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.
Enroll here: CBJ/BRH/JSD Benefit Enrollment Site
Important Benefit Documents
- CBJ Benefit Guide 2023-2024
- BRH Benefit Guide 2023-2024
- JSD Benefit Guide 2023-2024
- 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 Plan Books
- 2022-2023 Premera Medical Plan Book
- 2021-2022 Premera Dental Plan Book
- 2022-2023 Premera Vision Plan Book
Benefit Plan Comparisons
Premera Plan Summary of Benefits
- CBJ *HDHP* Summary of Benefits 2023-2024
- JSD *HDHP* Summary of Benefits 2023-2024
- BRH *HDHP* Summary of Benefits 2023-2024
- CBJ *Economy Plan* Summary of Benefits 2023-2024
- JSD *Economy Plan* Summary of Benefits 2023-2024
- BRH *Economy Plan* Summary of Benefits 2023-2024
- CBJ *Standard Plan* Summary of Benefits 2023-2024
- JSD *Standard Plan* Summary of Benefits 2023-2024
- BRH *Standard Plan* Summary of Benefits 2023-2024
- 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 the TBX Platform
Life Insurance Summaries
Life Insurance Certificates
- Basic Life Insurance Certificate
- Basic ADD Certificate
- Optional Life Insurance Certificate
- Optional ADD Certificate
Employee Information & Forms
- Filing a Life/AD&D Claim
- Update beneficiaries on the TBX Platform
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.
Spending Accounts
Thinking about enrolling a Flexible Spending Account or Dependent Care Account? Review the FAQs below to help.
Flexible Spending Plan Forms and Instructions
Dependent Care Account
Setting Up your FSA/DCA Portal
- Instructions for Activating Your Account
- BAC Mobile App Instructions
- Authorization for Direct Deposit
Health Savings Account
If you are enrolled in the CBJ High Deductible Health Plan (HDHP) with no other non-HDHP coverage, you are eligible to contribute to the Health Savings Account.
Group Voluntary Benefits
Enroll in your optional benefits on the TBX Enrollment Platform.
Watch the following videos for more information:
Supplemental Plan Summaries
- Group Disability Benefit Summary
- Group Accident Benefit Summary
- Group Critical Illness Benefit Summary
- Group Hospital Indemnity Benefit Summary
Supplemental Plan Certificates
- Group Disability Plan Certificate
- Group Accident Plan Certificate
- Group Critical Illness Plan Certificate
- Group Hospital Indemnity Plan Certificate
How to File a Claim
Your Content Goes Here
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)
The City & Borough of Juneau offers employees the ability to contribute to a 457 Deferred Comp and/or a 457 Roth plan in addition to the PERS Retirement plan. To get started in this plan, go to:
- City & Borough of Juneau employees: www.msqplanservices.org/myplan/301285
- Bartlett Hospital employees: www.msqplanservices.org/myplan/302663
Important to Know:
- Changes to employee contributions must be made online at the employee portal above or by calling 1-800-669-7400
- Changes can now be made bi-weekly. The cutoff is Sunday prior to payday
- NEW JULY 2023–TIER IV EMPLOYEES–Now when you contribute to the Mission Square 457 DC/Roth plan, the CBJ will match your contribution by up to 50%, depending on your years of service. For more information, see the MSQ CBJ Match FAQ 2023.
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!