Enrollment and Change Forms


  • To make changes to your medical, dental or vision plans, select and complete the Benefits Election form listed below and email it to benefits@cityofmarina.org.  
  • To enroll in the City’s voluntary life and AD&D insurance, select and complete the Standard Life & AD&D enrollment/change form listed below and email it to benefits@cityofmarina.org.
  • To enroll in the City’s Flexible Spending Accounts (FSA) for either Health and/or Dependent Care, select and complete the Flexible Spending Account form and email it to benefits@cityofmarina.org.

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

NOTE:  If you do NOT have any benefit changes for 2023, and you are NOT enrolling in the 2023 Flexible Spending Account Plans,  NO FURTHER ACTION IS NEEDED ON YOUR PART.  Your current benefit elections will automatically transfer over into 2023.