Retiree Annual Open Enrollment

This is your opportunity to make changes to your benefit plans, which go into effective on January 1, 2025. To ensure that you have the coverage you need, keep these very important points in mind:

If you DO NOT wish to make any changes to your benefits you do not need to take any action. If you wish to make any changes, please download the appropriate form(s) below for submittal to the Retirement Office.

Before you make any decisions regarding your benefits, make sure you have all of the information you need. Many plans have limitations, exclusions or waiting periods. The plan booklets provided by each company are your best source of detailed information about each plan. Plan documents may be viewed/printed from the Retirement website.

Medical Insurance - Retirees may change medical care providers, add a qualified dependent, enroll or cancel coverage during open enrollment or if they experience a qualifying event. Please note if you discontinue/cancel health care coverage on or after your retirement date you are eligible to re-join the City's health care plan during the annual enrollment period or if you experience a qualifying event, as long as you provide proof of continuous coverage from another health care plan/provider from time of cancellation through time of re-application. If you did not have City medical insurance coverage at the time you retired and chose not to enroll at your retirement, you are not eligible to join the City's group medical insurance. (City Commission Policy 150)

Optional/Voluntary Benefits - Retirees are not eligible to enroll in new policies or increase their current coverage levels. Retirees may only continue the optional/voluntary benefits they were enrolled in and approved for at Retirement. (Exceptions: Accidental Death, Long Term Disability and the Health Care Spending Account are not continued at Retirement) A retiree may only continue the coverage level they were enrolled in at retirement; therefore they cannot add dependents or increase the amount of coverage for their optional/voluntary benefits after Retirement. A retiree may drop a dependent or decrease the amount of their benefit(s), however, these changes are permanent and cannot be undone at a later date.

Annual Enrollment

Opens: 8:00 AM on November 15, 2024
Closes: 5:00 PM on December 16, 2024
Plan Year is January 1, 2025 through December 31, 2025

All documents listed below are PDF files:

General Info, Notices and Rates

CHP and FL Blue

Dental Insurance

Vision Insurance

Davis Vision Summary of Benefits

Life Insurance

Legal Insurance

ARAG Legal Plan

Annual Open Enrollment for Retirees

Change You Wish To Make	Forms Required
Changing plan from Capital Health Plan to FL Blue	CHP Status Change Form FL Blue Enrollment Form
Changing plan from FL Blue to Capital Health Plan	FL Blue Status Change Form CHP Enrollment Form
Changing plan from Capital Health Plan Medicare to FL Blue Medicare	CHP Status Change Form FL Blue Enrollment Form FL Blue Medicare Enrollment Form
Changing plan from FL Blue Medicare to Capital Health Plan Medicare	FL Blue Status Change Form CHP Enrollment Form CHP Medicare Enrollment Form
Adding or Deleting dependent from FL Blue	FL Blue Status Change Form
Adding or Deleting dependent from Capital Health Plan	CHP Status Change Form
Domestic Partner on FL Blue/Capital Health Plan	Domestic Partnership For Retirees Affidavit
Changing plan, decreasing or canceling coverage on Dental	Dental Member Status Change Form
Decreasing or canceling coverage on Vision	Vision Member Status Change Form
Changing MetLife	MetLife Change Form