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City of South Tucson Arizona The Pueblo within a city

Payroll / HR - Benefit Selection Forms

BENEFIT SELECTION GUIDE, to view please click on the following link:

https://user-7eH7e5h.cld.bz/City-of-South-Tucson-Open-Enrollment-2022

Updated benefits selection guide for FY2024 - PENDING / NO PLAN CHANGE

Medical Enrollment Form (Humana) (251 KB)

Dental Enrollment/Change Form (EDS/Principal Administered through Humana) (251 KB)

Dental Enrollment/Change Form (Assurant/SunLife) (42 KB)

Vision Enrollment/Change Form (EyeMed) (116 KB)

Flexible Spending Account Enrollment Form (Basic-FSA) (439 KB)

Medical Insurance Waiver Form (167 KB)

FY2024 Insurance Plan Rates (43 KB)

Contact Information

South Tucson City Hall
1601 South Sixth Avenue
South Tucson, Arizona 85713

Phone: 520-792-2424

Normal Business Operations
Monday - Friday
8:00am - 5:00pm

View Full Contact Details

Upcoming Events

Citizens Advisory Committee Meeting 04/30/24

04/30/2024 - 5:30pm