The open enrollment period for benefit elections effective January 1, 2015 begins Monday, October 20, 2014 and ends at:  

  5:00 pm on Friday, November 14, 2014.


Important Notice:  Due to new regulations in 2015 related to the Affordable Care Act all benefit eligible employees MUST complete the 1.1.2015 Election Participation Form. Please click on this link: 2015  ELECTION PARTICIPATION FORM.  Complete all sections of the form as it relates to you and your coverage needs for 2015.  Forms must be completed and returned to the HR Office by November 14, 2014.  

 2015 Insurance Rates:  To view the new rates for 2015 please click on this link: 
 2015 Insurance Rates

If you want to add/change Medical, Dental, or Vision you MUST complete an application for the plan(s) you are adding/changing only. 

Application forms for each benefit are provided below.  You can complete the application online.  It can be saved to your computer. 
Completed forms should be sent to:

Debbie Herndon, Benefits Manager, at one of the following:, fax 434.223.7049, or Campus Box 127, or delivered to the office on the 2nd Floor, Cabell House.

Forms must be RECEIVED by 5:00 pm on Friday, November 14, 2014.

Medical/Dental/Vision Insurance


Anthem (Medical): Information Booklet
Summary of Benefits and Coverage
Preventive Care
Coverage for Spectrum Disorder
Grandfathered Status
Nutritional Counseling
  Women's Health & Cancer Rights Act
Delta (Dental): Information On Low Option
  Information on High Option
  Dental Plan Changes
  Delta Dental Network Providers
Davis (Vision):                 Information on High Option
  Davis Vision Network Providers

Prescription Drug Coverage
(New for 2015)

Express Scripts (Prescriptions): Information On Coverage & Out-of-Pocket Maximum

Flexible Spending Accounts

If you wish to participate in the FSA Healthcare and/or Dependent Care Account(s), you MUST complete an application.

LD&B (FSA): Information

FSA Direct Deposit Form