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Health Forms

 

Health Insurance

 

If you need to update your Health Insurance contact Renee Jones at [email protected] for the necessary paperwork.

  

Open Enrollment

Buyout Memo for Open Enrollment
Health Change Memo for Open Enrollment


Open Enrollment is from November 1, 2020 through January 8, 2021. All changes will be effective January 1, 2021.

TO MAKE A CHANGE TO YOUR HEALTH INSURANCE:

If you would like to make any changes to your current insurance please contact Renee Jones at [email protected] for more information.

NO CHANGE TO YOUR HEALTH INSURANCE:

If you do not want to make any changes to your health insurance during Open Enrollment, you DO NOT need to do anything. Your current health insurance will remain unchanged.

BUYOUT/OPT OUT OF HEALTH INSURANCE:

** Even if you are already enrolled in the 2020 buyout, in order to opt out of the health insurance and enroll in the District buyout for the 2021 plan year you MUST complete the following STEPS:

To continue to Opt-out or Opt-out for the first time:

  1. Submit completed 2021 Health Insurance Opt-Out Election Form
  2. Submit completed 2021 Affordable Care Act (ACA) Waiver Form
  3. Submit a copy of your health insurance card for you and all of your dependents


PLEASE BE ADVISED THAT IF YOU MAKE A CHANGE DURING OPEN ENROLLMENT, YOUR INITIAL PAYROLL DEDUCTION MAY BE A LARGER DEDUCTION TO TAKE THE SUMMER MONTHS INTO ACCOUNT.


If you have any question in regards to Open Enrollment please email Renee Jones.

Beneficiary

Dental


Flex Benefits


Worker’s Comp

 


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