Retiree Open Enrollment

Retiree Open Enrollment is held during November of each year. Open Enrollment information is mailed by the end of October to all retirees currently enrolled in a County healthy plan. View the 2019 Open Enrollment video.

Go Green. Go Paperless. Reduce your environmental impact by signing up to receive Retiree Open Enrollment communications from the Employee Benefits and Services Division (EBSD). Please contact the EBSD at ebsd@hr.sbcounty.gov to update your email address on file.

Important Dates for 2019 Retiree Open Enrollment


2019 Retiree Open Enrollment Materials

2019  Open Enrollment Communications

2019 Open Enrollment Presentations


2019 Retiree Open Enrollment Forms

Kaiser Permanente

Kaiser Senior Advantage HMO
Enrollment Form
Disenrollment Form

Blue Shield

Blue Shield 65 Plus (HMO) Medicare Advantage
Enrollment Form
Disenrollment Form
Blue Shield Medicare Rx Plan (PDP)
Enrollment Form

Disenrollment Form

Delta

Please complete the County of San Bernardino Retiree Dental Plan Enrollment/Change Form (see below) to enroll or make changes to coverage.

County of San Bernardino

Retiree Medical Plan Enrollment/Change Form
Retiree Dental Plan Enrollment/Change Form
Retiree Medical/Dental Plan Cancellation Form
Retiree Disabled Dependent Certification

2019 Retiree Benefits and Enrollment Guide

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