Forms for Open Enrollment 2014
You can make your 2014 benefit elections on the enrollment form available at the link below. The enrollment form is a Microsoft Excel workbook that calculates rates for each option that you select. Once satisfied with your selections, please print a copy and sign where indicated. Return your printed and signed form to Ruth Sanoy, Office of Human Resources. Be sure to keep a copy for your records!
Also, check your January 2014 pay advice, or contact the appropriate benefit plan provider after the first of the year, to confirm that your requested changes have been made.
> 2014 Benefits Enrollment Form (Microsoft Excel file) - to add, change or stop coverage for any of these plans in 2014:
Medical + Vision
Health or Dependent Flexible Spending Accounts
Optional Life or Accidental Death/Dismemberment
> Cigna Beneficiary Designation Form
> Cigna Evidence of Insurability Form - for life insurance if requesting increased coverage for yourself or your spouse/LDA.