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Making Changes to Benefits
| Benefit | When can I enroll or make changes? | Open Enrollment | How can I enroll or make changes? | Benefit Website |
| Medical | Within 31 days of hire or first eligible, within 31 days of qualifying life event (marriage, divorce, newborn) or during Open Enrollment period | Annually in Aug Effective Oct 1 |
1. Complete Benefits Enrollment Change Form 2. Fax form to Human Resources (include any supporting documents for qualifying event) Fax # 845-4304. |
www.pchp.net |
| Dental | www.anthem.com | |||
| Vision |
Within 31 days of hire or first eligible, within 31 days of qualifying life event (marriage, divorce, newborn) or during Open Enrollment period if enrolled in HMP |
Annually in Nov Effective Jan 1, if enrolled in HMP |
Initial enrollment occurs at orientation. To make a change: |
www.eyemedvisioncare.com |
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Health Mgt. Program |
You may enroll anytime |
Call 455-4078 Complete on-line form prior to appointment |
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Flexible Spending (FSA) |
Within 31 days of hire or first eligible, within 31 days of qualifying life event or during Open Enrollment period |
Annually in Nov Effective Jan 1 |
1. Complete healthcare/ dependent care or transit/parking enrollment form. 2. Fax form to Human Resources Fax: 845-4304. |
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| VRS |
Enrolled automatically upon hire |
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Complete VRS-2 form to designate or change a beneficiary for VRS retirement benefit. Instructions are included on the form. |
www.varetire.org |
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Life Insur. (part of VRS) |
Group Life: Enrolled automatically upon hire Optional Life: You may apply to purchase additional life insurance at any time; if applied for within 31 days of hire or first eligible date, it is guaranteed issue for employee, otherwise coverage must be approved by Minnesota Life. |
1. Complete VRS-39 to enroll, increase, decrease or terminate Optional Life insurance coverage. Also, must complete VRS-32 form if application is submitted more than 31 days after hire date or first eligible date to enroll or increase coverage amount. |
www.varetire.org | |
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457 Deferred Comp Plan |
You can enroll, increase, decrease or stop payroll contributions at anytime | Anytime | Complete a simplified change formto change your contribution amount or stop contributions. Submit to Human Resources. | www.icmarc.org |