OPEN ENROLLMENT 2020 is here now - November 1 - 22, 2019
It's Open Enrollment Season! Open Enrollment is the time to select your benefit choices for 2020. The City will be accepting Open Enrollment changes through the Employee Online System from November 1st through November 22nd, 2019. Be advised that paper enrollment forms will not be accepted. Please review the Open Enrollment Benefit Letter for important 2020 plan changes.
- A new, Blue Shield Trio HMO 20 plan will be offered. The new plan includes benefit coverage that mirrors the Blue Shield HMO 20, however monthly premiums are at a lower cost than the Blue Shield HMO 20 plan, and the only difference is a narrower network of doctors to choose from.
- All Kaiser and Blue Shield plans experienced a rate increase. Please review your corresponding bargaining unit rate sheet for premium information.
- There will be an increase to the annual benefit cap for Delta Dental DPO and Local Advantage dental plans from $2,000 to $2,500 as well as a rate increase. Additionally, Local Advantage will offer a 50% coverage for dental implants.
- There will be an increased allowance for frames and lenses with VSP, from $120 to $150 per year.
The Human Resources Department will be offering Open Enrollment informational sessions, free flu shots, and free health screenings. The complete schedule of informational sessions can be accessed by clicking on the link below:
We encourage you to use on-line resources and toll-free provider numbers to obtain answers to questions from Plan Providers (e.g. Kaiser, Blue Shield of California, Delta, Local Advantage, and VSP) directly. You can obtain provider contact information by accessing the Provider Directory page. Specific problems or questions (e.g. billing) that cannot be addressed by the plan providers should be sent via email to email@example.com or by calling (951) 826-5639.
For benefitted employees, the City offers Medical plans that are provided through Kaiser Permanente and Blue Shield California. Each medical plan offers range of benefits to employees and their families.
You can review each medical plan’s benefit summary and access the Provider website by utilizing the links below.
Kaiser 15 Plan (HMO)
- Plan Summary (SOB $15 with Chiro)
- 2020 Kaiser Summary of Benefits HMO 15
- 2020 Kaiser HMO 15 Chiropractic Benefit
- Glossary of Health Coverage
- Kaiser 15 Evidence of Coverage
- Kaiser 15 Chiro Evidence of Coverage
Kaiser 30 Plan (HMO)
- Plan Summary (SOB $30 without Chiro)
- 2020 Kaiser Summary of Benefits HMO 30
- Glossary of Health Coverage
- Kaiser 30 Evidence of Coverage
Kaiser Additional Information
Blue Shield 15 Plan (HMO)
Blue Shield 20 Plan (HMO)
Blue Shield PPO Plan
- Blue Shield PPO Evidence of Coverage
- 2020 Blue Shield Summary of Benefits PPO
- 2020 Blue Shield PPO RX Benefits
- 2020 Blue Shield PPO Hearing Aid Benefits
NEW! - Blue Shield Trio 20 Plan (HMO)
- 2020 Blue Shield 20 Trio Network
- 2020 Blue Shield Summary of Benefits Trio 20
- 2020 Blue Shield HMO Provider Comparison
- Blue Shield Trio 20 Presentation Video
Blue Shield HMO Additional Benefits
For benefitted employees, the City provides a choice of three (3) dental plans which are provided by Delta Dental of California and Local Dental Advantage Plus. The three (3) choices include a DeltaCare (HMO), Delta Preferred Option (DPO) and Local Dental Advantage plan. Each dental plan offers a range of benefits for employees and their families.
Vision Service Plan
Vision Service Plan (VSP) allows participants the option of seeing an optometrist from their extensive listing or to go out of network. Directories of the contracted providers are available. Only employees who are covered by one of the medical plans are automatically covered by VSP.
The Vision Service Plan enrollment packet contains complete details of benefits, coverage areas, and exclusions. The City of Riverside Human Resources Department and Vision Service Plan Member Services are also available to answer questions.
For more information, please contact VSP member services at (800) 852-7600 or visit the VSP website
Flexible Savings Account
The City's, Section 125 Flexible Spending Account for Out-of Pocket Health related expenses and Dependent care cost are administered by TRI-AD. This plan allows employees to redirect a portion of their salaries to pay for the qualified Health Care or Dependent Care expenses on a pre-tax basis.
The following Flexible Spending Account documents contain complete details of benefits and exclusions. Please contact the City of Riverside Human Resources Department or TRI-AD Member Services for additional questions.
Health Care out-of-pocket expenses such as co-pays, prescriptions, deductibles, etc., that are not covered by insurance can be claimed (please refer to the TRI-AD FSA Brochure for details). The maximum that employees can elect on out-of-pocket Health related expenses is $2,700.
Child and dependent care costs for qualified individuals. Tuition costs for private schools are excluded. The maximum contribution is $5,000 per year. Claim forms are available in Human Resources and should be submitted be submitted to TRI-AD directly.
There is a monthly fee of $6.00 for enrolling in one or both FSA plans.
Employees should calculate anticipated costs carefully.
Amounts not claimed by the end of the year for Dependent Care will be forfeited.
Amounts left in a Health Flexible Spending Account, up to $500 may be carried over into the next plan year. There is a monthly administration fee of $6.00 applied for any balances that are carried over into the next plan year.
Once an employee signs up to participate in the plan, he/she cannot stop or change contributions unless they or a dependent experiences a material change in economic circumstances.
These are provisions under Section 125 of the IRS Code. Questions regarding qualified deductions should be directed to TRI-AD at (888) 844-1372.
As a new hire, enrollment must be made within 30 days of the date of hire, using the Employee Online System.
The Out-of-Pocket Health Care and Dependent Care deductions are effective the first of the month following date of hire.
If enrollment is not completed within 30 days of hire, employees must wait until the next open enrollment period.
Active, benefitted employees, can enroll in a FSA plan during the Open Enrollment period using the Employee Online System. Coverage is effective January 1st.
Per Section 125 of the IRS Code, once started, this plan cannot be stopped or changed unless:
The employee and/or a member of his or her family experiences a "material economic change."
The employee separates service from the City of Riverside.
Additional Life Insurance
This is a City-paid life insurance plan through Standard Insurance and is available to benefitted employees only. The value of the life insurance may differ between bargaining units; please refer to the Life Insurance Highlights. Additional life insurance coverage is available to all benefitted employees and eligible dependents; for more information please review the brochure below.
- Enrollment is automatic for benefitted employees.
- Beneficiary Designation can be completed via the Standard Online portal. Employees may change beneficiaries at any time.
The City of Riverside Human Resources Department and Standard Insurance Member Services are also available to answer questions.
Legal Service Plan
The City of Riverside is excited to offer LegalGUARD; an affordable optional legal insurance plan underwritten by Nationwide that protects members from unexpected personal legal issues.
Benefits are designed to meet the typical needs of an employee and their family. There are no deductibles to worry about for covered services. Benefits cover the attorney’s time. Other costs such as filing fees or court costs are not covered. Please visit the LegalGUARD website for a list of matters that are covered and detailed plan information. This plan offers the convenience of in-network and out-of-network benefits.
The LegalGUARD Plan is only $17.54 per month, via payroll deduction. Deductions are after-tax.
The Member’s spouse, or domestic partner, the parents of the Member or their Spouse, and Member’s unmarried dependent children, including stepchildren, legally adopted children, children placed in the home for adoption and foster children, up to age 19, and from age 19 up to 26 years if they are enrolled in an accredited school or college as full-time student(s) and are primarily dependent upon the Member for support.
Frequently Asked Questions
Open enrollment will take place November 1 through November 22, 2019. All benefit changes and/or new enrollments must be submitted using the Employee Online system no later than 5:00 p.m. on Friday, November 22, 2019.
Open Enrollment changes, including medical and dental plan changes, dependent additions/deletions, health opt-out, and Flexible Spending Account will have to be done through the Employee Online system.
The Open Enrollment Employee Online system is accessible through the City’s intranet or through the City’s internet (www.riversideca.gov). From the City’s internet, first click on 'Services', then 'Online Services' link, and then on the 'Employee Online' link. From the intranet page, you must click on the “Employee Online” link.
Your login is your 5 digit employee identification number. If you have forgotten your password and have an e-mail on file, you can utilize the “I forgot my password” link located on the main login screen. A temporary password will be e-mailed to the e-mail address on file. You can also contact the IT Help Desk at (951) 826-5508 during normal business hours (M-F, 8-5) to have it reset.
If you are on an approved leave of absence during the Open Enrollment period you can still access the Employee Online system through the City’s internet (www.riversideca.gov) under 'Services', then 'Online Services' link, and then on the 'Employee Online' link. If you need further assistance, please contact the Human Resources Benefits Team at (951) 826-5639.
If you are not making changes to your existing medical or dental plan, these plans will carry over to the 2020 plan year. If you participated in the Health opt-out program or Flexible Spending Accounts (FSA) during 2019 and wish to continue during 2020, you must renew your selection.
Yes, you may access the Open Enrollment system as many times as you need during the Open Enrollment period and make additional changes to any online changes submitted up until November 22nd by 5:00 p.m. You must first delete any existing pending requests before you can submit a new one. Please contact Human Resources at (951) 826-5639 if you experience any problems.
Plan summaries and 2020 rate information for the various Health and Dental plans can be found on the Human Resources Benefits webpage under the “Open Enrollment” link.
Medical and dental premiums are paid a month in advance; therefore, benefit premiums for 2020 will be reflected on your first paycheck in December.
Any plan changes made during the Open Enrollment period to your medical and/or dental coverage and flexible spending accounts will be effective January 1, 2020. Coverage effective date for Additional Life Insurance and Long Term Disability will vary based on the completion of the medical underwriting process (as applicable).
You will need to submit your address changes through the Employee Online system. Once you have accessed the system, under Personal Information, click on "Home Address", click on "Update Record", make any necessary changes and click submit.
If you miss the Open Enrollment deadline to submit changes to your medical and/or dental plans, add eligible dependents, or enroll in Flexible Spending (FSA) you will need to wait until next year's Open Enrollment season to make these changes; unless you experience a Qualifying Event.
If you have a Qualifying Event (marriage, birth of a child, loss of coverage, etc.) during the month of November (1st-30th), you may add eligible dependents to your medical and/or dental plan within 30 days of your qualifying event. Please note that qualifying events during the month of November are handled separately from Open Enrollment changes. Coverage effective date for Qualifying Events may be December 1, 2019 or January 1, 2020, depending on the qualifying event. To submit your request, you will need to complete paper enrollment forms (only for qualifying events in November); please contact the Benefits division at (951) 826-5639 to obtain forms.
Enrollment requests for Additional Life Insurance are accepted through The Standard's website. Employees interested in applying for Additional Life Insurance can access the link via the Standard's Web Portal system; simply click on "Add'l Life Ins" link.
Employees in the Fire and Police Units may enroll in LTD coverage through their respective associations. IBEW Field employees are automatically enrolled in LTD coverage.
Confidential employees hired on or after January 1, 2016, Executives, Management, Para-Professional, Sr., Professional, and Supervisory employees are eligible to enroll in LTD at any time. Requests must be submitted directly with The Standard and the link can be accessed through Employee Online by clicking on the LTD link.
Eligible dependents that you may want to add to your medical and/or dental plan are outlined in Personnel Policy V-9 Health Insurance and include:
- Spouse – A spouse as defined or recognized under State law or registered domestic partner
- Child – a biological or adopted child, a stepchild or a legal ward (guardianship)
- Grandchild (Legal dependent other than child) – a biological, adopted or step-grandchild for whom the employee has legal guardianship
- Disabled child - over the age of 26
Per the Health Care Reform Law, eligible dependents can be covered under the employee's health plan up to age 26. The City has also extended Dental and Vision coverage to these dependents. Any child over the age of 26 can continue coverage with certification provided by the insurance carrier.
If you have added an eligible dependent during the Open Enrollment period, you must submit supporting documentation to the Human Resources Benefits Division by 5:00 p.m. on November 22, 2019. Be sure to indicate your 5 digit employee ID number at the top right hand side of any documentation. Please refer to the Dependent Verification information sheet for additional information.
Yes, you may email a scanned copy of the documentation to firstname.lastname@example.org or fax it to 951-826-2421 or you may stop by the Human Resources Office and drop off a copy personally. All documentation must be submitted by 5:00 p.m. on November 22, 2019.
If dependent information (social security number, date of birth, address, etc.) is listed incorrectly in the Employee Online system, you may correct it by clicking "Dependent Information” and selecting the appropriate dependent. You will be redirected to another screen where you will be able to override existing information with correct information. When finished click the “save” button. Please note that name changes/corrections are not allowed, if you need to correct or change a dependent's name, please contact the Benefits division at 951-826-5639.
You may add a dependent to the “Dependent Information” screen; simply click on the “add record” button and complete all required information about your dependent. Per the Federal Health Care Reform reporting requirements, all employees must provide a valid Social Security Number (SSN) for each dependent. Keep in mind that adding dependents to the “Dependent Information” screen DOES NOT add them to your medical and/or dental coverage; please refer to subsequent questions for additional information.
If you wish to drop an existing dependent from your medical and/or dental coverage you may do so by following these easy steps:
- Click on Benefit Selection link.
- Click on the Medical/Dental link under Coverage Type.
- On the "Update Open Enrollment Benefit" screen uncheck only the box next to the dependent(s) you wish to remove from your coverage (Note: An unmarked checkbox next to the dependents name will tell the system you do not want to enroll that dependent into your plan.)
- If applicable, check the arbitration certification checkbox to acknowledge that you have read and agree to the arbitration language.
- Click the "Save" button to process your request.
If you are enrolling in a Blue Shield HMO plan, you will need to designate a Primary Care Physician (PCP) for yourself and each covered dependent. You do not need to designate a PCP if you are enrolling in the Blue Shield PPO plan or one of the Kaiser HMO plans. The PCP provider ID can be found on the Blue Shield website: blueshieldca.com/cor, under the "find a doctor" link. Once the PCP provider ID is located, you will need to copy and paste the 9-digit number on the Employee Online system. Be sure to verify you and your covered dependents are assigned to the correct PCP and medical group upon receipt of your membership card(s). If you need to change or correct your PCP or medical group, please contact Blue Shield at 855-599-2657.
For new Delta Care HMO members, you must contact Delta Care to designate a primary dentist at 800-422-4234 any time after December 22, 2019
If an employee is hired on the 1st, 2nd or 3rd of the month, then benefits are effective the first of the following month. Employees hired on the 4th through the end of the month must wait 30 days from the hire date and benefits become effective the first of the following month. Example: Hire date is June 15th, 30 day probation is till July 15th, and benefits become effective August 1st.
Spouse, domestic partner, children, step-children, adopted children and grandchildren or step-grandchildren for whom the employee has legal guardianship.
Yes, your dependent will not be eligible for coverage without a copy of the required documentation.
Contact the health and/or dental provider to find out the status of the card. Please refer to the Provide Directory link for telephone and website information.
Yes, you have 30 calendar days from the date your spouse loses coverage to add him/her to your insurance plan(s). You will have to provide the City with letter or Cobra letter from the employer.
No, employees can only switch plans during open enrollment.
Open Enrollment is generally the first three weeks in November. The Human Resources Department will notify you of the exact dates via a letter sent to your home address in October.
No, the City participates in PERS: Public Employees' Retirement System. Medicare portion of Social Security is the only deduction from the paycheck; for those employees hired after 4/1/86.
- Does HR need a copy of the claim form? No, HR does not need a copy of the claim form. Employees must submit to TRIAD directly.
- Who is responsible for reimbursing me and when can I expect the check ...biweekly or monthly? TRIAD will reimburse you the money according to how much is in the account. If the cost incurred is more then what is in account, TRIAD will only reimburse amount in account and then will send you a check biweekly till you have been reimbursed.
No, participation in the Flexible Spending Account plans must be renewed each calendar year during the Open Enrollment period. You must renew your contribution by following the steps indicated in the question below. If you do not submit a new request, participation in an FSA plan will terminate effective 12/31/19. The Flexible Spending Account (FSA) Health Care Plan has a carryover provision and balances up to $500 will be carried over automatically with no need to re-enroll in the plan. However, if you elect not to enroll for 2020, but you have a carryover amount, you will be responsible for the $6 monthly administrative fee for the entire calendar year.
To enroll in one or both of the Flexible Spending Account (FSA) programs: Start by clicking on the “Benefit Selection” link in Employee Online, then follow the steps below:
- Click on the "FSA Health Care or FSA Dependent Care" link.
- On the Add Open Enrollment Benefit screen, enter an Annual Deduction Amount.
- Click on the "Save” button to submit your request.
The maximum annual contribution for the Health Care Spending account is $2,650. The maximum annual contribution for the Dependent Care Spending account is $5,000. Contributions will be deducted from your paycheck bi-weekly for 24 out of 26 pay periods.
The administrative annual fee to participate in either the FSA Health Plan, Dependent Plan or both is $72 ($6 monthly deduction taken from first paycheck of the month).
You may contact Tri-AD regarding the FSA plan(s) via phone at 888-844-1372 or visit their website at www.tri-ad.com.
The Flexible Spending Account (FSA) Health Care Plan has a carryover provision and balances up to $500 will be carried over automatically with no need to re-enroll in the plan. However, if you elect not to enroll for 2020, but you have a carryover amount, you will be responsible for the $6 monthly administrative fee for the entire calendar year. Employees may also contribute the annual limit of $2,650 and could potentially have a total annual spending amount of $3,150 for 2020. There is no carryover provision for Dependent Care, therefore any unused contributions to the Dependent Care account will be forfeited at the end of the year. Therefore, make sure you allocate annual contributions conservatively.