The open enrollment period for benefit elections effective January 1, 2014 begins Monday, October 21, 2013 and ends at:
5:00 pm on Friday, November 15, 2013.
WAIVE YOUR RIGHT TO COVERAGE: If you are currently enrolled in Medical, Dental or Vision and wish to drop any or all of these you MUST submit a waiver form.
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: email@example.com, fax 434.223.7049 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 15, 2013.
If you want your benefits to remain exactly the same as last year NO action is required. If you want to add/change Medical, Dental, or Vision you MUST complete an application for the plan(s) you are adding/changing only.
|Anthem (Medical):||Information Booklet|
|Summary of Benefits and Coverage|
|Early Intervention Services|
|ACA Preventive Care Coverage|
|Delta (Dental):||Information On Low Option|
|Information on High Option|
|Davis (Vision):||Information on High Option|
Flexible Spending Accounts
If you wish to participate in the FSA Healthcare and/or Dependent Care Account(s), you MUST complete an application.