if the PERS Select PPO plan is affordable for you - review the affordability chart below.  Find your position and current step or calculate your annual salary to determine if the plan is affordable for you.

If you have questions or need assistance please contact Deborah Dobbins

Medical Plans

* To compare medical plans download the Health Benefits Summary above

* CalPERS website has a page for employees with Open Enrollment information

 Log in to My CalPERS to search for plans available by zip code, providers within a specific plan, and other valuable information to assist with your Open Enrollment plan decisions.

*The individual plan summaries - have more details than the "Benefit Summary"

Anthem Blue Cross Select HMO
Anthem Blue Cross Traditional HMO
PERS Select PPO  -  Affordable Option


Deborah Dobbins, Benefits Manager

2020 Challenger Drive  Alameda 94501

phone 510.337.7073  fax 510.522.8274


Forms and attachments MUST be in PDF format, not  jpg or photo images, please.  

Free "Apps" (Adobe, etc.) are available for download to phones

rate sheets

Delta dental ppo

Vision service plan

flexible spending

American Fidelity will conduct Open Enrollment for Flexible Spending Plans in NOVEMBER 9th - 20th, 2020.

Appointment scheduling will be offered on this web page and appointments will be virtual this year.

                  Watch for Email Notices!

enrollment forms

    Forms that are signed using/on PDF      MUST BE SUBMITTED USING AUSD EMAIL

You must download the medical form and save it to your computer before filling it out, thanks!

If you submit forms via fax or US mail a wet/ original signature is required.

Forms must be received or post marked by October 16, 2020.