To Make Changes
If you are interested in enrolling into a new plan or adding/removing dependents, please complete both the form for the plan you choose (available in Human Resources) and the Open Enrollment Change Notification Form(PDF) and return both to Human Resources by Friday, October 26th at 4:00pm.
To Keep Existing Coverage
If you are satisfied with your health coverage and do not want to make any changes, simply complete the Open Enrollment Change Notification Form to notify our office that you do not wish to make any change to your existing plan coverages for the 2019 plan year. For your convenience, here is a summary of all plan rates for 2019 (PDF).
2019 Plan Highlights & FAQs
Open enrollment is your opportunity to review and make changes to your medical, dental, and vision plans. During Open Enrollment you can add, delete, or change plans, or add/remove dependents from your coverage. To help navigate through Open Enrollment, we have included several frequently asked questions for your review.
The Shops offer Kaiser HMO, Anthem Blue Cross HMO & HMO Select and Anthem Blue Cross PPO.
Your plan options are:
Kaiser Plan Summary (PDF)
Kaiser Enrollment Form (PDF)
Anthem Blue Cross HMO Select Plan
Anthem Blue Cross HMO Plan
Anthem Blue Cross PPO Plan
New this year!
The Shops now offers Delta Dental of California as the Dental HMO and PPO plan options.
Delta Dental HMO
Delta HMO Plan Summary (PDF)
Delta Dental PPO
- Dental PPO Plan Summary (PDF)
Delta Dental Resources
The Shops will continue to offer the same vision plan benefits as we did last year. Our plan of choice has been VSP.
Hartford Life and AD&D Insurance
The Shops offer employer-sponsored life and disability insurance to full time employees. Below are plan summaries and services available for you.
- Hartford Basic Life and AD&D (PDF)
- Hartford Short Term Disability (PDF)
- Hartford Additional Services (PDF)
Voluntary Life and Accident Death & Dismemberment Plan
This year we will continue to offer a Voluntary Life and Accidental Death and Dismemberment Plan (AD&D). This plan will allow you to purchase additional life and/or AD&D coverage for you and your family. These voluntary plans are now offered through The Hartford and provide peace of mind that your family will be provided for should something unexpected happen.
Hartford Voluntary Plan (PDF)
Flexible Spending Account Option
The Flexible Spending Account is a voluntary plan where you elect to have automatic deductions taken from your check and put into a Flex Plan so that you do not pay taxes on that amount. The money that you elect to deduct can either be used to reimburse you for medical expenses and/or for childcare expenses that you incur during the year, depending on the deduction amounts for each plan in which you enroll.
The maximum annual contribution limit for Medical Flexible Spending Accounts is $2,650.
Benefits Waiver Program
The Forty-Niner Shops offers a Benefits Waiver Program to help manage your benefits coverage. If you have medical, dental, and vision coverage outside of the Shops, the Benefits Waiver Program pays you cash in lieu of medical coverage. You must provide proof of coverage to participate. To learn more about this program, please see the Benefits Waiver Programs summary below.