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Open Enrollment for 2023 is here!


All Full-Time employees should receive   Open Enrollment Election Return Forms   by Monday, November 7th.    Review  the information on your form,   Check  your address, and   Confirm   your elections ON THE FORM and   Sign! 
(see below for instructions for confirming your elections on your form)

"NO CHANGES" → If you are not making any changes or updates to your current elections, simply initial by your address, circle "No Change" next to Health, Dental & Vision and sign the bottom. 

"MAKING CHANGES" → If you are making any changes to the information on your Election Forms, you   must   fill out the corresponding change forms by downloading form below. You will need to circle the changes you are making on the    Election Return Form     to indicate what changes you are making, and the completed change forms will need to be attached to your signed election forms in order for changes to be applied. If no change forms are received, your coverage will continue as current.

All signed election forms and corresponding change forms are due back  to Human Resources no later than 
Friday, November 18th, 2022
~ Download all forms & summaries for future reference ~
** This page will NOT be accessible after the deadline **

CLICK BELOW TO VIEW SUMMARY &  CHANGE FORMS:
(Download forms to your computer in order to save entered data)

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BCBS Change form
Dental/Vision Form
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AFFILIATES

Southern Medical Corporation
Etech Medical Solutions
Bio Medical Resources

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OPEN ENROLLMENT 2023

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