Enrollment and Change Forms


  • Enroll or make changes to your CalPERS medical plan, and complete the PERS HBD-12 Enrollment form within 30 days from the date of hire, or qualifying life event.
  • Enroll in or make changes to the City’s voluntary life and AD&D insurance, select and complete the Standard Life & AD&D enrollment/change form listed below within 30 days from the date of hire, or qualifying life event.
  • Enroll in the City’s Flexible Spending Accounts (FSA) for either Health and/or Dependent Care, select and complete the Flexible Spending Account form within 30 days from the date of hire, or qualifying life event.

All above forms are fillable online and once completed, sign and email to benefits@cityofmarina.org.