ADD/DELETING DEPENDENTS

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If you are adding dependents (spouse and/or children) and changing plans or type of coverage (employee only, employee + 1, or Family) you will need to:

1.   Make your plan and/or coverage change in ESS;

2.   Submit an enrollment form with the dependent information listed; and

3.   Upload supporting documentation (birth certificates and/or marriage license). 

 

CASH IN LIEU

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If you wish to decline benefits and select Cash in Lieu this year please login to ESS and select “I DECLINE” for your benefit plan selection.  Use the Health Plan Enrollment form and select “Cash in Lieu” and upload documentation showing other group coverage (Covered California and Medical do not qualify).  You will not be allowed to switch to Cash in Lieu unless you show proof of other group health plan coverage. 

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Click HERE for the Health Plan Enrollment Form (use only for adding or deleting dependents only)

Click HERE for the Dental/VSP Enrollment Form (use for adding/deleting plan and/or dependents)

 

Questions – Benefits (510) 231-1159