Health Insurance Open Enrollment for Current City of Gilroy Employees 

The Open Enrollment period began September 11, 2017 and is available until NOON on October 6, 2017. During open enrollment, you will have the opportunity to make changes to your medical, dental and optional benefits such as vision, voluntary life insurance and AFLAC plans. This is also the time to sign up or re-enroll in the optional 2018 Flexible Spending Account (FSA) program with Discovery Benefits.​​The effective date for all changes made during the Open Enrollment period will be January 1, 2018. ​​All Open Enrollment Forms are provided below. If you are not making any changes you do not need to submit any forms. Your benefits will remain the same and will continue without any interruption. The only exception is the Flexible Spending Account.​ ​

Open Enrollment Letter ​​​​

CalPERS Health Plan Statements and Benefit Rate Sheets: Health plan statements and other Open Enrollment materials are available online to all active and retired members via myCalPERS. If you do not have a myCalPERS account, go to and follow the instructions provided. Below is a list of all the CalPERS medical plan information, forms and cafeteria plan rates. ​​​​

CalPERS Information
2018 CalPERS Rate Increase
Guide to myCalPERS Open Enrollment Statement ​​
Health Benefit Summary
Health Program Guide
Plan Change Form ​​​

Cafeteria Rate Plan Information (2018 Medical, Dental and Vision)​
Management, Confidential Unrepresented and City Council

Health Plan Directory (Medical, Dental and Vision)
Health Plan Directory ​​​​

Cash In Lieu (Medical Waiver): City of Gilroy Employees have the option of waiving medical coverage provided that they can show written proof of other health plan coverage. If coverage is waived, the employee will receive the “employee only” tier medical amount in their cafeteria plan allotment. Employees will receive this portion of the allotment, less the required CalPERS medical contribution ($133.00 for 2018) and less the required dental premium. Dental coverage cannot be waived. Employees must enroll themselves and their qualified dependent(s) in one of the Delta Dental plans; however enrollment for children can be waived until the age of 4. If an employee is selecting this option for the 2018 plan year, they will need to complete the City of Gilroy Medical Plan Waiver/Cash-In-Lieu form and attach proof of other medical coverage. This form will need to be completed for each plan year as it does not carry over from year to year. If not already enrolled with a City of Gilroy medical plan and do not complete the City of Gilroy Medical Plan Waiver/Cash-In-Lieu form employees will automatically be enrolled in the lowest cost Employee Only medical plan for 2018. ​​Below is the form needed to waive coverage.
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Medical Plan Waiver - Cash In Lieu Form ​​​

Dental: Enrollment is mandatory for all benefited employees. Employees must enroll themselves and all of their eligible dependents into one of the two dental plans available. Below are the benefit summaries for both Delta Dental and Delta Care. ​​​

Delta Dental
Delta Dental (Police)
Delta Care

Vision: Enrollment is optional for all benefited employees. Below is the benefit summary for Superior Vision. ​​​

Superior Vision Benefit Sheet ​​​

Flexible Spending Account (FSA): To enroll or continue to participate in the Discovery Benefits FSA plan (Medical Reimbursement or Dependent Care) employees will need to complete the annual enrollment form. It is important to note that continued enrollment in this plan does not carry over from year to year. The maximum yearly pre-tax deduction for the medical expense account is up to $2,000 and the dependent care is up to $5,000. There is a monthly participant fee (employee paid) of $4.50 which is set up on a pre-tax basis. The participant fee also applies through the end of the 90 day grace period (March 31, 2019) for 2018 plan year. Below is the form and benefit guide to enroll for 2018.​​​

FSA Enrollment Form
FSA Benefit Participant Guide ​​​​​

Commuter Benefit: This benefit program is administered through Discovery benefits and allows employees to set aside pre-tax dollars of up to $130 per month to us towards purchasing tickets on public transportation and parking. This include: BART, CALTrain, city and county bus lines and vanpools.  The city also has bike lockers available for employee use. Below is additional information about this program.

Commuter Benefit

Cigna Life Insurance: Employees may purchase voluntary supplemental life insurance for themselves and/or eligible dependents. An Evidence of Insurability is required for all new elections. Please note that in order to purchase life insurance for a spouse and/or child(ren), employees are required to purchase supplemental life insurance for themselves. This is an optional benefit fully paid for by the employee. Employees may also want to use this open enrollment period to update their beneficiary information for their life insurance, including the city-paid Basic Life Insurance. Below are the forms.​

Life Insurance Enrollment Form
Beneficiary Form

For additional information or questions please feel free to contact Adriana Contreras at 408-846-0285 or LeeAnn McPhillips at 408-846-0205