Frequently Asked Questions

Open Enrollment is your annual opportunity to make any change to your benefits. Outside of this open enrollment period, benefit changes can only be made if you experience a Qualifying Life Event.

The City’s open enrollment period is a four-week window that takes place in the fall (beginning in October and wrapping into November) where employees can select their benefit elections for the following calendar year (Jan. 1 through Dec. 31). The 2027 Open Enrollment period will take place in October and November of 2026 for benefit elections that are effective Jan. 1 through Dec. 31, 2027. The exact dates will be announced as we get closer to the window start date.

During Open Enrollment, it is important to review your current benefits to confirm they meet your personal and family needs. Access the SAP portal from Citynet through the quick links menu, and select the 2026 Open Enrollment tile to enter the benefits portal. Review your existing elections and update your medical, dental, vision, and life insurance coverage as needed. For those participating in a Flexible Spending Account (FSA), note that FSA elections do not roll over and must be re-elected each year. Supplemental employee and spouse life insurance coverage can be increased by one tier without submitting Evidence of Insurability (EOI), provided the new amount is within the Guaranteed Issue Amount (GIA). Be sure to review your life insurance beneficiary designations and submit your elections before the deadline to set your benefits for the upcoming plan year.

Yes, there are two provider changes for 2026:

EyeMed (Impacts all employees, except MEA): Beginning Jan. 1, 2026, EyeMed will be the City’s new vision provider, replacing the VSP plan. EyeMed will provide two vision plan options:

• EyeMed Silver Plan – Mirrors the current VSP plan, providing essential/basic coverage.
• EyeMed Gold Plan – Offers enhanced benefits and expanded coverage.

Important: Employees currently enrolled in the City’s VSP plan will be automatically enrolled in the new EyeMed Silver Plan, unless they make a different vision plan election during the open enrollment window.

Local 145 Cigna HMO (Impacts fire safety employees): Beginning Jan. 1, 2026, fire safety employees will have an additional Cigna HMO plan option, sponsored by the International Association of Firefighters (Local 145). This Local 145 Cigna HMO plan will replace the existing Anthem plan, effective Jan. 1, 2026.

Important: Employees currently enrolled in the Local 145 Anthem plan will be automatically enrolled in the new Local 145 Cigna HMO Plan, unless they make a different medical election during the open enrollment window.

If you do not take any action during the open enrollment window, most of your elections will carry over into the following calendar year except for the following:

Flexible spending accounts: FSA elections do not automatically roll over from one plan year to the next. If you want to enroll in the FSA for the following calendar year, you must do so during the open enrollment window.

Even if you're satisfied with your current benefits, it's a good idea to review your elections and confirm they still meet your needs.

During the open enrollment window, follow these steps: From Citynet, select the SAP Portal button located under Quick links. Then select the Open Enrollment tile. The application will walk you through the steps for reviewing, changing, and confirming your benefits enrollment.

You are not allowed to change your benefits outside of the enrollment window, unless you experience an IRS qualifying life event (birth of a child, marriage, etc) and you report the event and provide the necessary documentation within 30 days. Visit the Qualifying Events website for more information.

Yes. Flexible Spending Account (FSA) elections do not roll over and must be re-elected each year.

If you need assistance during Open Enrollment, help is available through several convenient channels. You can contact the Employee Benefits team by emailing Benefits@sandiego.gov or by calling 619-236-5924 and selecting option 1 in the phone tree. You may also request a one-on-one appointment, or attend a benefits fair or virtual drop-in session.

Changes made during Open Enrollment take effect on January 1 of the following year.

If you are enrolling new dependents to your health plan or enrolling in supplemental life insurance coverage for your spouse/domestic partner or child(ren), you must submit dependent verification documents (birth certificate, marriage certificate, etc.) to Benefits@sandiego.gov within 30 days of your enrollment deadline. If you fail to provide dependent verification, your dependents could be disenrolled. Review the Eligible Dependents document for a full list of dependent verification documents.

Yes, you should still complete your Open Enrollment elections even if you're planning to separate from City service. Doing so helps ensure continuity of coverage and may support eligibility for COBRA, especially if your retirement plans change.

PEHRA (Post-Employment Health Reimbursement Account) is a City-funded retiree health benefit designed to help eligible employees pay for health care expenses after they leave City employment.

If you satisfy the applicable age and service requirements under the program, a PEHRA account will be established in your name and funded by the City in accordance with the program's provisions. After you separate from City employment, you may use the funds in your account to reimburse eligible health care expenses in accordance with the plan's rules.

PEHRA is not a health insurance plan and does not provide medical coverage. Instead, it is a reimbursement account that can be used to help offset qualifying health care costs incurred after employment ends.

PEHRA is intended for eligible employees who were hired on or after July 1, 2005 that are on active City payroll as of July 1, 2026, or hired thereafter.

PEHRA has been approved for eligible employees represented by MEA, Local 127, and DCAA in contract negotiations.

Negotiations with Local 145, POA, and Local 986 are still ongoing. Information regarding PEHRA for employees represented by these bargaining units will be provided once negotiations have concluded.

Information regarding PEHRA eligibility for classified-unrepresented and unclassified-unrepresented employees will be provided after the conclusion of negotiations with Local 145, POA, and Local 986.

Please note that being part of a covered employee group does not automatically result in a PEHRA account. Employees in covered groups become eligible for a PEHRA benefit only after satisfying the plan's age and service requirements. Once those requirements are met, the City will establish and fund a PEHRA account in accordance with the plan's provisions.

Non-safety employees (general members) covered under PEHRA will become eligible for the PEHRA benefit when they meet the following age and service requirements:

• Age 55 (or older) with 20 or more years of eligible City service; or
• Age 62 (or older) with 10 or more years of eligible City service

Eligible City service does not include time working in non-standard hour positions.

Once you meet the applicable age and service requirements, the City will establish your PEHRA account and apply the funding.

No. There are no employee contributions applicable to PEHRA.

The amount the City contributes to your PEHRA account depends on when you satisfy the plan's age and service requirements.

For non-safety employees (general members), the maximum PEHRA funding amount is available to those who become eligible at age 55 with at least 20 years of eligible City service. Funding amounts are reduced on a prorated basis for employees who become eligible at later ages.

For non-safety employees (general members) who become eligible at age 62 or later with at least 10 years of eligible City service will receive an initial PEHRA funding amount based on their age and years of service when eligibility is attained. Additional PEHRA funding may be provided as eligible service is earned after initial eligibility, in accordance with the applicable funding schedule.

Employees must have at least 10 years of eligible City service to be eligible for PEHRA funding. Employees do not accrue additional funding amounts above 20 years of eligible City service.

Please refer to the PEHRA Funding Tables for Non-Safety Employees (General Members) for the specific funding amounts applicable to your circumstances.

• The contribution amount for a PEHRA-eligible non-safety employee (general member) who has at least 20 years of eligible City service when they are first eligible for funding is set forth in Table 1.
• If a PEHRA-eligible non-safety employee (general member) first becomes eligible for funding when they have at least 10 years but less than 20 years of eligible City service, the City’s initial contribution will be in the amount set forth in Table 2A. If the PEHRA-eligible employee is funded under 2A and continues to work for the City, the City will make additional annual contributions to the employee’s PEHRA account in the amounts set forth in Table 2B for each full year of eligible City service the employee accrues, until the employee retires from City service or has 20 years of eligible City service, whichever comes first.

The funding amounts are based on actuarial calculations used to project average life expectancy based on age and gender; these projections vary slightly between males and females.

Funding of PEHRA accounts is scheduled to begin on July 1, 2028. This means that covered employees who already meet the plans age and service requirements as of that date will have a PEHRA account established and funded shortly thereafter. Employees who meet the eligibility requirements in the future will have their account funded within about 60 days of their eligibility date.

PEHRA funds may be used to reimburse eligible post-employment health care expenses, subject to applicable plan rules and IRS requirements. Expenses include health plan premiums, prescription costs, co-pays, and other out-of-pocket expenses.

No. PEHRA can only be used to help pay for eligible health care expenses after separation from City employment.

• If you have at least 10 years of eligible City service by the time you separate from employment, your PEHRA account will be funded by the City once you reach age 62 (for non-safety employees).
• If you separate from the City with less than 10 years of eligible City service, you will not qualify for a PEHRA benefit.

No. You do not have to retire under SDCERS to qualify for a PEHRA benefit. Eligibility for PEHRA is based on satisfying the plan's age and service requirements. Employees who separate from City employment with at least 10 years of eligible City service may still become eligible for a PEHRA benefit upon reaching the applicable age requirement, subject to the plan's terms.

No. PEHRA is a reimbursement account funded by the City. It is not a health insurance plan. Instead, eligible participants may use PEHRA funds to reimburse qualifying health care expenses after employment ends.

Effective July 1, 2026, the City's Retiree Medical Trust (RMT) Plan for non-safety employees closed to new participation. The plan was available only to non-safety employees hired on or after July 1, 2009. Employees hired on or after July 1, 2026, are no longer eligible to participate in the RMT Plan.

Payroll contributions to the RMT Plan are also ending for current participants:

• July 17, 2026 – Last paycheck with RMT contributions.
• July 31, 2026 – First paycheck with no RMT contributions.

Your RMT account will remain open and continue to be maintained on your behalf. Although no additional contributions will be made after the July 17, 2026 paycheck, your existing account balance will remain invested according to the plan's investment options. Your account will continue to earn or lose value based on investment performance and will be available after you separate from City employment to reimburse eligible healthcare expenses, subject to the terms of the plan.

No. The RMT Plan does not allow participants to cash out their account balances or roll over their funds into another retirement plan, Health Savings Account (HSA), Individual Retirement Account (IRA), or other account.

No action is required. If you are currently participating in the RMT Plan:

• Payroll contributions will end automatically after the July 17, 2026 paycheck.
• Your account will remain active and invested.
• Your account will continue to be available after you separate from City employment for reimbursement of eligible healthcare expenses, in accordance with the plan.

Form 1095-C, also called the “Employer-Provided Health Insurance Offer and Coverage” form, is a tax document that provides information about the health insurance coverage offered to you by your employer.

Under the Affordable Care Act (ACA), certain employers are required to offer health coverage to eligible employees and report that information to the Internal Revenue Service (IRS). Form 1095-C is how that information is reported.

Only employees enrolled in the City’s Flexible Benefits Plan for at least one month in the applicable tax year will have a Form 1095-C. This includes those that waived medical coverage.

• Active Employees: Active employees can access their 1095-C online. From Citynet, access the SAP portal. From there, select the “Access Benefits Info” tile, then select the “Form 1095-C” tile. Select the applicable tax year to generate the form.
• Separated Employees: If you are a separated employee, contact benefits@sandiego.gov to request a copy of your 1095-C.

You do not need to attach Form 1095-C to your federal tax return. 1095-C is for informational purposes only. However, you should:

• Keep it with your tax records
• Use it as a reference if you are asked about your health coverage when filing your taxes

If you have questions about how this form affects your personal tax situation, please consult a tax advisor.

Your Form 1095-C includes:

• Your name, address, and Social Security number
• Your employer’s name and contact information
• The months you were offered health coverage
• The lowest-cost premium available to you for self-only coverage

No. Form 1095-C does not include information about your enrolled dependents.

If you are looking for documentation that confirms the months your dependents were enrolled in medical coverage, that information is reported on a separate form called Form 1095-B.

For questions about Form 1095-B, please contact your medical insurance carrier using the phone number listed on the back of your medical ID card.

If you have questions related to your Form 1095-C, please contact benefits@sandiego.gov for assistance with the following:

• Questions about the information shown on your Form 1095-C
• Difficulty accessing your Form 1095-C
• Reporting a potential error on your Form 1095-C

For questions about how Form 1095-C may impact your personal tax return, we recommend consulting a qualified tax professional.

To qualify for the flexible benefit plan, you must be working in a standard hour position as a full-time, half-time, or three-quarters time employee.

Employees working in a seasonal, provisional, or other non-standard hour position are not eligible for the flexible benefits plan. For questions about your eligibility, contact Employee Benefits at benefits@sandiego.gov or 619-236-5924 (option 1).

You can enroll your spouse/domestic partner or children in your health plans, as long as they meet the eligibility criteria and you provide the required dependent verification documents by the documentation deadline. For more information, review the Eligible Dependents document.

No, the City of San Diego does not allow dual enrollment in its health plans. If both you and your spouse or child are City employees:

• Each of you may enroll in individual coverage for yourselves, or
• One of you may enroll in coverage that includes the other as a dependent, while the other must waive coverage for that specific health plan.

This policy ensures compliance with plan rules and prevents overlapping coverage under City-sponsored health benefits.

The City provides funds in the form of Flexible Benefit Plan (FBP) Credits to assist with the payment of health plan premiums, basic life insurance premiums, and flexible spending accounts. The amount of FBP Credits you receive depends on three factors: your bargaining unit (union), your most recent hire date, and whether you are covering dependents under your medical plan. On the following pages you will find seven different FBP Credit tables for each of the City’s unions/employee groups.

If the total cost of your health plan options is less than your allocated FBP credits, the excess credits may or may not be forfeited. Depending on your most recent hire date and medical dependent coverage level, employees may have the option to allocate any excess credits to the 401k plan, referred to as 401k Flex contributions or to cash out the remaining amount as taxable income. If these options are not available to you, the excess FBP credit amount will be forfeited.

If the total cost of your health plan options exceeds your allocated FBP credits, the excess cost will be deducted from your paycheck on a pretax basis. However, if your domestic partner is not a tax dependent, a portion of the premium will be deducted on a post-tax basis.

The City’s payroll is processed bi-weekly, whereas the FBP is on a semi-monthly schedule. This means that there are a couple paychecks each calendar year where there are no FBP credits issued and no premium deductions collected for medical, dental, vision, FSA, and basic life insurance. For the calendar year 2026, FBP transactions will be skipped on the following paycheck dates:

• January 16, 2026
• July 17, 2026

If you enroll or increase your supplemental life insurance outside of your initial enrollment window or outside of the open enrollment window, you will be required to provide evidence of insurability (EOI).

During your newly eligible 30-day enrollment window, The Hartford offers a special option to those that enroll in Supplemental Life Insurance, in which evidence of insurability (proof of good health) will not be required for new enrollments up to the guaranteed issue amount (up to $250,000 for yourself and up to $50,000 for your spouse/domestic partner).

During Open Enrollment, you may increase your coverage by one tier (up to the Guaranteed Issue Amount) without submitting Evidence of Insurability (EOI).

If you elect coverage above the GIA, you will receive a letter in the mail from The Hartford within 30 days of making your election with instructions for completing the EOI steps online. There is no EOI requirement for enrolling in Child(ren) Life Insurance.

If both you and your spouse or child are employed by the City, each employee may enroll in supplemental life insurance coverage for themselves. However, the City’s plan does not allow dual enrollment in supplemental coverage for the same individual. This means:

• Both employees may elect supplemental life insurance for themselves only, or
• One employee may elect supplemental coverage for themselves and their spouse or child, while the other waives supplemental coverage.

This ensures that no individual is covered under more than one supplemental life insurance policy at a time. For help determining the best coverage arrangement for your household, contact Employee Benefits at benefits@sandiego.gov or 619-236-5924 (option 1).