Benefits are an important part of your total compensation package at the City of Milpitas. Human Resources staff administers comprehensive benefits programs eligible to City of Milpitas employees. They provide information and consultation on various benefits options available to employees. They oversee health care and flexible benefits; income protection, education; retirement, employee assistance program, medical related leaves; and a variety of other benefits.

HMO

2023 Anthem Blue Cross Select HMO Plan

2023 Anthem Blue Cross Select HMO Evidence and Coverage

2023 Anthem Blue Cross Traditional HMO Plan

2023 Anthem Blue Cross Traditional HMO Evidence and Coverage

2022 Blue Shield Access+ HMO Plan

2023 Blue Shield Access+ HMO Evidence of Coverage and Disclosure Form

2023 Health Net Smartcare Plan

2023 Health Net Smartcare Evidence of Coverage

2023 Kaiser Permanente Plan

2023 Kaiser Permanente Evidence of Coverage

PPO

2023 PERS Gold Basic Plan

2023 PERS Gold Basic Evidence of Coverage

2023 PERS Platinum Basic Plan

2023 PERS Platinum Basic Evidence of Coverage

PORAC Plan

2023 PORAC Evidence of Coverage and Disclosure Form

  • Cash in Lieu

    Allows you to waive City of Milpitas medical insurance coverage in exchange for cash, provided you have other health insurance coverage.  Employees waiving medical receive $125 per month on their paycheck.

Flexible benefit plans help employees save money by allowing them to pay for certain eligible expenses with pre-tax dollars. The tax savings help offset the impact of these expenses on disposable income. Employees may enroll within 30 days of employment, or within 30 days of experiencing a change in status event and during any annual open enrollment period.

  • Tuition Reimbursement

    Tuition Reimbursement provides an excellent opportunity for employees who wish to improve their current skills. To receive reimbursement an employee must:

    Step 1: Complete the Application fir Approval of Reimbursed Training Expenses

    • Obtain Supervisor Approval prior to training

    Step 2: Submit proof/copy of your enrollment/tuition fees; course description and the completed application for to Human Resources

    Step 3: Once your application has been approved by Human Resources you will be notified. Human Resources will hold the application until completion of the class. It is the employee’s responsibility to request the application be returned upon completion of course.

    Step 4: Submit proof of course (s) completion

    • Once you have received the Application for Approval of Reimburse Training Expenses sign the bottom section
    • Submit proof of course(s) completion and the completed application to Human Resources.

    Step 5: If all documents are in order and all procedures follows, the application will be sent to Finance for payment processing.

  • CalPERS

    The California Public Employees’ Retirement System (CalPERS) is the State of California’s retirement system in which the City of Milpitas participates. CalPERS is a defined-benefit retirement plan and it is coordinated with Social Security. 

    CalPERS

  • PARS

    The Public Agency Retirement Services (PARS) is a mandatory retirement savings program authorized by federal law for  employees who are not covered by a retirement system. PARS administers the  Program for City of Milpitas employees.

    PARS

  • 457 Deferred Compensation

    MissionSquare

  • EAP

    The City of Milpitas contracts with MHN to offer employees and their families access to a wide range of consultative services through an Employee Assistance Program (EAP).

    EAP is  available 24/7 to give assistance with parenting and family counseling, child and elderly care referrals; grief and loss; pet care; volunteer and service opportunities; adoption; estate planning; financial and legal consultations; career advancement and much more.

    MHN

    MHN Misc and Fire Employees

    MHN Police Employees

    MHN Information Guide- Police

How to Request FMLA/CFRA

  1. Complete the Request for FMLA/CFRA
  2. Take the appropriate Physician Certification form to the doctor to complete. Note: Some doctors, clinics, and/or hospitals prefer to use their own standard form. We will accept these forms in lieu of our form, provided that the medical note contains all of the required information.
    1. If the leave is for your own illness, use the Physician Certification – Employee
    2. If the leave is for you to care for a family member who is ill, use the Physician Certification – Family Member
  3. Complete the PHI Authorization Note: The form must be signed and completed by the person whose medical information is being received.
    1. If the leave is for your own illness, complete the form yourself.
    2. If the leave is for you to care for a family member who is ill, ask the family member to complete the form. Note: If family member is a minor the form must be completed by the parent/guardian.
  4. If you anticipate requiring Short Term Disability (you anticipate running out of leave balances prior to returning to work), please submit a memo to the HR Director requesting STD payments when your balances have been exhausted.
  5. If you plan on requesting extended time off, beyond the 12 weeks covered by FMLA/CFRA, you should submit a memo to your Department Head and HR requesting an extended medical leave of absence.
  6. Give the following completed documents to your Department Head for Approval:
    1. Request for FMLA/CFRA
    2. Memo requesting an extended medical leave of absence (if applicable).
  7. After your Department Head approves your leave, forward all paperwork to the Human Resources Department for final acceptance.
  8. If requesting Intermittent Leave, make sure HR receives copies of your time cards for tracking purposes.

Contact Human Resources as soon as possible, but no later than 30 days after the qualifying event to initiate any changes. It is necessary to provide documentation to Human Resources to substantiate the qualifying event and to establish the eligibility for, and the effective date of, the requested change within 30 days of the qualifying event.

Divorce

As a result of your recent divorce, please update the following applicable information with Human Resources:

  • Name and/or Address
  • Emergency Contact
  • Health Insurance Benefits
  • Dental Insurance Benefits
  • Life Insurance Beneficiary Designation
  • Spousal Life Insurance Coverage
  • Deferred Compensation Beneficiary Designation
  • CalPERS Beneficiary Designation
  • Flexible Spending Account Benefits
  • Tax Withholding Forms
Marriage

As a result of your recent marriage, please update the following applicable information with Human Resources:

  • Name and/or Address
  • Emergency Contact Card
  • Health Insurance Benefits
  • Dental Insurance Benefits
  • Life Insurance Beneficiary Designation
  • Spousal Life Insurance Coverage
  • Deferred Compensation Beneficiary Designation
  • CalPERS Beneficiary Designation
  • Flexible Spending Account Benefits
  • Tax Withholding Forms
Newborn/Adoption

As a result of your recent family addition, please update the following applicable information with Human Resources:

  • Health Insurance Benefit
  • Dental Insurance Benefit
  • CalPERS Beneficiary Designation
  • Life Insurance Beneficiary Designation
  • Child Life Insurance Coverage
  • Deferred Compensation Beneficiary Designation
  • Flexible Spending Account Benefits
  • Tax Withholding Forms
Over Age Dependent

As a result of your dependent’s upcoming or recent birthday, please update the following applicable information with Human Resources:

  • Health Insurance Benefits
  • Dental Insurance Benefits
  • Child Life Insurance Coverage

The following guidelines determine dependent status:

  • Dental – Up to 26 years regardless of marital or student status.
  • Medical – Up to 26 years regardless of marital or student status.
Death in Family

As a result of the death which occurred in your family, please update the following applicable information with Human Resources:

  • Health Insurance Benefits
  • Dental Insurance Benefits
  • Emergency Contact
  • Life Insurance Beneficiary Designation
  • Spousal/Child Life Insurance Coverage
  • Deferred Compensation Beneficiary Designation
  • CalPERS Beneficiary Designation
  • Flexible Spending Account Benefits
  • Tax Withholding Forms

Official Documentation

It is necessary to provide documentation to substantiate the qualifying event and to establish the eligibility for, and the effective date of, the requested change.

  • Court documents for adoption, divorce, marriage, etc.
  • Affidavit of Domestic Partnership
  • Documentation on company letterhead including:
    • Qualifying event date and type
    • Name of individual(s) affected by a status change
    • Name(s) of those covered on plan(s) and the effective date or termination date of other coverage
    • Medical and/or dental coverage effective date or termination date (or other benefits, as applicable)
  • Health Insurance Portability and Accountability Act of 1996 (HIPAA) “certificate of credible coverage” from your prior insurance plan.
    • In addition to the HIPAA certificate, written documentation supporting the special enrollment event is required (i.e. birth certificate, marriage certificate, proof of termination).

Coverage Effective Dates

  • Adding an Eligible Dependent -Dependents become eligible the first of the month after the qualifying event occurs.
  • Removing a Dependent – Dependents are removed from coverage as of the last day of the month in which the qualifying event occurs.
  • Coverage Cancellation – Coverage terminates as of the last day of the month in which the qualifying event occurs.
  • Adding Coverage – Coverage begins as of the first of the month after the qualifying event.
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