Open Enrollment for 2020 Plan Year

Open Enrollment is your annual opportunity to consider your benefit needs and options, and to make changes if needed. ACERA’s Open Enrollment period for group plans is November 1 – November 30, 2019; you can change your Kaiser Permanente or UnitedHealthcare medical plan, you can change your Delta Dental plan, you can change your vision plan, and you can add or drop medical, dental, and vision coverage for your eligible dependents. Open Enrollment for an individual medical plan through Via Benefits is depicted in the chart below.

How to Enroll During Open Enrollment

Requests for changes for all plans (except Via Benefits plans) must be made in writing to ACERA. ACERA accepts faxes of completed enrollment forms faxed to 510-268-9574. We also accept scanned copies of completed enrollment forms emailed to Emailed and faxed enrollment forms must be time stamped by 11:59 pm PST on November 30, 2019. Mailed enrollment forms must be postmarked by November 30, 2019. See the bottom of this page for enrollment forms.

If you’re enrolling in a plan through Via Benefits, you must conclude your enrollment with Via Benefits by the dates specified in the chart below. You must contact Via Benefits by phone or through the Via Benefits website. Instructions for enrollment through Via Benefits can be found in the Retiree Enrollment Guide linked below.

Open Enrollment Periods

 ACERA Open Enrollment Periods and Plan Years

ACERA Healthcare Plans Open Enrollment Period Plan Year
Kaiser Permanente HMO California (non-Medicare) November 1, 2019 -
November 30, 2019
February 1, 2020  – January 31, 2021
Kaiser Permanente Senior Advantage California (Medicare)
UnitedHealthcare SignatureValue HMO and SignatureValue Advantage HMO (non-Medicare)
Delta Dental
Vision Service Plan (VSP)
Via Benefits Non-Medicare Plans November 1, 2019 -
December 15, 2019
January 1, 2020 – December 31, 2020
Via Benefits Medicare Plans October 15, 2019 -
December 7, 2019


Look For it in the Mail Mid-October

All retirees and payees receive a packet in the mail in mid-October.

Open Enrollment 2020 Packet

2020 Retiree Enrollment Guide

Open Enrollment Letter

Making Your Via Benefits Reimbursements Easier

2019 Health Fair Pamphlet

Kaiser Permanente Flyer - Get More From Your Health Plan

VSP Flyer - What Do Your Eyes Say About You?

Delta Dental Flyer - Preventing Gum Disease May Reduce Alzheimer’s Risk

Group Plan Enrollment Forms

Medical Plan Enrollment Form

Dental Plan Enrollment Form

Vision Plan Enrollment Form

Other Relevant Forms

Affidavit of Dependent Eligibility

Affidavit of Domestic Partnership

Medicare Part B Reimbursement Plan (MBRP) Application Form

Medicare Part D Creditable Coverage Notice

Medicare Part D Creditable Coverage Notice