Benefits
This page contains forms and information about the various employee benefits offered by the City and Borough of Juneau. If you have any questions, please contact the Human Resources department.
2022-2023 Benefits Enrollment Guide
Important Benefit Documents
- CBJ Plan Comparison 2022-2023
- BRH Plan Comparison 2022-2023
- JSD Plan Comparison 2022-2023
- TBX Enrollment Platform for Life Insurance & Supplemental Benefits
- Nationwide Pet Insurance Enrollment
- 457 Deferred Comp Plan Enrollment
- Domestic Partner Affidavit – Statement of Financial Interdependence (CBJ)
- Domestic Partner Affidavit – Statement of Financial Interdependence (BRH)
- Domestic Partner Affidavit – Statement of Financial Interdependence (JSD)
- Affidavit of Marriage
Transparency in Coverage – Public Access Requirement
The Public Access Requirement is a rule that requires group health plans and issuers to provide certain price information accessible to plan participants and other stakeholders. The files must be updated monthly and include the following detailed pricing information:
- In network: Negotiated rates for all covered items and services between the plan or issuer and in-network providers.
- Out of network: Historical payments to, and billed charges from, out-of-network providers. Files are not required if there are fewer than 20 claims for a service for a provider.
- Prescription drugs: In-network negotiated rates and historical net prices for all covered prescription drugs at the pharmacy location level (this requirement is delayed pending further rulemaking).
These files can be found here: https://premera.sapphiremrfhub.com.
Policy Notices
- CMS Creditable Coverage Disclosure Notice
- CBJ HIPAA Notice of Privacy Practices 2021
- Premera Privacy Policy and Practices (External Link)
- COBRA Continuation of Benefits Notice
Benefit Coverage
- 2022-2023 Premera Medical Plan Book
- 2021-2022 Premera Dental Plan Book
- 2022-2023 Premera Vision Plan Book
- CBJ *Economy Plan* Summary of Benefits 2022-2023
- JSD *Economy Plan* Summary of Benefits 2022-2023
- BRH *Economy Plan* Summary of Benefits 2022-2023
- CBJ *Standard Plan* Summary of Benefits 2022-2023
- JSD *Standard Plan* Summary of Benefits 2022-2023
- BRH *Standard Plan* Summary of Benefits 2022-2023
- Highlights of Base Dental Coverage (CBJ)
- Highlights of Buy-Up Dental Coverage (CBJ)
- Highlights of Vision Coverage (CBJ)
Medical Forms
Prescription Claim Forms
- Express Scripts Mail Form – for employee use
- Prescription Reimbursement Form
- Secondary Insurance Rx Claim Form
Other Employee Information
CBJ Life Insurance
Enroll in Optional Life with AD&D coverage on TBX.
CBJ Life Insurance Policies
Employee Information & Forms
- CBJ Basic Life & ADD Summary
- Filing a Life/AD&D Claim
- Update beneficiaries on TBX
Additional New York Life Programs
- Healthy Rewards Program
- My Secure Advantage
- Secure Travel Program
- Program for Beneficiaries – provides bereavement and financial and legal support to your loved ones during their time of need
For more information, visit New York Life’s website.
Flexible Spending Account (FSA)
Flexible Spending Plan Information
- FSA Summary Plan Description
- Enrollment Guide (CBJ) – Not sure whether you want to participate in an FSA? Read this handout.
Flexible Spending Plan Forms and Instructions
Group Voluntary Benefits
Enroll in your optional benefits on TBX.
Watch the following videos for more information:
- Group Short-Term Disability Benefit Summary
- Group Accident Insurance
- Group Critical Illness Insurance
- Group Hospital Indemnity Benefit Summary
How to File a Claim
- Filing a Critical Illness or Accident Insurance Claim
- Filing a Short-Term Disability Insurance Claim
Nationwide Pet Insurance
PERS (Public Employees’ Retirement System)
PERS Tiers I–IV Plan Comparison Chart
PERS Tiers I–III Defined Benefit Plan Information
PERS Tier IV Deferred Compensation Plan Information
PERS Tiers I–III Beneficiary Designation Form
PERS Tier IV – designate or change your beneficiary online here.
PERS Voluntary Savings Plan Information – for Tiers I–III
PERS Voluntary Savings Plan Enrollment Form
457 Plan (Deferred Comp & Roth)
Get To Know Your 457
ICMA – enrollment is now online here.
Important Dates
Flex Spending Plan Important Dates
Don’t forget to use your Medical & Dependent Care Flex dollars! The deadline to accrue expenses towards balances from July 1, 2021-June 30, 2022 is September 15th, 2022 & the last day to submit claims is October 31, 2022.
To set up your account and track your spending, click HERE
To set up the BAC Mobile App, click HERE
Health & Dental Benefits
Open Enrollment May 23rd-June 10th, 2022
Open enrollment for employee benefits is happening May 23rd-June 10th, 2022. This is your chance to make changes to your benefit elections if you choose to. Watch for more information!
Other Benefits
Open Enrollment May 23rd-June 10th, 2022
Open enrollment for employee benefits is happening May 23rd-June 10th, 2022. This is your chance to make changes to your benefit elections if you choose to. Watch for more information!