Annual Enrollment (Nov. 6-20)


2019 Annual Enrollment Information

2019 Annual Enrollment Guide
2019 Annual Enrollment Form

Health Insurance
Health Insurance Options administered by Security Health Plan.

2019 SHP Certificate of Coverage-Large Group

Traditional Plan (380)-Schedule of Benefits
Traditional Plan (380)-Summary of Benefits and Coverage

High Deductible Health Plan with HSA (381)-Schedule of Benefits
High Deductible Health Plan with HSA (381)-Summary of Benefits and Coverage
2019 No Cost Prescription List (to be used with HDHP/HSA Plan Only)

Security Health Plan Enrollment Form*
*If you were not enrolled in the City's health plan in 2018, you will need to complete the SHP Enrollment Form in addition of the 2019 Annual Enrollment Form.

Out-of-area Dependent Coverage Form
Complete this form if you have dependents who live outside of the SHP service area.  Please complete one form per out of area dependent.

Care My Way Brochure

Traditional Plan

Monthly Rates*

Full Premium

Employer Cost

Employee Cost

Employee

$887.76

$754.60

$133.16

Employee + Family

$2051.88

$1744.10

$307.78

 

High Deductible Health Plan with HSA

Monthly Rates*

Full Premium

Employer Cost

Employee Cost

Employee

$755.52

$642.20

$113.32

Employee + Family

$1746.23

$1484.31

$261.92



Vision Insurance  (Hardware Plan Only)*
Coverage is provided by National Vision Administrators (NVA).
*Employees are automatically enrolled in the vision hardware plan if electing health insurance.
Vision Plan Benefit Summary
List of local in-network providers

Dental Insurance
Dental coverage is administered by Delta Dental. 
Delta Dental Benefit Summary
Link to PPO and Premium Providers: https://www.deltadentalwi.com/provider-search/dental/ 

Monthly Rates*

Full Premium

Employer Cost

Employee Cost

Employee

$46.17

$39.24

$6.93

Employee + Family

$141.85

$120.57

$21.28

 

Grandfathered, Non-Represented Group, and Clerical/Technical Group employees contribute 15% of premium.  Remaining employee groups (Streets, Wastewater, Parks Maintenance, Custodial, Ordinance Enforcement Officers, Police, & Fire pay 100% of premium.)


Flexible Spending Accounts(Medical and Dependent Care Available)
FSAs are administered by Employee Benefits Corporation (EBC).
Flexible Spending Account Summary Plan Description
Flexible Spending Account List of Eligible Expenses

All Flexible Spending Account enrollments must be completed online.
Online Enrollment Instructions