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Retiree Health Care Information
It's Open Enrollment Time again. Forms are due November 11, 2016!

All retirees covered or eligible for medical benefits with the City received an email with all the necessary attachments to be completed. The forms are provided here again for retirees and their covered spouses.

The City's Medical Plan is again, Plan A. Information about that plan is included below.

Retiree Under 65 and Covered Spouse, both under age 65 

Letter to Retirees (Read First)

City Medical Plan A

Under 65 Retiree Optional Plan B


Under 65 Retiree Optional Plan C

Under 65 Retiree Optional Plan D

Under 65 Declaration of Eligibility for Dependent Coverage

Enrollment Forms for Under 65:

HealthComp Form Under 65 with BOTH Dental & Vision Coverage

HealthComp Form Under 65 with Dental Coverage ONLY

HealthComp Form Under 65 with Vision Coverage ONLY

HealthComp Form Under 65 with NO Additional Coverage



Retiree and Covered Spouse, with one over age 65 and one under age 65

Letter to Retirees (Read First)

Over/Under 65 City Medical Plan A

Over/Under 65 Retiree Optional Plan B

Over/Under 65 Retiree Optional Plan C

Over/Under 65 Retiree Optional Plan D

Over/Under 65 Declaration of Eligibility for Dependent Coverage


Enrollment Forms for One Over 65, One Under 65:


HealthComp Under/Over 65 with BOTH Dental & Vision Coverage

HealthComp Under/Over 65 with Dental Coverage ONLY

HealthComp Under/Over 65 with Vision Coverage ONLY

HealthComp Under/Over 65 with NO Additional Coverage




Retirees and Covered Spouse, both over age 65

Letter to Retirees (Read First)

Over 65 Declaration of Eligibility for Dependent Coverage

Enrollment Forms for Over 65:

HealthComp Form Over 65 with BOTH Dental & Vision Coverage

HealthComp Form Over 65 with Dental Coverage ONLY

HealthComp Form Over 65 with Vision Coverage ONLY

HealthComp Form Over 65 with NO Additional Coverage