Open Enrollment 2018

Welcome to Open Enrollment for 2018-2019!
Elections made during this time will be effective 7/1/2018 and reflected on the 7/20/2018 paycheck.

All changes must be indicated on the 2018 Open Enrollment Payroll Deduction Form and must be accompanied by the appropriate forms.  Forms are provided under each topic area below.

2018 Open Enrollment Form - Active Employees
2018 Open Enrollment Form - Retirees

Click here to view the Open Enrollment presentation for 2018-2019.

Cost information for all City benefits may be viewed



Employees may choose from one of three different plans listed below.
Plan Options Comparison Sheet

Plan Additions for 7/1/2018

Buy Up

Summaries of Benefits and Coverage

Buy Up

Blue Cross Blue Shield Link

BCBS Enrollment Form


Employees may choose to participate in a Flexible Spending Account (FSA) if they are in the Base or Buy Up plan, or an HSA if they are in the HDHP plan.

What is an FSA?
How does an HSA work?
Health Equity Link

FSA Enrollment Form
HSA Enrollment Form

There is one plan offered through Delta Dental.

Plan Summary
Delta Dental Link

Delta Dental Enrollment Form


Employees may choose from the Exam Only or Buy Up plans.

Plan Summary
Savings Flyer
TruHearing Discount Offer
VSP Link

VSP Enrollment Form


The City provides Life/AD&D equivalent to one times the employee's annual salary (rounded to the next greatest thousand.)  Employees may choose to purchase additional coverage.

Plan Summary
Rate Table
Life Suite Services
Certificate of Insurance

Minnesota Life Enrollment Form


Short Term Disability income protection insurance provides a benefit for a “short term”disability resulting from a covered injury or sickness.  You may elect a weekly benefit in increments of $50, from a minimum of $100 up to a maximum benefit of $1,150 per week, not to exceed 60% of your covered earnings.  Benefits begin on the 30th consecutive day of disability and may continue for a maximum of 22 weeks.

Short Term Disability Highlights
Short Term Disability Rates

Reliance Standard Enrollment Form

Long Term Disability income protection insurance provides a benefit for a “long term”disability resulting from a covered injury or sickness.  Benefits begin after 180 days of total disability and continue to the maximum benefit duration:

Benefits will not extend beyond the longer of: Social Security Normal Retirement Age or Duration of Benefits below:
Age at Disablement Duration of Benefits
61 or less to age 65
62 3 ½ years
63 3 years
64 2 ½ years
65 2 years
66 1 ¾ years
67 1 ½ years
68 1 ¼ years
69 or more 1 year

Long Term Disability Highlights
Long Term Disability Rates (PSPRS)

Reliance Standard Enrollment Form


Benefit-eligible employees may contribute to a 457 Deferred Compensation retirement plan in order to supplement retirement savings. Employees may start, increase, decrease, or stop contributions anytime.  

The City currently offers two deferred compensation plans through the following companies:


Randall Neis - Retirement Plans Specialist


Kaity Childers - Financial Representative
(928) 853-0940
Voya Link

ICMA Enrollment Form
Voya Enrollment Form


Full-time benefit eligible employees may purchase up to ten (10) Purchase Days per fiscal year after completing six months of continuous service.  Days will be purchased at the employee's current rate of pay.  Unused days will expire at the end of the fiscal year.  These days are only available for purchase during Open Enrollment each year.

Purchase Day Program Request Form


Employees covered by medical insurance are eligible to receive a premium discount of up to $20/month with an additional $120 lump sum incentive each year.  Click here to review the program details.


The City of Flagstaff is required to provide employees with certain notices according to Federal law.  You may view these notices here.