Open Enrollment for the 2017 calendar year is underway. Benefit-eligible employees may enroll or make changes to their participation in insurance programs such as Davis Vision, Delta Dental and AFLAC, as well as the Flex Spending Accounts.
The 2017 Open Enrollment period is November 14, 2016 through December 2, 2016, with an effective date of January 1, 2017. View the letter to staff (PDF).
AFLAC and Flexible Spending Accounts
During the Open Enrollment period, all benefits-eligible employees will be given the opportunity to enroll in the AFLAC Supplemental plans (Cancer Care, Short-Term Disability, Life, Dental, Hospital Protection and Accident) and to participate in the Flexible Spending Accounts for the plan year of January 1, 2017 through December 31, 2017.
Meetings have been scheduled throughout the Open Enrollment period so that employees will have a chance to speak individually with an AFLAC representative. View the meeting schedule (PDF).
If you would like to participate in any of the programs for the 2017 plan year, you must complete the necessary forms and return them to the AFLAC representative or designee no later than Tuesday, December 2, 2016. If you are currently enrolled in the Section 125 Flexible Spending Plan, you are required to re-enroll each year.
- Flexible Spending: Enrollment Form (PDF)
Vision and Dental Enrollment and/or Changes
Benefits-eligible employees may also sign up for vision and/or dental coverage or alter existing coverage without a waiting period or having to submit proof of change.
- Delta Dental: Enrollment/Change Form (PDF)
- Davis Vision: Enrollment/Change Form (PDF)
- Davis Vision: Benefits Plan (PDF)
Health Enrollment and/or Changes
The Empire Plan does not have a traditional Open Enrollment period but allows for enrollment and changes throughout the plan year.
Exception: If you are currently enrolled in the Empire Plan and are paying for your insurance using pre-tax dollars and would like to cancel your coverage, you may only do so during the annual Open Enrollment period or within 30 days of a qualifying event. (See paragraph below regarding qualifying events.)
If you are not enrolled in the Empire Plan and would like to enroll, or if you would like to make changes to your existing coverage, please note that you may be subject to a three-month waiting period. This period is waived if you have a qualifying event, such as loss of prior coverage, marriage, addition of a child, or due to your spouse/domestic partner’s Open Enrollment period. All changes must be requested within 30 days of the qualifying event to have the waiting period waived.
- Empire Plan: Health Insurance Summary Plan Description (PDF)
- Empire Plan: Enrollment/Change Form (PDF)
- Empire Plan: Proof Required When Adding A Dependent (PDF)
- Empire Plan: Statement of Dependence (PS-457) (PDF)
- Empire Plan: Instructions for Enrolling Domestic Partners (PDF)
- Empire Plan: Application for Domestic Partner Benefits (PDF)
- Empire Plan: Dependent Tax Affidavit for Enrolling Domestic Partners PDF)
How to Enroll and Make Coverage Changes
Employees who wish to sign up or make changes to your existing health, vision, and/or dental coverage may simply print out and complete the appropriate enrollment/change form or contact Patty Savage to schedule a time to discuss their options. Required forms must be completed and returned to the Human Resources Office, Attn: Patty Savage, no later than Tuesday, December 2, 2016.