2009 Open Enrollment Information
If you have questions or need more detailed information, please contact Carol Bermillo at (408) 392-6720 or 1-800-732-6477.

OPEN ENROLLMENT GUIDE | top of page |

- Open Enrollment Guide (File size: 60 KB)

PROVIDER MEETING SCHEDULE | top of page |

- Provider Meeting Schedule (File size: 94 KB)

OPEN ENROLLMENT FORM | top of page |

Below are two versions of our Open Enrollment Form. The electronic version allows you to complete the form on-line, print it out, and send it to Retirement Services. You will be required to log-on to Member Services in order to complete the form on-line (have your Username and Password handy). The second version simply allows you to print the form, complete it by hand, and send it to Retirement Services. Both versions will look identical when printed.

Once you complete your form, please forward it to: Retirement Services Department, ATTN: Open Enrollment, 1737 North First Street, Suite 580, San Jose, CA 95112.

Open Enrollment Form - Electronic

- Open Enrollment Form (File size: 143 KB)