Below are new employee and health forms for you to review and fill out. Please bring these forms with you for your orientation along with the I-9 and SSA forms given to you with your offer letter. During your orientation, these forms as well as health benefits and City policies will be discussed in detail.
The attachment City Contribution describes how much the City will contribute towards your health premium. The attachment 2018 Bay Area Regional Premiums tells you how much the premiums will be through 2018 depending on which health plan you choose. If the premium is less than the City contribution, then there is zero out-of-pocket cost towards your health premium. If the amount is greater than the City contribution then you will pay the difference towards your monthly premium. If you wish to NOT enroll in health coverage with the City, then fill out the Health Insurance Waiver Form (attached below).
*Please note: The 2019 Bay Area Regional Premiums which will be effective January 1, 2019.
Also, Blue Shield will not be covered in many Bay Area counties including Alameda County beginning 2019.
The Human Resources Summary of Benefits page and the CalPERS site for Plans and Rates will provide you with more detail on your health coverage and rates.
Let us know if you have any questions.
HR TEAM!
510-747-4900
2263 Santa Clara Ave, City Hall Rm 290
2 forms of ID (one being your Social Security Card)
1. Signed Offer Letter
3. SSA-1945
5. Reciprocal self Certification
7. W-4 - 2018
9. Authorization for Direct Deposit
10. Paperless Paycheck Stub Request
If you wish to enroll any dependents in health coverage, please bring your marriage certificate and any birth certificates (for dependent children).
4. Vision Enrollment (optional)
5. Supplemental Retirement Beneficiary Designation
6. Life, AD&D and Disability Insurance
Vision The Vision Service Plan (VSP) is a voluntary benefit, fully paid by the employee except safety personnel who split the premium 50/50 with the City. Please review the Summary of Benefits provided below to learn more about your coverage and copays. |
Delta Dental Dental enrollment is mandatory for all benefitted employees. This benefit is fully paid by the City of Alameda, and any eligible dependents can be enrolled or unenrolled during this season. Please review the Summary of Benefits provided below to learn more about your deductibles and services covered. |
Discovery Benefits Inc.
For enrollment in the remaining 2018 calendar year, please call the Human Resources Department.
Transportation Savings Account (TSA)
Discovery Benefits Inc. will continue to provide a Transportation Savings Account (TSA), also commonly known as a Commuter Check Program. Employees interested in setting aside pre-tax funds for Parking or Mass Transit expenses, are encouraged to apply. There will be no Administrative Fee attached to this benefit, however, if an employee enrolls in the TSA benefit and either FSA program offered by DBI, the administrative fee for the FSA program will be reduced to $4.00/month. See the publications listed below to learn more about the benefits provided by the TSA program.
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Flexible Spending Account (FSA)
Enrollment in the Discovery Benefits Inc. (DBI) FSA Health Care Reimbursement and the Dependent Care program requires an annual election. This means you must submit a new form even if you are setting aside the same amount as previous years. Through this program, employees are allowed to set aside pre-tax funds in the amount of $5,000 per calendar year ($2,500 if parents are filing taxes separately) for eligible dependent care expenses, or up to the legal limit of $2,650 per calendar year, for eligible health care expenses. DBI will provide all participants a free debit card that can be used for health care expenses, in lieu of requesting reimbursements. A monthly administrative fee will be deducted, in addition to the annual election amount, in the amount of $4.75/month. See the benefits guide provided below, to determine if this is a voluntary benefit you want to elect.
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