Open Enrollment for 2022 is here!
All Full-Time employees should receive Open Enrollment Election Return Forms by Monday, November 1st. 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.
(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 19th, 2021
~ Download all forms & summaries for future reference ~
** This page will NOT be accessible after the deadline **
Friday, November 19th, 2021
~ 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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