NOTE: Meetings schedules on the side bar
All BENEFIT ELIGIBLE employees must complete the OPEN ENROLLMENT ACKNOWLEDGEMENT FORM. Please print, complete and return this form to the Human Resource Office, Box 2443 or scan and email to email@example.com by Friday, November 30, 2012.
OE Acknowledgement Form
MEDICAL plans, in 2013 the same 3 Highmark Blue Shield plans will be offered PPO1, PPO2, and PPO3. Please review the plans and their premiums. ONLY complete the Enrollment Form if you are making a change to your coverage type or dependents being covered. If you choose to opt out of our plans, please complete the Verification of Other coverage Form.
Enrollment Form Verification of Other Coverage Form
DENTAL plans, in 2013 the same 2 Delta Dental plans will be offered Low/1981 and High/1982. Please review the plans and their premiums. ONLY complete the Enrollment Form if you are making a change to your coverage type or dependents being covered.
PAYFLEX, please learn about the flexible spending program and how it can save you money on your dependent care and health care expenses. If you wish to participate in the PayFlex program 2013, you MUST complete the Enrollment Form. Enrollment for this program is done annually.
If you are interested in purchasing additional life insurance, Cigna has agreed to provide a guaranteed issue period for the supplemental life insurance plan. Employees may purchase up to $60,000 and spouses $10,000 without medical underwriting.
AFLAC, please review the current supplemental insurance plans and premiums offered by Aflac. If you are interested in enrolling in one of the plans for 2013, open enrollment is the only time you can join. Please email Karen Re at firstname.lastname@example.org or Michael Beck at email@example.com if interested.
MEDICARE D Creditable Coverage Disclosure, please read this important notice about your prescription Drug Coverage and Medicare.
Gettysburg College employees can make gifts through payroll deduction by submitting the Payroll Deduction form to Human Resources Office.
The Human Resource Office would like to thank everyone for their cooperation during open enrollment and wishes everyone a happy and healthy holiday season.